PhysicalTherapy & Chiropractor News

physical Therapy Queens: Preparing For Orthopedic Surgery

Prehab - The Role of Exercise Before Surgery

If you or someone you know is preparing for an upcoming surgery, the information you are about to read will be very useful. Most individuals are familiar with the thought of rehabilitation after surgery, but the idea of pre-surgical rehabilitation is gaining recognition.

Often, there is a period of waiting involved prior to any surgery. This time is valuable, and it can be utilized to prepare the body for surgery and facilitate a better outcome after the surgical intervention. When muscles, bones and joints are in optimum condition before the procedure, the impact of the inevitable muscle loss and joint stiffness is minimized post operatively. Essentially, the stronger a person is going into surgery, the better the chances of an easier and faster recovery after the surgery.

Individuals who participate in a pre-surgical rehabilitation program tend to regain function and return to their daily lives faster than individuals who do not participate in pre-surgical rehabilitation. Traditionally, a physical therapist helps with post-surgical rehabilitation, but you may be surprised to learn that the therapist can also be your biggest ally during the ‘pre-hab’ process.

Pre-Surgical Rehabilitation 101
It is common for the region that is about to be operated on to be inflamed and weak. With a carefully planned exercise routine, a physical therapist can help reduce inflammation and improve blood circulation to the affected area. This improves mobility and helps with pain relief. This also helps promote correct movement patterns and minimize compensatory movements like leaning and uneven weight bearing.

Improving health and fitness, and being in optimal physical health can go a long way towards the facilitation of post-operative recovery.

These are some simple guidelines to follow with a pre-surgical rehabilitation program:

Start the program at least six weeks prior to the surgery.
Start slowly. This is not the time to aggravate an existing issue or trigger a new one.
If you are physically fit, consider increasing your intensity, frequency, or duration as long as it doesn’t interfere with your current injury.
Yoga is an excellent way to prepare both the mind and body for surgery. The combination of relaxation and soothing movements can be beneficial before and after surgery.
One of the requirements for post-surgical discharge is that a patient is able to complete certain activities. Your physical therapist will collaborate with the surgeon to design your goals and establish benchmarks for recovery. For example, you may be expected to walk a certain number of steps or climb stairs before you are allowed to go home. Once this pre-requisite is met, you can start a home exercise program. Patients who are physically prepared for surgery can leave the hospital sooner and are likely to suffer fewer complications.

Physical Therapy and Pre-hab
A consultation with your physical therapist will involve an evaluation to determine:

Muscle and joint strength
Ability to move and perform day-to-day tasks (climbing stairs, getting in and out of bed)
Degree of assistance required from friends and family members
By working with a physical therapist prior to surgery and creating a pre-surgery rehabilitation plan, you will create a strong foundation for rapid recovery. Similar to the post-surgical collaboration, you can expect your physical therapist to work closely with your doctors to facilitate recovery even before you have surgery.

The physical therapist will help you familiarize yourself with walking aides and other supportive devices like crutches, walkers, or canes should they be needed. You will discover the importance of breathing, proper techniques and range of motion of important exercises that you’ll be doing after the surgery. This will reduce the stress and apprehension associated with discharge and facilitate independence. As your physical therapists, we are committed to keeping you as healthy as possible. If you or someone you know is considering surgery, schedule a consultation with us. ‘Pre-hab’ is a great way to speed up rehab and we are here to help you every step of the way.

Phone:718-520-8480 
Web:http://www.ForestHillsRehab.com

(Source: ForestHillsRehab.com)

Physical Therapy Queens: Headaches

Everything You (Didn’t) Know About Headaches

The common response to a headache is “Let me pop a painkiller and hope the pain goes away”. While this isn’t necessarily a bad idea, it’s not a long-term solution for headaches, particularly the ones that that have a musculoskeletal origin.

Most patients are unaware that physical therapy can play an important role in the treatment of headaches. Did you know that a physical therapist can evaluate symptoms and create a plan to reduce headache by restoring muscle balance? With certain types of headache, this has the potential to reduce or even eliminate the need for medication. For example, did you know that strengthening of the muscles surrounding the neck and jaw helps in the treatment of headache? It’s true; physical therapy can restore balance and relieve strain on muscles and joints in the head and neck region.

