Why You Need a Physical Therapist on Your Healthcare Team

With health in sharp focus as a result of the pandemic, now may be a good time to look at the team of experts you have in place and see if there are any improvements you could make. You probably have a family doctor, dentist, and optometrist. Maybe you have some specialist physicians, a trainer, or a massage therapist. If a physical therapist isn’t a part of your healthcare team, you’re missing out on taking care of a big part of your health. To understand why you need a physical therapist, you need to understand what they do.

Physical Therapists Help You Do Things

The American Physical Therapy Association defines PTs as “health care professionals who diagnose and treat individuals who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives.” So physical therapists help you do things that you have trouble with. That could be going for a hike, playing with your kids, or getting through a day of work without pain.

Physical Therapists Reduce Pain

Chronic pain is a huge problem worldwide. A big part of that is low back pain. Statistically, around 80% of people will have low back pain in their lifetimes. Physical therapists are trained to treat pain without surgery or medications. If you have back pain, an arthritic knee, neck pain, or an old injury that won’t go away, a PT may be able to help.

Physical Therapists Keep You Healthy

The APTA goes on to say that “PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles.” That means that a physical therapist can help you determine your risk for injury, choose the right fitness program, and improve the quality of your life by improving your health and ability to move.

Physical Therapists Can Help You Live Longer

It’s well known that the risk of many of the leading causes of death can be reduced by exercise. Some of these conditions would include heart disease, cancer, lung disease, diabetes, and stroke. By helping you move better with less pain, finding the right exercise program, and helping you to make healthy lifestyle choices, a PT could help you live longer.

Physical therapists have a unique set of skills and expertise that can do a lot to improve your health and quality of life. If you don’t have one, consider adding one to your healthcare team.

Get PT First During the COVID-19 Pandemic

Because of the closures of physician’s offices, stoppages of elective surgeries, and social distancing guidelines resulting from COVID-19, many people with pain or joint issues have had appointments or surgeries delayed. If you’re one of them and you haven’t seen your PT yet, you should. Here are some reasons why:

Early PT leads to better outcomes

Studies have shown that people who receive PT sooner have better outcomes, lower costs, are less likely to have surgery, use opioids or have unnecessary testing. Because back pain is so common, there is a lot of outcome data from people with back pain.  A study of 150,000 insurance claims published in Health Services Research, found that those who saw a physical therapist at the first point of care had an 89 percent lower probability of receiving an opioid prescription, a 28 percent lower probability of having advanced imaging services, and a 15 percent lower probability of an emergency department visit. Unfortunately, only 2% of people with back pain start with PT, and only 7% get to PT within 90 days.

Early PT saves money

The rising cost of healthcare is well known and early PT is something that has been shown to reduce costs without reducing the effectiveness of treatment. A study published in the Journal of Orthopaedic and Sports Physical Therapy showed that patients who obtained physical therapy via direct access (without going to a physician to get a referral first) had significantly lower medical costs—an average of $1,543 less per patient than those who chose referral from a physician. They also had significantly fewer visits and spent significantly fewer days in care.

Surgery may not be as effective as you think

Many patients look to surgery as the fix for their pain, but surgeries aren’t always as effective as patients believe. A large study looking at worker’s comp patients with back pain found that people who have surgery have a 1 in 4 chance of having a repeat surgery, a 1 in 3 chance of a major complication, and a 1 in 3 chance of never returning to work again. Recent large studies of arthroscopic surgeries for meniscal tears have shown no difference in outcomes between people who have surgery and those who don’t. Other procedures with questionable effectiveness include kyphoplasty, vertebroplasty, and injections for nonspecific back pain.

So, if you were planning on seeing your PCP or a specialist for an orthopedic condition or pain and you haven’t seen a PT yet, you should consider making PT your first stop. You could end up getting better faster for less money and you might avoid riskier treatments like opioids or surgery.

Physical Therapy: A Cost-Effective Method of Treatment for Pain

Achy joints, stiff neck, back pain, creaky knees… sound familiar? If you are experiencing any of these bodily sensations, you are not alone. Musculoskeletal pain affects one out of every two people in the United States ages 18 and over. That is well over 100 million people every year! It is the most common cause of disability and the primary reason people seek healthcare. When left untreated, it can become chronic, and will likely negatively impact a person’s quality of life.

Between visits to doctors and specialists, diagnostic tests, pain medications, and lost wages from time off from work, people with chronic pain spend a lot of time and money in quest of answers to their problems. And worst of all, as a result of physical inactivity – they become subjected to comorbidities such as cardiovascular disease.

But there is good news! Physical therapy can help with all of the above – from pain relief to savings on health care costs.

Physical therapy is a healthcare service that is highly effective in alleviating pain and supports patients throughout all levels of healing – from initial diagnosis all the way through to the restorative and preventative stages of recovery

Proven Benefits of Physical Therapy: Evidence-based studies support the following benefits:

  • pain reduction
  • improving outcomes and optimal levels of function
  • improving strength and flexibility
  • stimulating the healing process
  • restoring movement
  • injury prevention and pain management

Value-Based Healthcare Option: Physical therapy is a health service that delivers proven value for every dollar spent.

For instance, the average cost of one round of PT at a total of 10 visits is $1000 while compared to an MRI at $2,611 or $6,754 for a year’s supply of opioids.

Pursuing physical therapy prior to a primary care physician can result in:

  • lower costs on claims for patients
  • early access savings of $5,000 in annual health care costs for every patient
  • up to 72% drop in medical costs per year

Holistic Approach to Prevention and Wellness

Physical therapy takes a preventative and holistic approach to health. In fact, the American Heart Association recommends patients participate in physical therapy as their initial plan of care. Research demonstrates PT can:

  • serve as a highly effective alternative to opioids and in some cases, surgery
  • empower patients to take control of their pain
  • promote physical activity and overall health and well-being
  • play a critical role in solving the opioid crisis

Direct Access: Since pain is frequently managed first in primary care settings, most people don’t realize that some states, like Pennsylvania, allow direct access to physical therapy.

Direct access allows a patient to contact a PT directly, without a referral and saves a significant amount of wait time for an appointment. The average wait time to see a PT is 24-48 hours compared to 24 days for an appointment with a primary care physician.

Additionally, research has shown that patients who visit a physical therapist directly for outpatient care had 86 percent fewer visits on average than those who were referred by a physician.

If you are currently in pain and are not sure where to begin, try calling your local physical therapy clinic and use these questions as a guideline for the help you are seeking:

  • Does the provider accept your insurance plan?
  • Is the provider Direct Access licensed?
  • Is your insurance plan applicable to Direct Access?
  • How soon will it take to get an appointment?

What to Expect: Whichever way you come to physical therapy, you can expect to:

  • undergo a physical exam and evaluation through a series of functional tests
  • receive a clinical diagnosis, prognosis, plan of care, and a set of goals
  • receive physical therapy interventions and self-management strategies

When patients have greater control over their bodies and the type of care they need, medical adherence increases and health outcomes improve. With the added perks of decreased medical costs and time saved, it’s a win-win!

As healthcare continues to trend more toward prevention and wellness, why not climb aboard and test the waters of physical therapy? You’ve got nothing to lose and everything to gain.

The bottom line is, movement is medicine. When you move, you feel better. When you feel better, you are more likely to eat better, more motivated to move more, to socialize more, and to get outdoors more. So what are you waiting for?

The physical therapists at HARTZ PT are excellent resources for patients to learn new ways to care for themselves so they are able to achieve their most optimal levels of functioning.  The best part is, with a no obligation phone consultation, they will answer your burning questions for free!  Feel free to contact one of our offices to learn how you can begin your journey towards greater health!

