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What happens during my first visit?

Arrive at your appointment with your Initial Evaluation Paperwork completed.
You will provide us with your prescription for physical therapy.
We will copy your insurance card.
You will be seen for the initial evaluation by the therapist.
The therapist will discuss the following:

Your medical history.
Your current problems/complaints.
Pain intensity, what aggravates and eases the problem.
How this is impacting your daily activities or your functional limitations.
Your goals with physical therapy.
Medications, tests, and procedures related to your health.
The therapist will then perform the objective evaluation which may include some of the following:

Palpation
- touching around the area of the pain/problem. This is done to check for the presence of tenderness, swelling, soft tissue integrity, tissue temperature, inflammation, etc.
Range of Motion (ROM)
- the therapist will move the joint(s) to check for the quality of movement and any restrictions.
Muscle Testing
- the therapist may check for strength and the quality of the muscle contraction. Pain and weakness may be noted. Often the muscle strength is graded. This is also part of a neurological screening.
Neurological Screening
- the therapist may check to see how the nerves are communicating with the muscles, sensing touch, pain, vibration, or temperature. Reflexes may be assessed as well.
Special Tests
- the therapist may perform special tests to confirm/rule out the presence of additional problems.
Posture Assessment
- the positions of joints relative to ideal and each other may be assessed.

The therapist will then formulate a list of problems you are having, and how to treat those problems. A plan is subsequently developed with the patient's input. This includes how many times you should see the therapist per week, how many weeks you will need therapy, home programs, patient education, short-term/long-term goals, and what is expected after discharge from therapy. This plan is created with input from you, your therapist, and your doctor.

What do I need to bring with me?

Make sure you bring your physical therapy referral (provided to you by your doctor) and your payment information. If your insurance is covering the cost of physical therapy, bring your insurance card. If you are covered by Workers' Compensation, bring your claim number and your case manager's contact information. If you are covered by auto insurance or an attorney lien, make sure you bring this information. Please bring your Initial Evaluation Paperwork with you to your first appointment.

How should I dress?

You should wear loose fitting clothing so you can expose the area that we will be evaluating and treating. For example, if you have a knee problem, it is best to wear shorts or sweats. For a shoulder problem, a T-shirt or tank top are good choices, and for low back problems, wear a loose fitting shirt and pants, again so we can perform a thorough examination.

How long will each treatment last?

Treatment sessions typically last 45 to 90 minutes per visit.

How many visits will I need?

This is highly variable. You may need one visit or you may need months of care. It depends on your physician's orders, diagnosis, the severity of your impairments, your past medical history, etc. You will be re-evaluated on a monthly basis and when you see your doctor, we will provide you with a progress report with our recommendations.

Why is physical therapy a good choice?

More than half of all Americans are suffering from pain. Whether it is a recent episode or a chronic problem, pain in America is a serious problem. Physical therapists are well equipped to not only treat pain but also its source.

What do physical therapists do?

You have probably heard of the profession of physical therapy. Maybe you have had a conversation with a friend about how physical therapy helped get rid of his or her back pain, or you might know someone who needed physical therapy after an injury. You might even have been treated by a physical therapist yourself. But have you ever wondered about physical therapists--who they are and what they do? Many people are familiar with physical therapists' work helping patients with orthopedic problems, such as low back pain or knee surgeries, to reduce pain and regain function. Others may be aware of the treatment that physical therapists provide to assist patients recovering from a stroke (e.g., assisting them with recovering use of their limbs and walking again).

The ability to maintain an upright posture and to move your arms and legs to perform all sorts of tasks and activities is an important component of your health. Most of us can learn to live with the various medical conditions that we may develop, but only if we are able to continue at our jobs, take care of our families, and enjoy important occasions with family and friends. All of these activities require the ability to move without difficulty or pain.

Physical therapists are experts in movement and function. A large part of a physical therapist's program is directed at preventing injury, loss of movement, and even surgery. Physical therapists work as consultants in industrial settings to improve the design of the workplace and reduce the risk of workers overusing certain muscles or developing low back pain. They also provide services to athletes at all levels to screen for potential problems and institute preventive exercise programs. With the boom in the golf and fitness industries, a number of physical therapists are engaged in consulting with recreational golfers and fitness clubs to develop workouts that are safe and effective, especially for people who already know that they have a problem with their joints or their backs. Not only with golfers, but physical therapists also work with many other recreational and professional athletes in dance, ballet, rodeo, hockey, soccer, track & field, cycling, volleyball, runners, football, basketball, baseball and softball, etc.