After a complete evaluation, the physical therapist may decide to use manual therapy, which includes joint mobilizations and massage to provide welcome relief to overworked tissues. The result is relief from the pain of headache and a smile on your face.

A migraine is a severe headache that may require medical attention. It is a disorder of the central nervous system involving blood vessels and nerves, resulting in intense pain. Once the cause of the migraine has been identified and treated by a physician, a physical therapist can facilitate a quick recovery to help the patient resume a normal, healthy life.

Pain Relief at the Source
One of the objectives of physical therapy intervention is adjustment of soft tissues and correction of mechanical dysfunction associated with the headache. There are several ways that a physical therapist can help achieve this. If sensitive tissues (blood vessels, nerves) in the neck are compressed, the physical therapist can use mechanical or manual traction procedures to facilitate decompression, improve circulation and relieve pressure around the affected tissues.

The prescription of a home exercise program to improve posture and movement patterns can be another part of the treatment process. Unknown to most patients, poor posture contributes to head and neck pain.

Depending on the severity of your headache, physical therapy can be a valuable adjunct to medications prescribed by a physician. While medications help control the pain of headache, a regimen of physical therapy improves the body’s inherent ability to fight factors that trigger headaches.

Physical Therapy and Referred Pain

One of the causes of headache is referred pain (from other parts of the body). When the muscles and joints in the upper back, neck and shoulder are under stress, they become inflamed and cause pain. Due to the complex and interconnected network of nerves and blood vessels in the upper body, this pain often spreads upwards, triggering a headache or a debilitating migraine.

This is exactly where a physical therapist can help. With a precise combination of exercises, manual therapy and relaxation techniques, the therapist can facilitate pain relief. If you’ve been suffering from headaches, a viable, drug free option is available to you. You don’t have to live with pain any longer because physical therapy is a viable, scientific treatment option. Just call us and we’ll get you started. We’ll do everything we can to put that smile back on your face.

http://www.ForestHillsRehab.com

Physical Therapy & Chiropractic Forest Hills: Arthritis

Aquatic Exercises for Osteoarthritis
Osteoarthritis is a common joint disorder. It is a normal result of aging and regular wear and tear on the joints. Weight gain is also a contributing factor.

The bony surfaces at the joints are protected by a rubbery tissue called ‘cartilage’. When the cartilage starts to break down, the bones begin to rub against each other causing swelling, stiffness, and pain. These symptoms begin to appear as one grows older and are often triggered by weight bearing activities (walking, climbing stairs). Past injuries or fractures can also trigger degenerative changes that result in osteoarthritis.

Physical therapy management of individuals suffering from osteoarthritis emphasizes three key areas: exercise, pain relief and specific manual therapy techniques. A combination of these three approaches can alleviate the pain and discomfort caused by this chronic condition.

Aquatic or Land-based Exercise?
Exercise is a crucial part of the plan to improve the quality of life for individuals with osteoarthritis. In an effort to determine the effectiveness of exercise for pain relief, both water-based exercise and land-based exercises have been compared.

Both types of exercise are beneficial and help to reduce pain and improve function. The soothing medium of water tends to promote relaxation and is a comfortable environment for muscle strengthening and joint mobility.

Regular exercise, whether it is aquatic or land based, helps reduce joint pain and increase muscle strength. Also, weight loss (which can occur as a result of regular exercise) will decrease pressure on joints and contribute to pain relief. Exercise contributes to a feeling of well-being and reduces the health risks associated with a sedentary lifestyle.

In situations where a pool is not available, land-based exercise is an effective solution. Both types of exercise work well and your physical therapist will help you choose what’s best for you given your condition, comfort level and goals.

Benefits of Aquatic Exercises

If you are suffering from pain and discomfort related to osteoarthritis, water is an excellent medium for a safe and soothing exercise program that can reduce pain during and after exercising.