Blood flow Restriction Training (BFRT)

Blood flow restriction training is becoming more popular in the training and rehabilitation world. It is a very useful technique that helps patients recover faster and more efficiently, especially for those who are limited in lifting heavier weights. This is great news for people who might not be able to tolerate heavy weight, such as the elderly, people with chronic diseases and those rehabbing from injury or surgery. BFRT has also been shown to decrease the effects of muscle atrophy (loss of muscle) for those who cannot lift heavy weights. When used correctly, BFRT can be a key component of any rehabilitation.

The Evidence: BFR training originates from the creation of Kaatsu training by Dr. Yoshiako Sato, and since then, a growing body of evidence has supported the use of blood flow restriction training. The theory behind BFRT is to partially occlude blood flow to a limb, as well as to allow blood pooling in the limb. This deprives the muscle tissue of oxygen, which may sound like a bad thing but this environment is similar to that of a high intensity workout. This reduction in oxygen leads to an increase in anabolic hormones, cellular swelling, and larger type II muscle fiber recruitment. Muscle tissue, blood vessels, and bones use anabolic hormones to facilitate repair, hypertrophy and increase strength. Muscle fatigue during BFR training stimulates the brain to release growth hormones which will circulate through the bloodstream, targeting anabolic receptors on all muscles that were used. This creates a “systemic response” and so BFR training will have a positive effect on all muscles in the area, not just those muscles below the level of occlusion. These hormones have a protective role for tendons and muscle collagen structures as it increases collagen synthesis. This makes BFR a great tool for recovery in athletes. For safety purposes, it’s important to understand we’re not cutting off blood flow all together for extended periods of time, as this would be dangerous.

Typically normal hypertrophy and strength gains are seen at lifting loads greater than 60% of a person’s 1 repetition max. BFR training hypertrophy and strength gains are seen at loads 20-30% of 1 repetition max. In other words, half the weight with similar results! With BFR training we are also able to see strength and hypertrophy gains in as little as 4 weeks, whereas normally it would take 8-12 weeks.

Would you benefit from BFR training?  Although we do not recommend replacing high load resistance training with blood flow restriction training, it can be used in the rehab setting to increase muscle strength and size when a person is unable to lift heavier weights. For example, after most surgeries there is a period in time when a patient is restricted from using heavier loads and low load exercises are not enough to stimulate muscle hypertrophy. Studies have also shown that BFR training increases sprint speeds and muscular power.

Although BFR training is very safe under a physical therapist’s supervision, it is important to take precautionary measures. Those with a history of vascular compromise, history/risk of DVT, pregnancy, and varicose veins should not try BFR training.

Arthritis + Aquatics = Pain Relief

It is no secret that most of us take our bodies for granted, assuming they are going to work when and how we want them to work.  However, the reality is, at some point, after using and abusing our bodies year after year, it is just going to scream, “Stop!”.  That “voice of reason” may come in the form of joint pain, commonly caused by arthritis.

Believe it or not, osteoarthritis is alive and well in every single one of us in some form or another.  By definition, osteoarthritis is the painful inflammation and swelling of a joint.  However, let’s not sugar coat the reality.  Simply put, arthritis hurts!   So, what can we do to manage those painful symptoms?

When working in the physical therapy world, arthritis has a daily presence.  Therapy professionals are always studying and researching ways to best treat arthritic joints. Time after time, there is one that just makes the most sense – Aquatics!

Why Aquatic Therapy? Well, aquatic therapy eliminates the weight-bearing stresses that we experience every day, reducing stress on the joint and therefore, less pain.   If fact, when standing in water up to your calves, you are already putting 15% less weight on your joints, at your knees, 35% less, hips 50%, shoulders 75% and neck 90% less stress on your joints!

Reducing the stress on these joints, will also reduce the pain you experience when moving the joints.  With the joints now given the ability to move pain-free in the water, patients are able to begin strengthening the muscles surrounding the arthritic joint.  Why is this so important?  Several long-term benefits will come from increasing the strength of the surrounding muscles of an arthritic joint:

  • Increased stability and balance
  • Reduced need for compensation by other limbs
  • Less demand on the arthritic joint resulting in a decrease in inflammation
  • Reduced pain when on land

We would suggest starting an aquatic exercise program with slow walking in shallow water at a comfortable depth.  For some variety, you can walk forward, backward or sideways…you can even march or jog if you are feeling good!  All walking motions are able to be duplicated in the deep water for a complete non weight bearing exercise.

If you are looking to focus on upper extremity joints, arm raises to the front and side are both easy to perform.  These are also easy to incorporate with walking for an added total body strengthening experience.  Besides walking, a patient favorite exercise is grabbing a noodle, placing it under the arms and gently moving your legs in a bicycle motion.  This exercise is best performed in deeper water with varying rates of intensity.

Aquatic therapy is one of the most effective means of treatment for an individual of any age suffering from arthritis.  HARTZ Physical Therapy offers aquatic facilities at our Lititz, Lancaster-East and Mount Joy locations.

What is a Net Promoter Score (NPS)?

Net Promoter Score®, or NPS®, measures customer experience. Calculate your NPS using the answer to a key question, using a 0-10 scale: How likely is it that you would recommend HARTZ Physical Therapy to a friend or colleague?

Based on the answer, respondents are grouped as Promoters (score 9-10), Passives (score 7-8) or Detractors (score 0-6).  Subtracting the percentage of Detractors from the percentage of Promoters yields the Net Promoter Score, which can range from a low of -100 (if every customer is a Detractor) to a high of 100 (if every customer is a Promoter).  Given the NPS range of -100 to +100, a “positive” score or NPS above 0 is considered “good”, +50 is “Excellent,” and above 70 is considered “world class.”

HARTZ Physical Therapy is proud to have achieved an
average Net Promoter Score in 2019 of 96.

Aquatic Therapy Isn’t Just for Older People

Aquatic therapy is often an overlooked form of rehabilitation when it comes to individuals with sports related injuries. In today’s world, we all want results faster and quicker, especially competitive athletes who routinely excel in their sport.  But an injury setback can be extremely frustrating, especially when it happens mid-season.  Immediate access to care is essential, but even then, typical rehab on land may be slow and difficult to see progression, especially for injuries which are weight-bearing or involve damage to muscles, tendons or ligaments.

Water can be a crucial component to the recovery process because it allows athletes to gain confidence in their performance, while also recovering in a safe manner.  Due to the unique properties of water, athletes will be able to perform key movements far sooner than they would on land, making it an ideal medium for beginning rehab. Buoyancy, or the ability to float in water, reduces weight bearing on all joints, allowing athletes to perform sport specific movements while reducing the impact. For example:

  • Basketball players can work on jump shots
  • Baseball players on swinging
  • Soccer players can work on kicking

The water also provides resistance to athletes in all planes, which improves both cardiovascular and muscular endurance.

If you are suffering from a sports related injury and want to add diversity to your rehabilitation program in a safe and fun environment, get in the water!

HARTZ Physical Therapy has aquatic therapy  in Lititz, Lancaster-East and Mount Joy.

The No. 1 Thing You Can Do to Improve Your Physical Therapy Experience

Dealing with the pain and limited mobility associated with an injury or illness can be stressful for so many reasons. You might have questions like, “How long will I be sidelined?” and “What do I need to do to get better?” Or maybe you’re worried about how you’ll pick your children up from school, walk to the train for your commute or prepare meals for your family.

These are all perfectly normal concerns. Luckily, there are some ways that you can gain control over the situation and ensure that you return to the activities you care most about—especially if physical therapy is part of your plan.

