3 Common Concerns About Going To Physical Therapy

Not sure if you can afford physical therapy? Don’t think you’ll have time to go to physical therapy sessions? Worried that physical therapy will hurt? Read on to find out what to do…

physical-therapy-costConcern: I think I will have a payment for every visit and I’m not sure I can afford physical therapy

What to Do: The first thing to do is check your health insurance benefits. Find out:

  • If the physical therapist you are considering is an In-Network Provider (versus Out-or Network). An In-Network provider will be covered better (i.e. you will have a lower co-insurance or co-payment).
  • What the co-insurance or co-pay is for physical therapy

If you still have financial concerns talk to your Physical Therapist about them. The physical therapy clinic may have a policy in place to help you. Or you can inquire about this before you choose which clinic to go to. This policy is called a Financial Hardship Agreement. Depending on your situation and physical therapy clinic policy you may be eligible to set up a payment agreement that reduces or eliminates your personal financial obligation.

physical-therapy-timeConcern: I work / go to school and can’t go to physical therapy appointments that many times per week

What to Do: Make sure your Physical Therapist knows about your schedule constraints on your first visit.

When making your treatment plan for physical therapy it’s important to know how many visits per week you can be available for. If your job situation is such that you will only be able to attend physical therapy sessions before or after work, or if you can only come during your lunch break, tell your physical therapist. You can also often schedule all of your coming appointments in advance to reserve a specific day and time.

physical-therapy-questionsConcern: I have never had physical therapy before and I’m not sure what to expect OR I’m scared that it will hurt

What to Do: Read reviews posted by patients that have visited the clinic you are thinking about going to. And ask questions about the physical therapy clinic philosophy. Some clinics are more aggressive and use techniques that may be somewhat uncomfortable (i.e. dry needling and ART techniques). Other physical therapy clinics use very gentle techniques. Choose the physical therapist that’s right for you based on your preferences and concerns.

If you are thinking about physical therapy and live in or near Arvada – give us a call at 720.222.9669. We will verify your insurance benefits, we have financial hardship agreements available for qualifying individuals, and we practice a pain-free approach to physical therapy.

The Benefits of Physical Therapy Before Knee and Hip Replacement

physical-therapy-knee-replacementPhysical therapy is commonly prescribed following both total hip replacement and total knee replacement surgery.

Common problems following these types of surgery include:

  • Post surgical pain
  • Post surgical swelling
  • Gait impairment requiring the use of an assistive device such as a walker, crutches or a cane
  • The need for scar management to promote proper healing of the incision
  • Decreased range of motion
  • Muscle guarding and tightness
  • Muscle atrophy resulting in decreased endurance and strength

A Physical Therapist helps you recover from the surgery and regain functional qualities like range of motion, muscle flexibility, local muscular endurance and strength.

All of this physical therapy is usually done AFTER you have surgery.

But what if you could get better results if you did a couple of physical therapy sessions BEFORE you have surgery?

A new study showed that “patients receiving preoperative physical therapy showed a 29 percent reduction in postoperative care use.”(1)

Specifically many of the patients that received physical therapy for pre-hab (pre-surgery treatments) didn’t need to see a Physical Therapist after surgery and those that did went for fewer sessions. This resulted in significant savings in both time and money.

Sound good? If so here’s a quick checklist to make sure you go to the right Physical Therapist for your pre-hab.

How To Find The Right Physical Therapist For Your Pre-Hab

  • Make sure your Physical Therapist is an expert in outpatient orthopedics

Outpatient orthopedics is a type of physical therapy that (1) specializes in seeing you in a clinic setting versus coming to your home or treating patients in a hospital and (2) specializes in joint related problems like hip and knee degenerative arthritis. Not all Physical Therapists are experts in this type of care so be sure to ask about this before you make your first appointment.

  • The Physical Therapist you choose should have a training in and a strong background in exercise prescription

Physical therapy comes in many shapes and sizes and some Physical Therapists just aren’t that good at exercise prescriptions. So another question to ask is if the Physical Therapist has expertise in prescribing pre-operative exercise.