Your physical therapist can provide you with a customized exercise program to help you manage the pain and discomfort associated with osteoarthritis, and the therapist may recommend aquatic exercise. Exercise performed in water allows the muscles to be challenged by water resistance, and also minimizes the weight bearing strain on the joints due to the effect of buoyancy.

With a little assistance from your physical therapist, you can live pain free and increase your mobility. All you have to do is to make an appointment today. Aging doesn’t mean you have to stop being active. Don’t allow painful joints to restrict your lifestyle. Chances are, we can help you. Call us today and start enjoying the benefits of exercise under the supervision of your physical therapist.

View this video Newsletter - http://www.foresthillsrehab.com/Newsletter/physicaltherapy_newsletter.html

(Source: ForestHillsRehab.com)

Physical Therapy Forest Hills Post: Insurance

In network versus out of Network Insurance

What does “in network” and “out of network” insurance mean when talking about visiting your physical therapist?

In network means that your physical therapist has agreed to accept a reduced rate for services from your insurance company. It also means that the provider will follow any necessary guidelines created by the insurance company such as getting pre-authorization for care, or limiting your care to a certain number of visits, or services.

Out of network generally means that the physical therapist does not accept the reduced rate, and restrictive guidelines imposed by the insurance carrier.

So which is better?

Well there’s no simple answer to this, because there are a lot of variables to consider. Each situation must be examined case by case, but let’s take a look at a few scenarios.

In network plans are most commonly associated with a copayment for each visit. This means that the patient will pay a set fee each visit, no matter how many services are provided for that visit. (This is not always the case, but it is the most common).

When talking about physical therapy, it is also quite common to require “preauthorization” for treatment. What this means is that you will need to visit your physical therapist for an examination, and pay a copayment for this service. The physical therapist would then have to submit the exam findings to the insurance carrier in attempt to get authorized for a certain number of sessions which may take a few days.

It is important to note that even if authorization is granted, the insurance carrier is not guaranteeing payment for these services and may still reject the claim for any number of reasons. The authorization simply states the most the insurance carrier will pay for a certain case.

The authorization is often limited to only a few sessions over a short period of time, and “by code” or individual service, such as one unit (8 minutes is the threshold) of exercise or manual therapy for example.

So, in this case, the insurance company would authorize 8 minutes of exercise per session, for which the patient would pay a set copayment.

Look at a few specifics:

GHI in network allows a maximum of 16 physical therapy visits per calendar year, before requiring pre-authorization. GHI will pay a Maximum of $27 each visit minus the copay (example if you have a $20 copay, GHI will pay $7 maximum per session). GHI will not pay anything past the first code which is met at 8 minutes.

Most other carriers like Blue Cross, Aetna, Oxford for example will require some type of preauthorization after the initial exam, carry a set copay, and limit to a maximum payment of one code per session as well (8 minutes). These carriers generally also require ongoing authorizations at least every 30 days. (some plans vary, but this is a very common scenario).

In each of this situations, the physical therapist is not going to get paid past the first 8 minutes of therapy.

I don’t know of too many conditions that a patient would consult a physical therapist for that would respond well to 8 minutes of care.

So in-network may provide a slightly lower out of pocket cost for the patient in the short term, but may likely result in very limited care. Over a longer care plan, or more involved case, a patient may find it more beneficial to use out of network benefits.

Out of network plans work differently.

Typically if your insurance carrier offers out of network coverage, you can use any physical therapist you like and do not have to follow all of the restrictive guidelines of in network (although even this is changing).

With out of network plans, you will typically have a deductible (which varies widely plan to plan). The patient will pay for each visit out of pocket, and this amount paid will be applied to the deductible until the deductible is met. For ease of calculation, assume a $1000 deductible, and a visit to the physical therapist is $100. The patient will pay the physical therapist $100 each session for 10 sessions.

After the deductible is met, the insurance carrier will often cover a percentage of the physical therapy bill, typically 70% or 80%. This means the patient is responsible for the remaining percentage. In the above case of a $100 per visit cost, and 80%/20% coverage, the patient would pay $20 each session (20% of $100) after the deductible is met.