What you can do before your very first appointment—and during physical therapy—to take control of that injury-related stress? First and foremost, it’s important to come prepared for physical therapy. And no, I’m not talking about dressing appropriately and arriving on time (or even better, 15 minutes ahead of your scheduled appointment). That stuff is important, of course, but there’s one thing you can do in the days leading up to your appointment that will set you up for success.

Any guesses? I’m talking about starting a list. What kind of list? Well, every time that you feel pain in the affected area or notice an activity that is harder than it was pre-injury, add it to the list! And the more specific you are, the better. Here’s an example to help drive this point home: Let’s say that you’re recovering from a moderate meniscus tear and you have an appointment with your physical therapist in three days. Take notes on how your knee feels first thing in the morning after you’ve been off your feet. How does your knee react when you stand up from a chair—does it feel unstable? Or do you find that you need to clutch the back of the couch on your way to the bathroom? Sharing each of these details helps your physical therapist understand your limitations beyond the injury printed on your intake form.

Now let’s take that list a step farther and add some details about the activities that you typically participate in on a regular basis. Let’s say that you normally play a weekly round of golf, spend your mornings weeding your garden or meet up with friends for a four-mile walk two evenings a week. These activities have become an important part of your life so let’s make sure that they’re factored into your list, perhaps in the “what you hope to get out of physical therapy” category. Painting a clear picture of how active you are—and what types of activities and sports you participate in—can help your physical therapist design an individualized treatment plan and to better help you on your road to recovery.

The ABCs of Medicare

If you are approaching the magic Medicare number of 65 years of age, chances are you have been thinking about how you will go about getting on Medicare and what your options are to get the coverage that’s best for you.  This blog is meant to be an introduction to the general options available to give you a starting point for your research.

TRADITIONAL MEDICARE: This in the most well-known coverage and it includes two parts:

  • Part A: coverage for hospital visits
  • Part B: coverage for doctor visits and therapy

MEDICARE ADVANTAGE PLAN: Sometimes called “Part C”, Medicare Advantage Plans wrap Part A and Part B benefits into a private plan administered through Medicare-approved insurance company.  This provides an alternative way to receive your coverage through private insurance companies approved by Medicare.  Most of these plans include additional benefits, such as vision, dental, and/or prescription drug coverage. When you enroll in a Medicare Advantage plan, you are still in the Medicare program, and you are still required to pay your monthly Medicare Part B premium; however, your Medicare services are covered and administered through a single policy.  Since Medicare Advantage plans are available from private companies that contract with Medicare, each plan sets its own premium; some have very low premiums, however, they might not be the right plans for everyone.  The costs and additional benefits vary widely among plans so it is essential to do your research to figure out which one is right for you.

MEDICARE SUPPLEMENT PLAN / MEDIGAP PLANS: Medicare Supplement plans are also offered by private insurance companies and act as just that, supplementing the coverage from Medicare.  In other words, they often pay the costs that Medicare does not. These are also known as Medigap plans. There are many different supplement plans to choose from, varying in cost and coverage. While Medicare Supplement plans may help with deductibles and other expenses not paid by Medicare, they do not cover services if traditional Medicare does not cover them, such as long-term care, dental care, or eye glasses. In addition, these plans do not provide prescription drug coverage.

THESE PLANS DO NOT WORK TOGETHER: Medicare Advantage plans do not work with Medicare Supplement plans. This means that you cannot use your Medigap plan if you enroll in a Medicare Advantage plan. You may enroll in a traditional Medicare plan with a supplement, OR in a Medicare Advantage (known as a replacement plan) BUT NOT BOTH.

MEDICARE PRESCRIPTION DRUG PLAN: If you are looking for a Medicare Advantage Prescription Drug plan, it is a good idea to check whether it covers your prescriptions. Each Medicare Advantage Prescription Drug plan has its own formulary (list of covered prescription drugs). The formulary may change at any time; you will receive notice from your plan when necessary.

CHOOSING THE RIGHT PLAN: When deciding on a plan, it’s essential to compare the benefits and costs in relation to your specific health care needs. The Medicare.gov website suggests considering these 7 things when choosing what coverage is best for you:

  • Costs: How much are your premiums, deductibles, and other costs? How much do you pay for services like hospital stays or doctor visits? Is there a yearly limit on what you could pay out-of-pocket for medical services? Make sure you understand any coverage rules that may affect your costs.
  • Coverage: How well does the plan cover the services you need?
  • Your other coverage: If you have other types of health or prescription drug coverage, make sure you understand how that coverage works with Medicare.
  • Prescription drugs: What will your prescription drugs cost under each plan? Are your drugs covered under the plan’s formulary? Are there any coverage rules that apply to your prescriptions?
  • Doctor and hospital choice: Do your doctors accept the coverage? Are the doctors you want to see accepting new patients? Do you have to choose your hospital and health care providers from a network? Do you need to get referrals?
  • Quality of care: Are you satisfied with your medical care? The quality of care and services offered by plans and other health care providers can vary. How have Medicare and other people with Medicare rated your health and drug plan’s care and services?
  • Travel: If you travel out of state or out of the country, is there any coverage available with any of the plans?

COVERAGE CHANGES / ELECTION PERIODS: Changes to your Medicare insurance can be made during the Annual Election Period, which runs from October 15 to December 7 each year. You can switch from Original Medicare to a Medicare Advantage plan at this time, and make other coverage changes. If you’re already enrolled in a Medicare Advantage plan and want to switch plans, in most cases a good time to do so is during the Annual Election Period.  When you change Medicare plans during the Annual Election Period, your new coverage generally begins on January 1 of the following year. If you’re enrolled in a Medicare Advantage plan and want to switch back to Original Medicare, Part A and Part B, you can do so during the annual election period or during the Medicare Advantage Disenrollment Period, which runs from January 1 to February 14 each year.

This is a lot to think about and there are a lot of decisions to make – be sure to do your research to ensure that you are selecting the coverage that is right for you.  There are resources available online and many private insurance companies may be able to offer advice. If you have questions on what the physical therapy benefits are with your plan, please give us a call and we will be happy to get that information for you.

For more information about the Medicare Enrollment Process, click the links below:
Getting Started with Medicare
Medicare vs Medicare Advantage Plans: How to Choose

What are Therapeutic Modalities?

Therapeutic Modalities…it may sound like a term from Star Wars, but believe it or not, this is a medical term.  If you have been to a physical therapist, you may have experienced therapeutic modalities without even knowing it!  This blog is meant to help you understand what this term means and how therapeutic modalities might be utilized on your road to recovery.

WHAT ARE THEY? Therapeutic modalities are tools your physical therapist might use to help generate healing and assist with muscle reeducation.  This tool can help by decreasing pain and swelling or lessening muscle spasms which may be causing the pain. A few examples of the most common therapeutic modalities include hot and cold packs, devices which will apply pressure and cooling to the affected area (such as Game Ready equipment), electrical stimulation, ultrasound and iontophoresis among others.

HOW ARE THEY USED? It’s important to note, therapeutic modalities are not required to be used during therapy sessions. On the contrary, they are available for use at the therapist’s discretion, based on the patient’s needs.  Therapeutic modalities should never be used exclusively without other forms of therapy such as exercise, stretching and manual therapy.  As a matter of fact, the American Physical Therapy Association (APTA) released a position statement this past August on the use of Therapeutic modalities:

“The use of biophysical agents as a standalone intervention, or the use of multiple biophysical agents with a similar physiologic effect, is not considered physical therapy nor is it considered medically necessary without documentation that justifies the use of the biophysical agents for those purposes”

SO WHY USE THEM?  Therapeutic modalities have been used as a part of the practice of physical therapy for many years. The rationale behind their continued use is based on documented patient experience, or therapists witnessing an improvement in their patients following use of such devices. However, current research does not confirm or discredit the use of the therapeutic modalities as a way to achieve therapeutic goals.  There is some evidence to suggest that certain therapeutic modalities produce no physiologic benefit at all!