  • Choose a Physical Therapist that does low-tech exercise for your home exercise program

Low-tech exercise means that your physical therapy exercises can be done at home with little to no equipment. This is in contrast to physical therapy that is done on exercise machines (like the kind you might see in a gym). The reason this is important is that if you will be having surgery there’s a good chance you will need to do the exercises frequently and a home program designed by a Physical Therapist is your best bet to get the results you want.

  • Choose a physical therapy clinic close to your home or office location

In the event that you do need to go to physical therapy after your surgery it only makes sense to find a physical therapist with a clinic near you. Traveling after surgery can be challenging! Make it easy on yourself and keep the drive to your physical therapy appointment to a minimum.

If you live in or near Arvada – give us a call at 720.222.9669


1. http://www.medicalnewstoday.com/releases/283617.php

The Key To Relieving Chronic Low Back Pain

low-back-pain-physical-therapyIn a new article posted by Wake Forest Baptist Medical Center Dr. Tadhg O’Gara, M.D., an orthopaedic surgeon states that “The key to avoiding lower back pain is keeping pressure off your lower lumbar discs (and) that means keeping an arch to your lower back.”(1)

In other words – the position of your spine can have a profound effect on pain.

Physical therapists often refer to your lumbar spine position by referencing your pelvic position. Terms like neutral spine and anterior and posterior pelvic tilts are common descriptors.

If you have low back pain be sure to see your doctor or physical therapist to get a diagnosis. The reason is that back pain can come from many sources – some structural (i.e. a disc bulge), some mechanical (i.e. posture) and some medical (i.e. kidney problems).

“Once the reason behind the pain is determined, the most frequently prescribed treatment is physical therapy, not surgery.”(2)

A physical therapist skilled in the treatment of low back pain can offer pain relief as well as help restore normal and healthy posture, motion, and function. They accomplish these things using tools of the trade such as soft tissue and joint mobilizations, modalities (i.e. electrical stimulation) and therapeutic exercises.

According to Dr. Karvelas  “Patients need to recognize that posture and activity are crucial in relieving and preventing back pain… They need to learn what exercises to do on their own and how to do them properly to prevent future flare-ups.”


1. http://www.sciencedaily.com/releases/2014/10/141006094440.htm

Exercise Helps Decrease Pain and Increase Function For People With Hip Arthritis


“Gray343”. Licensed under Public domain via Wikimedia Commons – http://commons.wikimedia.org/wiki/File:Gray343.png#mediaviewer/File:Gray343.png

I’m always excited when research confirms something that I’ve seen first-hand in my physical therapy clinic. In this case – new research shows that an exercise program can help patients with hip osteoarthritis.

The program (called the Tübingen exercise approach) resulted in a statistically significant decrease in pain and an improvement in physical function as compared to the control group.

In other words… Those who did the program experienced a significantly greater decrease in pain and had increased function compared to those that didn’t do the program.

This looks to be very similar to the type of program we do in my Arvada Physical Therapy office. The main parts of the program focus on:

  • Increasing strength
  • Improving balance
  • Improving proprioception (awareness of body position)
  • Improving flexibility

You can check out the full article HERE.

The main takeaways are:

1. If you have hip osteoarthritis (aka degenerative joint disease) you may benefit from a structured exercise program.

2. The program in this study lasted for 12 weeks.

3. This program consisted of 1 class per week (in a group therapy setting) and 2 independently done sessions (at home).

4. The structured class lasted 60 to 90 minutes per session.

5. The home exercise sessions were 30 to 40 minutes each.

I did a google search to find the specific protocol but had no luck. However, based on the desired outcomes (listed above) I believe a qualified outpatient orthopedic Physical Therapist should be able to put together a program that is similarly effective.

In my experience, working with well over 1000 hip arthritis patients in programs that included physical therapy exerices, 60 minutes might be a bit too much to start with. The people who come to my physical therapy office who have hip arthritis are usually between 55 and 65 years old. Many are overweight. Most are not in great physical condition (they are out of shape).