However, the physical therapist would not likely need to get preauthorization for the first visit, so the patient would be able to receive treatment that day.

Additionally, the physical therapist would not be limited to a set number of codes per session, and would often not be limited to a set number of sessions.

Let’s take a look at a more detailed example.

Assume the physical therapist’s fee is $100 per session, during which time he/she will provide electric stimulation with hot pack, manual therapy and therapeutic exercise. The patient’s condition requires 24 visits.

The in network copayment is $30 (common) and the out of network benefit is 80/20 with $1000 deductible.

In network authorizes 10 visits. In this case the patient will be allowed 10, 8-minute sessions (hot pack for example) for $300. The next 14 would be paid out of pocket (since not authorized) for an additional cost of $1400 (14 X $100). Total cost: $1700

If the patient utilized the out of network benefits, he/she would likely be able to receive full treatment day one, and therefore likely finish the care plan sooner. This patient would pay $1000 for the first 10 sessions, then $280 for the next 14 ($20 X 14). Total cost: $1280.

In this case the out of network is not only less expensive, but would allow significantly more comprehensive treatment that the in-network plan.

Although this is not always the case, the patient with out of network insurance will often find that they will be able to receive more care, at a similar cost to the in network benefit when it comes to physical therapy especially for more involved cases, and cases requiring longer term care.

It is important to discuss your benefits with your physical therapy billing specialist and compare the long term costs of in versus out of network before beginning a physical therapy program.

For more information about your specific insurance benefits give us a call today at (888) 595-7282. We will be happy to verify and discuss your insurance benefits prior to starting care.

Forest Hills Rehabilitation
108-14 72nd Ave, 4th Flr
Forest Hills NY 11375
(888) 595-7282
(718) 520-8480

http://www.ForestHillsRehab.com

Physical Therapy Forest Hills: Get the Most From Your Physical Therapy

How To Get The Most From Your Physical Therapy Appointments

An appointment with a physical therapist is an excellent step towards improved function and injury prevention. To make the best use of your time, please use the following guidelines:

Wear comfortable clothes. Jeans or long sleeves are not advisable during your initial evaluation since the therapist may need to evaluate your joint stability.
Make sure to arrive on time or a few minutes prior to your appointment in case you need to fill out some forms.
Elaborate on the things you are unable to do, or the level of function you would like to achieve with the physical therapist. This will help the therapist to serve you as effectively as possible.
Provide information about when the pain started, the nature of pain (sharp or dull), what caused it, and what aggravates it.
Remember that you and your physical therapist are part of a team with a common goal - to get you better as quickly as possible. Do your home exercise program exactly as instructed and try not to miss any appointments in an effort to reach that goal.

Preparing for Physical Therapy
When you visit a physical therapist for the first time, we understand that you may not know what to expect. Here are some things to consider before you seek physical therapy:

Ask your physician about your condition and if physical therapy is right for you.
Talk to your friends and ask if they have worked with a physical therapist and what their experience was.
If you have health insurance, contact your provider and educate yourself about your benefits and physical therapy coverage.
Become familiar with your medical history and medications and discuss them with your physical therapist during the first appointment.
If possible, try and define your goal. Ask yourself what you want to accomplish and share them with your therapist.
Remember, a physical therapist is an expert on strength and mobility so if you have any questions related to aches and pains, it’s likely that your physical therapist may be able to assist you quickly and effectively.

Physical Therapy Instead of Surgery?

There are several conditions in which physical therapy is a good treatment option, and knee osteoarthritis is one of them. Individuals who experience knee osteoarthritis respond well to physical therapy, especially in the early stages. A well planned physical therapy program has been shown to improve the body’s ability to function by improving strength and coordination. This may reduce the need for surgery.

The President of the American Physical Therapy Association, Scott Ward, PT, PhD has said, “Physical therapy is effective and should be considered not only by patients themselves, but also the primary care doctors and orthopedists that are treating them.”

Physical therapists recognize and correct abnormal movement patterns, and create a comprehensive treatment approach each patient.