WHEN MIGHT THESE BE USED? As a patient who is actively engaged in your therapy, here are some things to keep in mind when talking to your physical therapist about their plan to use (or not to use) these tools:

  • Modalities should never be used exclusively during your therapy visit. For example, if your therapy session begins with a hot pack and Estim, it should be either preceded by or followed with manual (hands on) therapy and rehabilitation exercises or stretches during the same visit.
  • These tools are designed to have an immediate impact. If a modality does not demonstrate a change following the initial application (i.e. decrease pain or muscle spasm, improve a muscle’s ability to contract), it should be modified or discontinued.
  • If the use of a modality does not produce a carryover effect (for example: decreased pain) for >1 day after its use, it may not be medically necessary.

In the end, the choice to use therapeutic modalities, or physical agents, lies solely on the clinical judgement of your physical therapist. He or she may choose to utilize a particular modality initially to help you cope with your pain and then discontinue use after you demonstrate decreasing pain levels. Conversely, they may choose to add it to your therapy plan after several visits to help with muscle reeducation.   However these tools are utilized, it is important to have an open line of communication with your therapist about your progress and their evolving plan to get you back on track toward full function.

As a patient, you have the choice of where you go for physical therapy.  This allows you to be your own advocate. It gives you a voice in a medical world where patients often feel their questions and concerns are the last to be considered.  Choose a physical therapist that explains why they chose certain interventions, and why not, and don’t be afraid to ask questions. We, as physical therapists, are prepared to answer them, and happy to do so.

3 Holiday Stressors that can be Reduced by Physical Therapy

Holidays are hard. And we’re not talking about buying gifts for the person who doesn’t need anything or putting up with difficult relatives. Holiday tasks are physically difficult be it shoveling snow, cooking big dinners, walking around town singing Christmas Carols, or lugging your decorations upstairs from the basement. Unfortunately, during the holidays, we often put aside taking care of ourselves, just like we put aside the fruitcake! In the clinic, we notice this from our patients who often reduce or avoid physical therapy visits until the new year, citing holiday stress caused by too much to do and not enough time to do it!

Here are three holiday stressors that can be reduced by physical therapy:

REDUCING THE 12 PAINS OF CHRISTMAS: Physical Therapy during the holidays will equip you to handle the holidays with grace – and less pain! Taking care of that pulled hamstring will improve your dance moves for New Years!  Finally resolving your tennis elbow will make icing all of those cookies so much easier!  We won’t even mention what a little back therapy will do for you the next time you have to pick up children while playing Santa Claus! During a holiday that is usually marked by increased activity, use the knowledge and healing of PT to make all of that activity more enjoyable.

REDUCING OUT OF POCKET COST: Money is always on our minds during the holidays. Paying for all those gifts, traveling to visit family and friends and funding your massive light display all increase the December budget. The opposite is true for physical therapy. At the end of the year, your PT may cost less if you have covered your deductible.  This makes your therapy a money saving experience! With the dollars you’ll save on PT you can buy that extra present or a few extra jugs of eggnog to keep you going into the New Year! Most health insurance plans renew in January, triggering a new deductible to meet. Squeezing in a few appointments before January 1st can save you some money in 2019. Now that’s a great New Year’s resolution!

REDUCING MENTAL STRESS: Physical care of yourself during the holidays is also good for you mentally. Taking some time for yourself calms you during a time that can be stressful. So get away for an hour and do something that makes you feel good both physically and mentally. It will help you feel calmer and in control of your health. It may even allow you to avoid “stress eating” that whole plate of cookies! If you need a break in the middle of your hosting duties, take five to complete your at-home therapy exercises and gain a little peace on earth.

The holiday season truly is a wonderful time of year for many things, including physical therapy. We are proud to make your holidays a little merrier and brighter here at HARTZ PT. Four locations in Lancaster County are eager to serve you this December and we wish you and your family a happy holiday and a healthy New Year!

3 Pitfalls to Avoid when seeking a Physical Therapist

Your favorite restaurant is closing due to a health code violation. A new teapot is shattered because the mailman dropped your package.  That “contract-free” phone plan has you tied down for two years.  Different industries have different shortcomings and physical therapy care is no different. Below are three key checkpoints to make sure that you are getting the care you deserve at your rehab facility:

  1. CHECK THE PATIENT FLOW: Shall we state the obvious? More patients create more revenue. With that reality it can be very tempting for clinics to attempt to pack in as many patients as possible, thereby increasing the payday. If you find that every time you see your therapist, you are rushed through your treatment, then maybe it’s time to look elsewhere. Sure, a productive clinic can be busy, however a quality clinic should make you feel heard and understood at your sessions. There should be appropriate time to have your complaints addressed and your questions answered without being brushed aside. In addition, ensure you have proper supervision while you perform your exercises. If your treatment team is burdening you with four exercises and consistently leaving (hopefully not for coffee breaks) you might also want to reconsider the quality of care you are receiving.
  2. APPROPRIATE EXPLANATION OF PAIN NECESSITY: Many patients have experienced self-described “torture” at the hand of physical therapists. Although there are some occasions where pain may be necessary, the rationale for pain provocation should be explained thoroughly.  The patient should be in control and have the power to say when “enough is enough”. Trusting your therapist and having them respect your pain tolerance is crucial. Pain in therapy must be productive.
  3. CONSISTENCY IS KEY: Consistent care by qualified professionals has been proven to result in better outcomes. In other words, seeing the same patient care team virtually every visit, including frequent 1-on-1 follow-ups with the Physical Therapist. Patient care being passed from clinician to unfamiliar clinician with no consistent follow up can lead to disorganized care, inconsistent treatment sessions, and a superficial understanding of you and your treatment regimen. Certainly, clinician vacations, illness, or unforeseen circumstances may change your treatment team temporarily but for the most part, having access to a consistent team of providers will facilitate continuity of care.

Three top pitfalls among physical therapy clinics are a “factory approach” to care, inconsistency in your treatment team, and pain without corresponding gain in function. If you think your provider is falling into one of these traps, it may be time to look around. As an independent small business, our values of focused attention, consistent care, and appropriate application of treatment intensity are keys to our success during the past 20 years. We invite you to Experience the Difference for yourself.

Sleeping Away your Pain

We know your type, you go above and beyond to advance, progress, and accomplish. You are up at dawn and burn the midnight oil to get ahead. And when an injury presents itself, you work with your physical therapist to recover, whether it be attending every visit in the clinic or doing your home exercise program ten times per day!  However, something you may not have considered, is how sleep deprivation can play into your recovery.

Sleep deprivation is widespread. The CDC considers it a public health problem. It is estimated that up to 90% of sleep pathologies are undiagnosed! Think you sleep well and long enough already due to tracking your sleep? Don’t be too sure. In trials of over 80 sleep tracking devices (think Fitbit) worn by consumers, only one withstood a clinical trial. Most of the devices overestimated sleep duration and quality and underestimated awakenings at night.

Sleep helps you recover. A recent article in Physical Therapy, a professional PT research journal, reviewed the correlation of quality sleep to injury rehabilitation. Not only does sleep increase cognitive function as we’ve heard so often, but it also facilitates increased immune function and tissue healing as well as decreased perception of pain.  Imagine, get your 8 hours of solid shut-eye each night and feel no pain (well, OK maybe just less pain)

We can help maximize your comfort to get more sleep! Our professionals know how to make you more comfortable at night. While we are not sleep specialists, we do know how to position you for maximum comfort in that recliner after shoulder surgery or baby that back to get as much deep sleep as possible.