At 360 Physical Therapy, our "hands-on" approach defines our practice and helps us achieve high quality results. We provide evidence-based programs that include therapeutic exercise, functional training, and our extensive manual therapy skills. Depending on your specific needs, our physical therapists may also "manipulate / mobilize" a joint (that is, perform certain types of movements) or apply soft-tissue mobilization to a muscle to help facilitate proper movement, healing, and function. Our clinicians also use methods such as ultrasound (which uses high frequency waves to produce heat), moist heat packs, and ice. In addition, our therapists also educate patients on how to self-manage their care via a custom-tailored Home Exercise Program. Although other health practitioners will offer some of these treatments as "physical therapy," it's important for you to know that physical therapy can only be provided by state licensed physical therapists or physical therapist assistants. All physical therapist assistants must complete a 2-year education program and can only work under the direction and supervision of physical therapists.

Most forms of physical therapy treatment are covered by your insurance, but the coverage will vary with each plan. Most states do not legally require patients to see their physicians before seeing a physical therapist. Most of the time all you have to do is ask your doctor if physical therapy is right for you.

Reference: APTA

Why are people referred to physical therapy?

You and others may be referred to physical therapy because of a movement dysfunction associated with pain. Your difficulty with moving part(s) of your body (like bending at the low back or difficulty sleeping on your shoulder, etc.) very likely results in limitations with your daily activities (e.g., difficulty getting out of a chair, an inability to play sports, or trouble with walking, etc.). Physical therapists treat these movement dysfunctions and their associated pains and restore your body's ability to move in a normal manner.

Who pays for the treatment?

In most cases, health insurance will cover your treatment. Click on our insurance link above for a summary of insurances we accept and make sure you talk to our receptionist so we can help you clarify your insurance coverage.

Who will see me?

You will be evaluated by one of our licensed and highly trained physical therapists and he/she will also be involved with your treatments during subsequent visits. Unlike some clinics, where you see a different physical therapist each visit, we feel it is very important to develop a personal relationship with you to maintain continuity of care. Since only one physical therapist knows your problems best, he/she is the one that will be working closely with you to speed your recovery.

Are there physical therapy specialists?

Orthopedic Physical Therapy - Probably the most common physical therapy specialist is the orthopedic specialist. These specialists care for post-surgical patients, arthritis, tendinitis/tendinosus, fracture rehabilitation, muscle sprains and strains, neck and back pain, hip and knee problems, shoulder, elbow, and wrist conditions. Some are board certified as Orthopedic Certified Specialists (OCS).

Hand Therapy - Most physical therapists are well trained to treat hand and wrist conditions. Some therapists have taken additional courses and training and have passed a hand therapy certification examination. These therapists are called Certified Hand Therapists (CHTs).

Sports Rehabilitation - Experts in assisting with recovery after injury and surgery. Many sports specialists help with retraining the athlete utilizing running, throwing, jumping, and sport-specific programs to name a few. A therapist with the Sports Certified Specialist (SCS) title has passed a board certified test.

Aquatic Physical Therapy - Aquatic therapy takes advantage of the physical properties of water to assist with the rehabilitative process. Buoyancy, turbulence, hydrostatic pressure, and thermal properties of water can assist with the rehabilitation of a patient. Those suffering from chronic pain, osteoarthritis, fibromyalgia, rheumatoid arthritis, lumbar fusion surgery, or with a limited weight-bearing status are just a few of the many different patient populations that can benefit from aquatic therapy.

Manual Therapy - Manual therapy is a broad term that describes a variety of hands-on treatment techniques that are applied to movement dysfunctions. Grade five mobilizations, Mulligan mobilizations with movement, Maitland and Kaltenborn techniques, functional technique, neural mobilization, joint mobilization, craniosacral therapy, strain/counter strain, myofascial release, etc. These are some of the more popular manual therapy techniques. Many manual therapists will take continuing education courses, obtain certifications in manual therapy, and will sit for board certification from the American Physical Therapy Association and other organizations. Most physical therapists incorporate manual therapy techniques as a part of a complete treatment plan.