This was just one example of what physical therapy can do for you. For more information on how we can help treat bones and joints (and improve wellness), please contact us. We’ll answer any questions you have about what physical therapy can do for you, and if you need to come in, we’ll see you as quickly as possible.

If you or someone you know is considering surgery, ask your physician if physical therapy is right for you. In some cases, physical therapy can indeed be a viable alternative to surgery.

Forest Hills Rehabilitation
108-14 72nd Ave, 4th Flr
Forest Hills NY 11375
(888) 595-7282

(Source: ForestHillsRehab.com)

Physical Therapy & Chiropractic Forest Hills: Neck Pain

Health Update: Neck Pain

What Is This Pain in My Neck!

“When I woke up this morning, I couldn’t move my neck! Every time I try to move it, I feel sharp pain on the left side of the neck shooting down into the shoulder blade. It just came out of nowhere!”

Chances are, you are suffering from a common condition called torticollis, which literally means, “twisted neck” after the Latin terms of “torti” (twisted) and “collis” (neck). The common name for this is “wry neck,” and it’s basically a painful muscle spasm, like a “Charlie-horse” but located in the neck muscles. Usually, a person wakes up in the morning with this and the cause is often related to sleeping with the window being open or a fan or air conditioner blowing on you. It can also relate to a “cold settling in the muscle” after a cold or flu virus. Trauma such as falling or a car accident can also cause torticollis. However, most of the time, patients with torticollis are not sure what caused the abrupt onset of symptoms.

Usually, torticollis will gradually improve over a 2 week time frame. However, it only takes a few days to a week (at the most) if you receive chiropractic adjustments. Most importantly, without treatments, the sharp pain can last a week and can severely limit your activity, often prohibiting work as well as your desired “fun” activities. Hence, most people prefer having this treated as opposed to “waiting it out.” In some cases, it can last longer than a month and in rare cases even longer, so getting this treated is highly recommended. Also, try to get in for a treatment immediately before the muscle spasm really sets up. We find this to be the most effective approach. Here are a list of symptoms and treatment suggestions for torticollis:

Acute Torticollis Symptoms
Muscle spasms
Neck and shoulder pain
Neck and spine contortion (neck twisted to right or left side of body)

Pain Relief Treatments for Acute Torticollis
Chiropractic neck and spinal adjustment
Physical Therapy
Stretching
Analgesics
Heat packs
Muscle relaxants
Rubs and ointments (Icy Hot, BioFreeze)
Massage with essential oils

courtesy: Forest Hills Rehabilitation
http://www.ForestHillsRehab.com

Physical Therapy & Chiropractic Forest Hills: Keep Your Bones Strong

Forest Hills Rehabilitation: Keep Your Bones Strong

A healthy skeletal system is important for several reasons. Bones have several functions in the body. These include the protection of organs, structural integrity and calcium storage. Bones also serve as anchors for muscles.

As one grows older, the ability to build bone is decreased. Staying healthy and starting early are ways to keep your bones in good shape. Bone health is affected by the following factors:

Race, body frame and family history.
Hormone levels, including thyroid hormone.
Physical activity levels.
The amount of calcium in your diet. Low calcium contributes to early bone loss, diminished bone density, and increased risk of fractures.
Gender - Women tend to have less bone mass compared to men.
Men with low testosterone levels can experience a decrease in bone mass.
Excessive alcohol consumption and tobacco use.
Eating disorders and other diseases. People who have bulimia or anorexia are at risk for bone loss.
Age: As you age, your bones become thinner and weaker .
Use of certain medications are damaging to the bones.

The Healthy Bone Formula
To keep your bones healthy, start as soon as possible. Here are some guidelines to help keep your bones healthy.

Eat high-calcium foods. Dairy products such as milk, cheese, and yogurt are good sources of calcium.
Consume plenty of vitamin D.
Avoid excess protein and sodium.
Avoid smoking and limit alcoholic intake.
Bone-boosting medications may be an option, after consulting with your physician.
Women may consider hormone therapy. Estrogen, especially when started soon after menopause, can help maintain bone density, and this should be discussed with a physician.
Exercise daily.
When exercising, change your routine often to surprise your body and challenge your bones.
Play sports and spend time outdoors. Challenge your body with movements that provide the impact necessary for bone stimulation.