So when we start physical therapy the program is developed with progression in mind. We start so the exercise program presents a small to moderate challenge.  Then we progress as you show signs of improvement.  We do this by gradually increasing the challenge of the physical therapy exercises.

This lets you progress at your own rate. Also it makes physical therapy an enjoyable experience. And why would anyone come back to any physical therapy clinic week after week for 3 months if the experience was unpleasant?

The Best Way For Overweight Adolescents to Lose Fat

overweight-exercise-physical-therapyNew research shows that the best way for obese young adults to lose weight (and body fat) is to regularly participate in an exercise program that combines anaerobic (aka resistance training) with aerobic (aka cardio) exercise.

The results also show that the exercise groups did better than the diet alone group.

In my experience the best results for body composition changes come from sticking to a good program that combines ALL three factors. And this is true for all age groups (not just young adults)!

Here are some tips that I share with my physical therapy patients:

For Diet / Nutrition
1. Clean up your diet. Stop eating junk foods such as colas, chips, ice cream, donuts, etc.

2. Start to estimate your total intake of calories for the day. There are dozens of apps that can help make this easier – so no excuses!

3. If needed… (if after cleaning up your diet you are still not losing inches or weight) decrease your total daily caloric intake by 300 to 500 calories per day.

For Resistance Training
1. Start SLOWLY! Light weights and basic movements are just fine. As you get into a routine and start getting in better shape you can always increase the challenge as needed.

2. If you’ve never lifted weights hire a personal trainer to teach you some basic movements.

3. Shoot for 3 to 4 days per week of 20 to 30 minutes per session.

4. Be consistent.

For Aerobic Training
1. Do your cardio AFTER you do your Resistance Training (not before).

2. Start slowly. Shoot for 5 to 10 minutes at a pace that gets your heart rate up to 65% to 70% of your max heart rate.

3. Work up to 20-30 minutes of aerobics per session and up to 70-80% of your max heart rate.

And if you come to my Arvada Physical Therapy office – let us know that you are interested in exercise and nutrition tips for weight loss and we’ll be happy to help. (Consider this one of the benefits of working with a Physical Therapist that is also an internationally recognized fitness expert!)

Can Running Help You Live Longer?

physical-therapy-and-runningI’m not a fan of running. But I AM a fan of living longer and improving my quality of life.

So when I came across this research paper my interest was definitely piqued!

You can have a look at the summary of the research by CLICKING HERE.

The take away is that “Running, even 5 to 10 min/day and at slow speeds <6 miles/h, is associated with markedly reduced risks of death from all causes and cardiovascular disease.”(1)

When I googled the journal article title I also came across a great blog post HERE.

It does an excellent job of pulling out the relevant points in the article.

As a Physical Therapist (and as a person with a history of knee pain and arthritis) I am very aware of how hard running can be on your joints. And I commonly treat patients in my Arvada physical therapy office for running related problems. So I wanted to throw in some useful tips just in case you have problems or concerns about your knees:

1. Wear excellent socks (such as merino wool socks). Great socks provide protection for your feet and good shock absorption which can lessen the overall stress and strain to your joints.

2. Wear excellent shoes. The blog post mentions this… I’m just re-iterating. I get this question all of the time in my physical therapy practice: “What running shoes do you recommend?” My answer is (1) the best ones you can afford and (2) running shoes that you ONLY use for running and replace them as soon as you feel a difference in the quality of your runs.

3. Avoid pain. This sounds like a no-brainer but many people have a no-pain no-gain mentality. I tell my physical therapy patients this advice several times a day… If it hurts don’t do it.

4. Try kinesiology tape on your knees and legs. I wrote a blog post on 2 techniques I developed specifically for knee pain. I use this in my physical therapy office AND on myself! You can check out the blog post HERE. You can also get tons of cool taping techniques from the RockTape.com website video collection. Just click on the Lower Extremities tab on the right side of the page for specific techniques.


1. http://content.onlinejacc.org/article.aspx?articleid=1891600