Daily exercise aids sleep as well. This article reminds us that regular moderate exercise has a positive benefit on sleep quality as well. A physical therapist can recommend specific exercises which will be safe to perform, even if you have some limitations. A HARTZ PT, we also provide our signature Medically Adapted Gym and our Better Bones, Better Balance Class designed to help you achieve your goals.  Improved sleep may be a side benefit of trying out these programs.

Sleeping is crucial to your recovery and quality of life. So next time you find yourself skimping on sleep, do yourself a flavor and get a little shut eye. It might help you more than you realize.

Works Cited: F.Al-dughmi, Catherine, et al. “Sleep Health Promotion: Practical Information for Physical Therapists .” OUP Academic, Oxford University Press, 18 May 2017, academic.oup.com/ptj/article/97/8/826/3831304.

Direct Access to Care will result in Cost Savings for Patients

Researchers in South Carolina have completed a 2-year study (click for link) comparing claims and outcomes data for a group of patients suffering from neck and back pain.  The patients were divided into two groups:

  • Those who selected treatment through physical therapy first (Direct Access).
  • Those who chose traditional routes to care, primarily consultation with a physician first.

They found that improvement in pain and disability was similar, but direct access patients with neck or back pain incurred $1,543 lower average costs than those who chose referral from a physician, with no adverse events.

What does this mean for me?   Patients should consider physical therapy as a first option for pain relief.  Physical therapists are experts at identifying imbalances and weaknesses in the musculoskeletal system, which often lead to pain.  At the same time, we know our limitations and will refer patients to the best physicians in the area, if necessary.

Getting the Most for your Healthcare Buck

Have you ever gone into a clothing store, picked out an outfit and made the decision to purchase it without knowing the price?  Of course not!   Price transparency is so important in this country, with one major exception, the healthcare field.

Sure, reimbursements can vary widely by insurance company, but there will always be a range.  Your healthcare provider and your insurance company should be able to provide you with a range prior to providing services.  You might be shocked by what you find out.

The healthcare environment today and specifically reimbursement rates of most large private insurers, favor large hospital-based organizations.  Smaller, independent clinics are not playing on a level playing field.  This price advantage given to hospital-owned entities is forcing insurance companies to raise premiums for members (and lower rates for independent clinics) without offering better coverage.

Believe it or not, outpatient physical therapy clinics at hospital-owned clinics are paid 2-4 times that of an independent clinic for a same exact service!

Why, you might ask?  The answer is simple…bargaining power.  When hospitals negotiate with insurance companies, they roll up all of the services they offer, including hospital stays, inpatient and outpatient physician visits and surgeries as well as inpatient and outpatient physical therapy, into the same bucket.  Insurance companies don’t want the hospital to stop taking their insurance for ALL of their services, so agree to pay a much higher rate for everything, including outpatient physical therapy.

Here is a recent example:  A local hospital charges $111 – $156 for 15 minutes of therapeutic exercise.  So, for a 1-hour outpatient physical therapy visit, the hospital will bill your insurance company between $444 and $624.  This charge does not vary by insurance company.  What does vary, is the rate of reimbursement.  Although insurance companies and clinics often will not share specific contract information with prescribers, we do have knowledge of price discrepancies in a couple of situations:

SELF PAY: Self-pay outpatient PT patients at this hospital are allowed a 25% discount from the total charge.  Therefore, a self-pay patient will owe between $333 and $468 for a 1-hour outpatient PT visit.  At an independent clinic, charges will range between $75 and $125 per 1 hour visit for a self-pay patient, resulting in a savings between $208 and $393 per visit.  Expanding that savings to a typical 10 visit plan of care, the patient will save $2,000-$4,000!

AETNA: Aetna pays 85% of what a local hospital charges them for outpatient physical therapy.  So, for a one-hour visit, Aetna will pay the hospital between $377 and $530.  FOR THE SAME ONE HOUR VISIT, Aetna will pay an independent clinic around $75 per visit. This is a total price difference of over 500%.

What does this mean for today’s consumer?  It could mean HUGE savings!

For those with high deductible plans and large out-of-pocket maximums, you could be paying for the first several thousand dollars out of your own pocket!  This means you could pay for an ENTIRE plan of care (8-10 visits) at an independent clinic for less than just 2-3 visits at a hospital-owned clinic.

Price transparency in the healthcare market has never been easy, however the information is out there.  Knowledge is power and the truth is, you have a choice.  It is ALWAYS your choice where to go to physical therapy.  Research your options.  Find out what you will pay.  With more and more patients paying higher amounts out of pocket, you can’t afford not to.

CLICK HERE to learn more about price disparity in the US healthcare market.

Tips for Traveling after a Joint Replacement

The surgery is done and now is the time to get back to your life.  A joint replacement of any kind is not an easy surgery from which to recover. It takes time!  When the time comes to travel again via car or plane, here are some tips to help make the trip more enjoyable.

4-6 weeks post-surgery:  The majority of surgeons will recommend that you wait a minimum of 6 weeks post-surgery before traveling, however some say you can travel as soon as you are comfortable sitting down, but a minimum of 4 weeks.  This decision depends largely on the length of time you will be traveling, and what mode of transportation you will be utilizing.

Pick your Seat: If you are traveling by air, it is best to select what seat you have on the airplane.  Upgrading to first class is the best solution, but many times not financially possible.  The row of seats behind the partition (between first class and economy) tend to have a little more leg room.  Emergency exit rows also have a little more leg room but since you are traveling after a major operation you might not have the ability to move fast enough to perform the duties required in those rows in case of an actual emergency.  It would also be best to obtain an aisle seat if the other options listed are not possible.

Frequent Breaks: Sitting for long periods of time is very common when traveling. The affected extremity tends to grow tight and stiffen up.  If possible, while on the plane, attempt to get up every 15-20 minutes.  If your travels by plane take you across the country, try to split the trip up and make a stop along the way (at least one layover) to give yourself the opportunity to get off the plane and walk around until your next flight is called.

Security Woes: Going through security at the airport is challenging for anyone. Getting through security after a joint replacement may require a little more preparation. Some physician’s offices may give you a letter stating you have had a joint replacement surgery.  You should also inform the TSA agent upon your arrival at the security checkpoint, that you have received a joint replacement very recently.  You should be prepared to go through extra screening.  Wear loose fitting clothing in the case that you are asked to show your surgical incision.  The more prepared you are, the smoother the process.

Car travel does not have security component, but you still want to plan your trip with frequent stops to give yourself time to get up and walk around. This will help avoid stiffness and tightness at the surgical location and surrounding extremity.  Some knee replacement patients prefer to sit in the back seat to keep their leg elevated across the seat, while others prefer the passenger seat pushed back all the way leaving as much leg room under the dash as possible.

Traveling after a joint replacement is possible, it just takes a little more planning.  It is always a good idea to consult your surgeon or physical therapist prior to your trip for additional recommendations specific to your state of recovery.

PT is First Step to Pain Relief

Physical therapists work closely with physicians such as orthopedists, neurologists, pediatricians, general practitioners, neurosurgeons, and podiatrists.  In collaboration with these other health care providers, PTs work to help patients achieve healthy, active lifestyles. They manage health care over the long term and can be instrumental in helping to avoid injury in the first place.