Osteopractor - Is a physical therapist or medical doctor that has completed an evidence-based post-graduate training program in the use of high-velocity low-amplitude thrust manipulation and dry needling for the diagnosis and treatment of neuromusculoskeletal conditions of the spine and extremities. The American Academy of Manipulative Therapy is dedicated to teaching physical therapists, osteopaths and medical doctors the science and art of thrust manipulation and dry needling. The Diploma in Osteopracticâ„¢ is a 12 to 18 months post-graduate training program and is only awarded to licensed physical therapists, medical doctors, or osteopaths that have successfully:

Certified in Dry Needling
Certified in Spinal Manipulative Therapy
Completed the Extremity Manipulative Therapy
Completed the Instrumented-Assisted Soft-Tissue Mobilization
Completed the Differential Diagnosis & Multi-Model Management
Balance, Dizziness, and Vertigo Rehabilitation - Many suffer from dizziness or BPPV (benign paroxysmal positional vertigo). Some clinics specialize in the rehabilitation of patients with vertigo. Patient education, strengthening, safety awareness, posture and balance exercise, walking exercise, and special techniques that affect sensory and balance centers of the brain and limbs are all important components of a rehabilitation program.

Geriatric Physical Therapy - Some therapists specialize in the rehabilitation of seniors. As the body ages, a variety of challenges arise. We stiffen, we lose strength, our balance skills decline, our bones become brittle (osteoporosis), our endurance decreases, and we take longer to recover from injuries. Balance and fall prevention are of paramount importance to the therapist who is working with seniors and some clinics are solely dedicated to caring for those with balance problems. Most physical therapists work with seniors/geriatric patients. Some have obtained additional education, have passed a board examination, and have earned the Geriatric Certified Specialist (GCS) title.

Lymphedema Rehabilitation - We take it for granted but a special component of the circulatory system, the lymph system, helps filter and drain fluid from our arms and legs. When this drainage system is damaged, painful swelling can result. Some therapists specialize in the treatment of lymphedema as it is called. Special positioning, massage and bandaging techniques are utilized by the lymphedema specialist.

Osteoporosis Rehabilitation and Prevention - Some practitioners specialize in the evaluation and treatment of osteoporosis patients. Working in concert with your medical doctor, the therapist will often design a specialized weight-bearing and resistance training program for those with this silent disease.

Fitness and Wellness - Physical therapists are well trained to help with your fitness needs and wellness programs. If you need an exercise program, have trouble with your weight, are concerned about osteoporosis, have an issue with diabetes, or you would like to learn how to prevent falls, physical therapists can help. The previous examples are just a few of the many programs physical therapists offer.

Women's Health - Some therapists specialize in women's issues such as pregnancy problems, pelvic pain, and incontinence. Special treatment is available for women who have these problems. Many that suffer from incontinence do so needlessly. A physical therapist may be able to help.

Industrial Rehabilitation - Specialists in industrial rehabilitation help with those that have suffered on-the-job injuries. Moreover, they will evaluate work tasks, fabricate assistive devices, evaluate your ergonomic situation, and help redesign work flow/tasks to decrease the incidence of injury. Often, industrial rehabilitation specialists will evaluate your ability to perform certain job tasks with a Functional Capacity Evaluation (FCE).

Pediatric Physical Therapy - Pediatric therapists specialize in the rehabilitation of children. They may assist with kids who suffer from cerebral palsy, developmental disorders, neurological disorders, and/or orthopedic problems. A Pediatric Certified Specialist (PCS) is a board certification that some may obtain from the American Physical Therapy Association.

Cardiac and Pulmonary Rehabilitation - A small percentage of physical therapists practice in this discipline. Those that pass the board certification have the title of Cardiovascular and Pulmonary Certified Specialist (CCS) work with patients who have had heart attacks, bypass surgeries, angioplasty, breathing problems, emphysema, and other heart/lung related conditions. Physical therapists are well equipped to work with these types of patients because many of them have orthopedic ailments that limit their ability to function. In other words, a physical therapist can address the heart and lung problems as well as the muscle problems that are concurrently present.

Neurological, Spinal Cord Injury, and Traumatic Brain Injury Rehab - A large portion of physical therapists work with patients who suffer from these conditions. Functional retraining including, walking, wheelchair use, getting in and out of bed or chairs (transfer training), moving in bed (bed mobility), and retraining patients to use their shoulders, arms, and hands are just some of the services these therapists provide to those with neurological involvement. A certified specialist holds a Neurologic Certified Specialist title (NCS).

Amputee Rehabilitation - many physical therapists specialize in the rehabilitation of amputees. Caring for the injured limb, functional and walking training, training in the use of assistive devices (crutches, canes, prosthetic limbs, etc.) are all provided by a therapist who specializes in care for amputees.