Physical Therapy and Bone Health

Orthopedics is a branch of medicine that mainly focuses on the muscular and skeletal systems. Physical therapy in this field deals with diagnosing, managing and treating injuries in the muscular and skeletal system and the associated rehabilitation.

A physical therapist specializes in the treatment of bone-related conditions (fractures) and joint injuries, among other conditions.

Strength training, joint mobilizations, hot or cold packs, and electrical stimulation are some techniques used by physical therapists. Other methods include:

Stretching and strengthening exercise protocols to encourage muscle balance during recovery.
Hot and cold therapy to increase blood circulation and assist with healing.
Ultrasound machines: The use of high or low frequency sound waves to facilitate healing.
With a unique training background and the right set of skills to help you strengthen your bones and joints, a physical therapist is best suited to help you recover from injuries and strengthen your bones at the same time.

Call us today - taking the time to strengthen your bones is one of the best decisions you’ll ever make to improve your health, and we’ll help you every step of the way.

Forest Hills Rehabilitation
Our Website: http://www.ForestHillsRehab.com

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Physical Therapy & Chiropractic Forest Hills: Stretching

Make Time To Stretch at Work
An eight-hour work day, especially when associated with sitting in one position, can cause muscle tightness. The simple solution is to stretch your body at regular intervals whether you’re at the office, at home, or outdoors. Here are some tips to remember when stretching.

Don’t rush. Start stretching slowly. Do not overstretch.
Breathe normally. Never hold your breath.
When stretching, hold the stretch for about 15 to 20 seconds and feel the tension in your muscles subside as they stretch.
Repeat the same stretch 2 to 3 times to improve your muscle flexibility.
Avoid sudden movements when stretching.
Enjoy stretching. Use the time to relax.
Maintain good posture while stretching.
If you feel any discomfort, pain, tingling, numbness, or loss of strength, stop stretching and contact your physician or physical therapist immediately.
Stretching helps improve blood circulation, release tension, and boost energy. Don’t forget to take a few minutes to stretch every day.

Benefits of Stretching
It’s simple and easy to stretch your muscles. Regular stretching has several benefits including:

Improved circulation. Stretching increases blood flow which brings nourishment to your muscles and gets rid of waste products. This helps reduce recovery time for muscle injuries.
Decreased muscle tension, anxiety, stress, and fatigue.
Increased flexibility and joint range of motion. You feel refreshed and relaxed after you stretch.
Improved exercise performance. Stretching before exercise is a good way to increase the effectiveness of exercise.

A Simple Office Chair Stretch

Working in an office usually means sitting in one area for several hours. This ultimately leads to bad posture and low back pain due to tight hip flexors and shortened hamstrings. You can help prevent these aches and pains by performing the following simple stretches:

Finger and Hand Stretches. Place your hands on your desk, and stretch your hands while spreading your fingers until you feel a stretch. Hold for 10 seconds. Repeat 5 to 10 times.
Wrist Stretches. Sit upright in your office chair. Lift one arm and stretch it out in front of you with your palm facing upward. Gently grab your fingers with your other hand. Slowly pull the hand of your extended arm down. Hold 10 seconds. Repeat 5 to 10 times.
Shoulder Stretches. Lift your right arm and reach behind your head. Place your hand on your upper back making certain your arm is as close to your ear as possible. Use your left hand to gently hold your right elbow while pulling it towards the back of your head. Hold for 15 seconds.
Spine Twist. While sitting upright in your chair, place your left arm behind your left hip. Hold onto your chair as you twist your upper body to the left. Place your right hand onto your chair to increase your stretch. Hold for 10 seconds. Repeat this exercise five times with each side.
For more information on the right stretching techniques for you, please contact your physical therapist, Michael Jocson, PT or Fabricio Rodrigues, PT. We’ll help you restore muscle flexibility by teaching you the right (and wrong) ways to stretch.

Phone: 718-520-8480
Web: http://www.ForestHillsRehab.com