Because of a law called Direct Access, it has become increasingly common for physical therapists to begin seeing patients without a physician referral.  Direct Access to physical therapy has been law in Pennsylvania for over 10 years and allows patients timely access to physical therapy as an entry point into the health care system.  Most health insurance plans cover physical therapy obtained under this law, as long as a therapist is Direct Access certified. (Medicare is the exception to this rule)

In addition to allowing the healing process to start sooner, seeing a physical therapist first can make good financial sense. There are times when a few sessions of PT are sufficient for full recovery, and expensive x-rays, MRIs and medications are not necessary. If it does turn out that an injury is more complicated and a patient needs further diagnostic tests, these can easily be ordered afterward. Physical therapists are trained to know their limits and refer patients to physicians when the injury is beyond the scope of their expertise.

During an initial physical therapy visit, a patient can expect an in-depth assessment of their specific pain. Goals for treatment will also be discussed. After a thorough evaluation is performed, an individualized treatment plan will be initiated. The patient and physical therapist will work together as a team towards achieving the goals that are established. Common treatments used in PT include therapeutic exercises, manual (hands on) therapy, and a home exercise program for the patient.

Choosing a physical therapist is much like choosing one of your physicians.  It is best to do some research to find a PT who is knowledgeable, compassionate, and will treat you like the individual that you are.  Be your own advocate and investigate your options prior to scheduling your first appointment: making a phone call or a visit to a clinic is always a good idea. Or turn to friends and family members who may be able to offer advice based on experience.

A good physical therapist can help you improve your quality of life. You can live your life pain-free and get moving and enjoying life again. In many cases this can be achieved without surgery or prescription medication. Call us to get on the path to a pain-free life today!

Aquatic Therapy

Exercising in the water is considered one of the most heart-healthy and joint-friendly ways to exercise.

Have you ever noticed while you are in the water that you are able to do things in the water that you cannot do on land?  When you are in water, the buoyancy of the water makes you feel like you are floating, right? Feeling lighter in the water means there is less weight being distributed through your joints such as the ankles, knees and spine.  Your shoulders also get a well-deserved break since the buoyancy of the water allows your arms to float to the surface of the water.

So, you might ask, how aquatic therapy works.  Physical therapists use the water to, as I stated before, allow patients to do things in the water they may not be able to do on land. For example, if they have pain in their knees when walking on dry land, aquatic therapy would allow the patient to walk without any pain in their knees while in the water, thereby allowing them to strengthen the muscles more effectively. In fact, when you are standing in waist-deep water, you are putting 50% less weight through your lower extremity joints; increase the depth of the water to chest-deep, and the benefit is 80% less strain on your lower extremity joints!  What a great opportunity to take stress off your joints!

Did you ever just float in the water and feel better, more rested?  It is not a big surprise that one of the underlying meanings of the word buoyancy is lightness of spirit/cheerfulness.

Now I know you are wondering how the water is going to get your stronger. I agree, you cannot just float around all the time.  Let me introduce you to viscosity, otherwise known as drag, which is the reason why you cannot walk or run as fast in the water as you can on land.  In the water, you are surrounded by resistance. Every movement you take forward or back, is more effort than it is on land. It has been found that exercises in the water provide up to twelve times more resistance than exercises performed in “air” or on land.

Now all you have to do is put the two together for everything to make sense.  When you do your exercises, you are working harder doing them in the water; however it does not feel harder, due to the buoyancy of the water.   Have you ever participated in a water exercise class in which you felt great during class, however once you finished, your muscles felt so much more tired on dry land?  You can thank buoyancy and viscosity for that!

Swimming is not only great exercise, but swimming in conjunction with aquatic therapy can be a significant tool in aiding with recovery from an injury or managing chronic pain. Arthritis, for example, is a condition seen widely across America. Over 49% of adults 65 and older suffer from some form of Arthritis. The Arthritis Foundation recommends swimming the best exercise for those who suffer. Swimming with arthritis can reduce pain while also increasing strength and flexibility.

HARTZ Physical Therapy offers aquatic therapy in our Lititz, Lancaster-East and Mount Joy offices. It is a great option to help manage chronic arthritis pain and to recover from from an injury in a low weight-bearing environment.

– Wendy Enck, PTA, Aquatics Specialist and long distance swimmer.  Wendy works at our Lancaster-East office.

Tips for a New Patient

PT Picture4-crop-small

We know physical therapy can be intimidating, especially when you don’t know what to expect.  We are here to help you through it so we’ve answered many common questions that patients who are new to PT may have.  If you have an additional questions, please do not hesitate to call us!   

Do I have to visit a doctor first or can I go straight to physical therapy for my problem? Direct access is exactly what it sounds like: patients having direct access to physical therapy services. In Pennsylvania, most commercial insurance plans allow you to see a physical therapist that has a Direct Access certification for up to 30 days without a referral from a physician. If the therapist determines that you require treatment for longer than this amount of time, your physical therapist will make a recommendation or referral for you to see your primary care physician or a specialist, as needed. A physician’s referral is currently needed if you are covered by Medicare.

 How do I choose a physical therapy clinic? These are some things to consider when seeking a physical therapy clinic:

  • HANDS ON CARE: A variety of techniques could be utilized in your care.  This should always include hands-on manual therapy and instruction, as well as implementation of therapeutic exercises.  Beware of therapy sessions revolving largely around electrical stimulation or ultrasound, as the research supporting the effectiveness of these methods is spotty, at best.  Hands-on care has been proven to provide the quickest and most effective route to recovery.
  • COST: Cost will vary significantly by provider, so it’s a good idea to call the clinic to ask them to check your benefits.  For those with large out-of-pocket maximums, high deductibles, or health savings accounts, consider care at a smaller clinic, where insurance reimbursements, and therefore cost, is often lower.  Large companies and hospital-owned outpatient clinics have negotiated higher rates with insurance companies and will hold patients responsible for covering the initial costs until the deductible or out of pocket maximum is met.
  • LOCATION/HOURS: The clinic should be conveniently located. Since sitting and driving often aggravate orthopedic problems, there should be a very good reason for you to drive a long distance for rehabilitation.
  • Check the clinic’s hours of operation to ensure they fit with your schedule.
  • REPUTATION:  It is important to research the reputation of that physical therapy clinic specifically, NOT their overarching umbrella of physicians, as you won’t be seeing the physicians during therapy.  Check their website, testimonials and online reputation.  In addition, you could also ask the clinic to view their patient satisfaction survey results.
  • ASK AROUND: The single most important thing you can do is ask your family and friends about their experiences in physical therapy.   There are many options in today’s healthcare arena and word-of-mouth referrals are, by far, the most reliable type of research. *Please keep in mind, physicians who offer in-house physical therapy will typically refer you to their affiliated clinic.  Similarly, all LG Health physicians are strongly encouraged by their employment contract to refer you to an LG Health rehabilitation clinic, unless the patient insists to go elsewhere.   However, the best quality of care, more efficient outcomes, and more cost effective treatment is often found at an independent clinic specializing in outpatient physical rehabilitation.  We encourage you to do your research to find the clinic that best suits your individual needs. It is your health, so it is always your choice where to go for your physical therapy needs.

What should I bring with me to my first appointment?
 Photo Identification
Insurance Card(s)
Physician’s referral for Physical therapy (except Direct Access patients)
List of current Medications
Completed New Patient forms

How should I dress? You should wear loose fitting clothing so you can expose the area that will be evaluated and treated. For example, if you have a knee problem, it is best to wear shorts or loose fitting pants that can be pulled up above the knee.

How long will my appointment last? A typical initial evaluation will last approximately one hour. The time for follow-up treatment appointments can vary, depending on the complexity of your plan of care, however a good rule of thumb is to allow an hour for each appointment.