Wound Care - Some therapists specialize in the treatment and care of wounds. This is accomplished by the removal of unviable tissue (debridement), the application of special dressings and prescription drugs/ointments, and the use of ultrasound, electrical stimulation, and aquatic modalities to promote healing. Exercise and patient education are also routine components of a wound care program.

ECS (Clinical Electrophysiologic Certified Specialist) - A physical therapist who is board certified to perform electroneurophysiology examinations such as nerve conduction studies and electromyography.

Is physical therapy painful?

For many patients, one of the primary objectives is pain relief. This is frequently accomplished with hands-on manual techniques, modalities such as ultrasound, electrical stimulation, and/or heat or cold therapy. Movement often provides pain relief as well. Your physical therapist will provide you with the appropriate exercises not only for pain relief but to recover range of motion, strength, and endurance.

In some cases, physical therapy techniques can be painful. For example, recovering knee range of motion after total knee replacement or shoulder range of motion after shoulder surgery may be painful. Your physical therapist will utilize a variety of techniques to help maximize your treatment goals. It is important that you communicate the intensity, frequency, and duration of pain to your therapist. With this information, your therapist will be able to easily adjust your treatment plan.

What types of treatments will I receive?

There are numerous types of treatment interventions. Please see our Specialty Services page for more detail.

Will I get a massage at physical therapy?

Massage may be part of your treatment, if indicated. Our Physical Therapists are trained in a variety of techniques that may help with your recovery. Deep tissue techniques may be part of the rehabilitative process. Massage is used for three reasons typically - to facilitate venous return from a swollen area, to relax a tight muscle, or to relieve pain. Contrary to common thought, massage does not increase circulation.

What happens if my problem or pain returns?

Flare ups are not uncommon. If you have a flare up (exacerbation), please give us a call. We may suggest you come back to see us, return to your doctor, or simply modify your daily activities or exercise routine.

Can I go to any physical therapy clinic?

Yes, you have the right to choose any physical therapy clinic. Our practice is a provider for many different insurance plans.
The best thing to do is give us a call and we will attempt to answer all of your questions.

Can I go directly to my physical therapist?

All fifty states have some form of direct access. In most cases, if you are not making significant improvement within 30 days, the therapist will refer you to/back to your physician.
Seeing a physical therapist first is safe and could save you hundreds of dollars or even thousands of dollars.

Can my therapist provide me with a diagnosis?

In most states, physical therapists cannot make a medical diagnosis. This is something that your medical doctor will provide for you.
Physical therapists are important members of your medical team. At this point in time, physicians are typically the health care providers that will provide you with a medical diagnosis.

How does the billing process work?

Billing for physical therapy services is similar to what happens at your doctor's office. When you are seen for treatment, the following occurs:
1. 360 Physical Therapy will bill your insurance company, Workers' Comp, or charges you based on Common Procedure Terminology (CPT) codes.
2. Those codes are transferred to a billing form that is either mailed or electronically communicated to the payer.
3. The payer processes this information and makes payments according to an agreed upon fee schedule.
4. An Explanation of Benefits (EOB) is generated and sent to the patient and the physical therapy clinic with a check for payment and a balance due by the patient.
5. The patient is expected to make the payment on the balance if any.
It is important to understand that there are many small steps (beyond the outline provided above) within the process. Exceptions are common to the above example as well. At any time along the way, information may be missing, miscommunicated, or misunderstood. This can delay the payment process. While it is common for the payment process to be completed in 60 days or less, it is not uncommon for the physical therapy clinic to receive payment as long as six months after the treatment date.

What will I have to do after physical therapy?

Some patients will need to continue with home exercises. Some may choose to continue with 360 Physical Therapy's Wellness After Therapy Program. It is our independent gym exercise program that they can use to continue with their program long term. Others will complete their rehabilitation and return to normal daily activities. It is important that you communicate your goals to your therapist, so he/she can develop a custom program for you.

Is my therapist licensed?

Our Physical therapists (PTs) and physical therapist assistants (PTAs) are licensed by the state of Arizona or Oklahoma.

How do I choose a physical therapy clinic?

These are some things you may consider when seeking a physical therapist:
The therapist should be licensed in Arizona and Oklahoma.
How many years of experience does the therapist have.
Ask your family and friends who they would recommend.
Does the therapist have a specialty or post-graduate certifications?
Can you briefly interview the therapist before the first visit?
Demographic convenience. They should be conveniently located, since sitting and driving often aggravate orthopedic problems.
Do they have a service that can address your problem?
Who does your referring physician recommend?
Do they take your insurance or are they willing to work with you if they are not a preferred provider?
What are the hours of operation?