What happens during my first visit and subsequent visits?  Your first visit, otherwise known as an initial evaluation, will include a thorough review of your medical history and a physical examination of the problem area, including establishing a baseline of function.  The therapist will establish various attainable and measurable goals and develop a treatment plan, which outlines the frequency and duration of therapy, and most importantly, specific interventions and therapeutic exercises geared to increase function. Throughout the course of therapy, the therapist will stay in touch with your physician so they can work together to ensure you are on track to a full recovery.

At each visit, part of the therapist’s job is to explain in layman’s terms, how your body is healing and responding to the treatment. and how therapy and on-going at home exercises can result in complete healing and achievement of your goals.  With successful completion of each stage, the patient will eventually “graduate” from physical therapy with not only full function, but also the knowledge of how to avoid re-injury or recurrence of the problem.

 Is physical therapy painful? While the ‘ole adage No Pain, No Gain should rarely apply to physical therapy, in some cases, physical therapy techniques may be uncomfortable or slightly painful.  Your physical therapist will utilize a variety of techniques to help maximize your treatment goals and minimize pain.  It is important that you communicate the intensity, frequency, and duration of pain to your therapist. Without this information, it is difficult for the therapist to adjust your treatment plan.

How many visits will I need? This is highly variable. You may need one visit, or you may need months of care; it will depend upon your diagnosis, the severity of your impairments and your past medical history. You will be re-evaluated on a monthly basis. In addition, when you see your doctor, we will provide them with a progress report with our recommendations.

What now? It is important to remember that it is always THE PATIENT’S CHOICE where to go for physical therapy.  We encourage you to do your research, ask around and determine where is the best fit.   Small independent outpatient PT clinics often have an advantage over their larger competitors.  By specializing solely on physical therapy, we are able to ensure the highest quality of service, which translates to an efficient and effective outcome for our patients.

If you have any questions, please do not hesitate to call our office or feel free to stop in and take a tour, you will be able to experience the difference from the moment you walk in our door.

Prehabilitation – Preparing for your Surgery

PT Picture2-crop-smallPre-hab, or pre-habilitation, is a growing necessity; it’s the proactive approach to minimizing pain and injury, following a surgical procedure, such as total knee or hip replacement.  Furthermore, by utilizing both strengthening and range of motion exercises, it prepares your body to withstand a stressful event, such as surgery.

The better physical shape you are in before joint replacement surgery, the better your results will be. In addition to teaching you exercises that will prepare you for your surgery, your physical therapist will show you how to walk with assistance after your operation (if a knee is being replaced). He or she will also discuss precautions and home adaptations, regardless of the joint that is involved. Keep in mind it’s always easier to make these modifications before you have surgery than after the fact.

If you are overweight, it’s a good idea to shed some pounds prior to surgery. Losing excess body weight may help you recover more quickly, and will help improve function following your procedure. A physical therapist can design a customized exercise program that will help you achieve your weight loss goals safely. (Another option is to join our Medically-Adapted Gym for a couple of months prior to surgery)

A study conducted by Harvard Medical School, found that knee and hip-replacement surgery patients who participated in pre-hab exercises (land and water-based) for six weeks prior to surgery, reduced odds of needing inpatient rehabilitation by 73 percent… 73 percent! Click here to read more!

Exercise regimens for pre-hab will vary depending upon the complexity of the injury or the damage incurred from years of stress on joints. Most regimens will include building strength and range of motion exercises; this will help muscles recover more quickly after a traumatic event (e.g., surgery).

As you consider scheduling a knee or hip replacement procedure, it is important to involve a family member or caregiver who will serve as a postoperative “coach”. This individual will assist you as you rehabilitate at home. Be sure to define who that coach will be and include them in the information gathering process.

Need help getting started on a pre-hab program? Give us a call and we’ll help you get on the road to recovery in no time.

How is an Independent Private Practice Different?

Have you ever had that dream, where you are running as fast as you can and getting nowhere?  Translate that feeling to your health…when you are injured, your first goal is to get back to 100% as efficiently as possible.  It is not always going to be a speedy recovery, but it would be nice to know that your health care providers aren’t wasting your time, right?  When it comes to your health you should always investigate the quality of your treatment options.

In regards to physical therapy services, excellence can vary by practice setting. In a recent article published in “PT In Motion” magazine, the writers studied patients with low back pain at various rehabilitation clinics. You might be surprised to learn of specific differences they found between privately-owned and physician-owned physical therapy clinics.

Physical therapy received in a private practice setting provides quicker healing and requires fewer treatment sessions. In this low back pain study, choosing a private practice resulted in an average of two fewer PT sessions vs. a physician-owned practice. That translates into fewer co-pays, reduced travel and personal time expenditures, and ultimately a quicker return to your previous quality of life!

This study also confirmed that this reduction in visits for patients utilizing private practice settings did not decrease the quality of treatment received. Instead private practices scored high in treatment units for strengthening, flexibility gains, progressed endurance, and functional activities. Physician-owned rehabilitation services used fewer units for these important treatments and instead billed for more passive modalities, such as electrical stimulation, ultrasounds, and thermal agents – widely considered less effective than the aforementioned units.

So patients at private practice clinics:

  • needed fewer visits to get well
  • benefitted from more hands-on treatments instead of less effective modalities
  • paid less both personally and through insurance
  • showed results as good or better than physician-owned clinics

Utilization of private practice clinics is an excellent way to reduce ever-growing healthcare costs keeping physical therapy affordable for everyone.

HARTZ Physical Therapy is a proud to be an independent, locally owned and operated private practice. We have been improving the quality of life for our patients for over 15 years with efficient, exceptional service.  If you are dissatisfied with your healthcare, give our practice a try. You may be surprised to learn what a difference private practice can have in your care!

Works Cited
News Now Staff. “Physician Self-Referral to Physical Therapy for LBP Does Less, Costs More.” PT in Motion. PT in Motion. 11 Aug. 2015. Web. 22 Oct. 2015. http://www.apta.org/PTinMotion/News/2015/8/11/MitchellStudyLBPSelfReferral/

 

X-Rays, CT Scans, MRIs…What’s the Difference?

Image courtesy of PinkBlue at FreeDigitalPhotos.net

Image courtesy of PinkBlue at FreeDigitalPhotos.net

X-ray vision is highly inconvenient. Think about it. Government agents and mafia criminals would try to force your allegiance and Christmas presents would never be a surprise. Good thing we don’t need superhero powers to see inside the human body. More than just exposing anatomy, diagnostic imaging provides medical professionals with key understanding into your health: something even Superman can’t do. There are three common imaging procedures we will explore below: X-rays, CT scans, and MRIs.

Radiographs (a.k.a. X-rays) utilize an electromagnetic beam to view our body structures. These structures are illuminated depending on how much X-ray they absorb. Bones absorb a lot of ray so they appear the whitest compared to air (think lungs) and soft tissues (organs, muscle). X-rays not only spot bone fractures but they can also expose cancer, lung disease, and other pathologies. The big fear with undergoing X-rays is radiation exposure. However the amount and intensity of radiation exposure is indescribably small compared to potentially harmful quantities. Most medical professionals agree that the benefits of X-rays always outweigh the risks.

CT scans (a.k.a. CAT scans) are a more detailed X-ray. CT scans involve a specialized X-ray machine shaped like a donut. A patient is slid through the machine on a table while the ring uses a spinning mechanism to take pictures. This is really cool because it takes a lot of images that can be pieced together to show a 3-D picture of your body. You may receive an internal contrast material before the procedure. This material provides a strong color contrast from surrounding body tissue. The material will run through different passageways or spaces (blood vessels, intestines, etc) to identify any abnormalities.

MRIs: smashing insurance company piggy banks in an office near you. This image is prime for viewing soft tissues in the body. Muscle, fat, nerve, etc., are all included. This is like a CT scan in that it can display a 3-D portion of the body vs. a single plane (or picture). This is a result of MRI slices. An MRI takes pictures at regular intervals throughout your body like cuts through a loaf of bread. When you put all of the slices together you get a picture of the body through different depths. This is accomplished by the application of a magnetic field (hence the name of Magnetic Resonance Imaging). The image is a result of the tissue’s atomic response to the magnetic field.

These are the very basics of the three most common imaging procedures. At HARTZ Physical Therapy, we often see the positive effect that imaging techniques can provide our patients.  We are happy to spend whatever time is needed to help our patients understand what is causing their pain and how we plan to help them along the road to recovery.

Laura McEllhenney, Licensed Physical Therapist Assistant, HARTZ Physical Therapy, Lititz, PA

Physical Therapy Acronyms – What do they mean?

Image courtesy of smarnad at FreeDigitalPhotos.net

You are constantly bombarded with information. Advancing technology, career specialization, and information availability can overload you with extraneous jargon. If you’re feeling jaded from current buzzwords and overly-important-sounding titles, take a look at some physical therapy abbreviations with substance. PT, OCS, and CSCS for example . What are these? And why do they matter? We at HARTZ PT believe they do matter. That’s why you will see a lot of them on our website after our clinician’s names. This alphabetical code explains your PT’s education, background, and specialty areas that lead YOU to a faster recovery process. When looking for a physical therapist you should know what these letters mean for treatment.

PT: All practicing therapists have a minimum of this four year bachelors degree. These PTs have many years of experience in the field and, like all therapists, have continuing education requirements necessary to maintain a PT license.

MPT: Masters in Master in Physical Therapy.  For many years throughout the 1990s and early 2000s, physical therapists graduated with a 5 year Masters degree in physical therapy

DPT: Current doctoral degrees are designated by the letters “DPT.” As Direct Access and PT responsibilities increase, a doctorate degree most accurately displays the appropriate level of training a PT requires. All programs now require students to obtain a doctorate degree.

PTA: Physical Therapist Assistant. They are trained to work under the supervision and plan of care of a physical therapist. They can adjust your treatment but they must do so under a PTs selection of treatment options. These professionals are qualified to treat patients after their initial evaluation with a PT and require continuing education units to maintain their license. If you see a PTA floating around, you now know about their clinical role. PTAs can be eligible for selected certifications, however most are held by PTs.

OCS: This signifies an Orthopedic Clinical Specialist entailing 2,000 hours of work in the orthopedic field and application for screening measures by the APTA (American Physical Therapy Association). Completion of these steps leads to extensive testing on relevant orthopedic treatment material. This brings orthopedic treatment to a higher level of care. Several HARTZ PT therapists have achieved this specialized certification.

ART: Active Release Techniques – an increasingly recognized treatment approach which improves recovery time. ART is a relevant manual technique that is used to speed the healing process of damaged body tissues such as muscle and fascia. Full body certification involves learning over 500 specific ART maneuvers. Hayden McDevitt is the only full body ART certified physical therapist in Lancaster county and treats patients at HARTZ PT’s Lancaster office.

COMT: This stands for Certified Orthopedic Manual Therapist. This highly recognized certification is earned through Maitland Australian Physiotherapy Seminars. An applicant must complete over 100 hours of coursework before sitting for a two-day board exam which includes a written test, “live” video patient exam, and a hands on exam. This ensures high levels of accurate assessment and treatment. Megan Sabol is COMT certified and practices at the HARTZ Lancaster office.

CSCS: This stands for Clinical Strength and Conditioning Specialist. It proves that your clinician has passed a rigorous exam on strengthening, injury prevention, and sport specific training. You are also likely to find athletic trainers who are CSCS certified. Board certified strength and conditioning specialists treat at multiple HARTZ locations.

So what’s the bottom line for all of this? Physical therapists are committed clinicians which is reflected in the letters after their names.  They continue to achieve advancing degrees and competency requirements which are reflected in their title. This commitment can also overflow into some “extras” attached to a PT’s name and will ultimately lead to better patient care.

3 Tips for the Physical Therapy Delinquent

Woman in the gymThis is your second week of physical therapy visits at your local clinic. Shiny exercise balls and bright sneakers abound in its friendly treatment gym. You may not want to be here (making time and treating your injury can be difficult) but the experience is pleasant overall. The physical therapist you have been working with asks a question.

“How are your home exercises?” Gulp.

“They’re fine.” You force a half smile.

However your exercises are not fine. The PT staff don’t know that you have not been performing your exercises. In fact you are a HEP (home exercise program) delinquent. While you come to therapy, apply effort, and are slowly improving, completing your home exercises never seems to work out. You forget to do them or make time for them. Those few exercises can’t really make a difference can they?

Maybe this scenario doesn’t describe you perfectly, but at some point during PT you may find yourself thinking, “Does this really matter? Can’t I get better without doing these?” The truth is that your HEP is vastly important in your recovery process. At HARTZ PT we explain the purpose and importance of your daily program. However if you ever have any questions about the purpose of your HEP make sure to ask a member of PT team. If you still lack motivation for your physical therapy, read on! Here are three important things to remember the next time you are unmotivated to perform your home exercise program (or even attend PT in general).

1. Change your exercise outlook (even if you hate the idea of exercising).
Whenever physical therapy at home gets tough, mentally focus on your future success. If you find yourself using words like “boring,” “mundane,”, or “uncomfortable” (although they may be true), they should be replaced with “completion,” “success”, and “improvement.”

2. Set “little is much” as your mantra.
We recognize that baking soda, car keys, bacteria, PIN numbers, etc., are very important, albeit small. We at HARTZ identify that little things also allow us to succeed in the healing and recovery process. Maybe your four home exercises seem small enough to skip – however they join a long list of “little things” that add up to massive importance in your therapy.

3, Own your recovery process.
This is your body, your health, and your healing process. Achieving full recovery is ultimately up to you – despite the importance your therapy team plays in the process.  Remind yourself that you alone have the responsibility to take care of your body. Sacrificing now and doing your exercises will pay massive dividends later!

There are several strategies to improve your home exercise program compliance (resulting in speedier improvement). Chat with us about it – we are here to help!

Laura McEllhenney, PTA 

Active Release Techniques – Effective Treatment for Overuse Injuries

The secret’s out: Active Release Techniques (ART) can help you get back to enjoying life – sans pain – more quickly than you previously thought. No, this isn’t a pill or a magic potion that covers up the problem, it’s a technique that helps heal.

But what is it?

ART is a versatile soft tissue management technique that can aid in the recovery of tendinitis, bursitis, knee pain, chronic stiffness, and more. Dr. Michael Leahy (DC, CCSP), founder of ART, describes the principle behind ART as “applying tension to tissue in order to lengthen it or make it slide relevant to adjacent tissue.” The ART specialist is able to assess tendon tightness, adjusting treatment depending upon the patients’ needs.

How does overuse occur in the first place?
When soft tissue is overused, there may be tears or pulls. When muscles are torn, dense scar tissue is created which can cause nerves to get trapped in the entanglement. If you think about pinching your finger in the doorway, you may better understand why this can cause pain. This pain may be identified as tingling or numbness.

Why is ART different?
Providers of ART must learn over 500 treatment moves (specific to ART) in order to receive credentialing. Full-body ART certification does not happen overnight; it is specific anatomical education, paired with frequent practice, that providers must be committed to learning.

If you’ve had reoccurring pain from overuse, don’t waste another minute being in pain.

-Hayden McDevitt, DPT, OCS, CSCS

*Hayden McDevitt is the only Physical Therapist in Lancaster County to receive full-body ART certification. He practices at the Lancaster HARTZ PT location and is presently accepting new patients.