What if I experience pain as a result of exercise/activity?
This is a difficult question to answer as it relates to a perception of one’s symptoms. Your therapist should explain when you should and when you should not feel pain. After certain surgical procedures we attempt to restrict certain motions or activities to avoid over straining of tissues. With the right guidance and supervision however, pain does not mean harm nor does it have to be a sign of tissue damage. It is OK to feel certain types discomfort as you initiate exercise but it should not increase to a level of high pain. Ask your therapist for specifics.
Xcel Physical Therapy has the LARGEST rehabilitation pool in the area. It is 30 ft x 12 foot and includes various depths, spa, handicap chair lift, swim jets, and spa. We use Bromine and a UV light to reduce harmful chemicals. Our pool is 88 degrees and the spa is around 103 degees. Our locker/shower facility is adjacent to the pool so there is no need to walk around with a wet bathing suit. To comply with your doctor’s orders and your needs our therapists will instruct specific exercises for you to do.
What about the theory: NO PAIN, NO GAIN?
This theory does not work. There is an appropriate amount of discomfort to be experienced in many techniques. Certain surgical procedures such as the standard Knee Replacement are very stable and can endure more tensile strain from manual procedures than others such as a Rotator Cuff or Anterior Cruciate Reconstruction and as a result one may experience some degree of knee pain in a replacement whereas the amount of pain in a rotator cuff or ACL surgery should be less with intervention. In general though, improvement is not correlated with pain.
After therapy I was sore and flared up, should I stay home to rest or see my physician?
The definition of a flare up is a functional decline with or without symptom exacerbation. It implies that you can not stand as long or raise your arm up as high. Soreness or increased pain is not a flare up and is expected upon resumption of activities or doing a new exercise. If there are signs of inflammation, infection, instability, or substantial rise in pain then you should follow-up with your therapist to see if a physician referral would be appropriate.
How often should I do my exercises at home?
As a general rule of thumb, most resistance or strength exercises performed in the physical therapy field can be performed 1-3 times daily. For those training at a much higher intensity and resistance such as bodybuilders or weight-lifters you should allow at least 1 rest day before retraining that segment. Exercises geared toward flexibility or range of motion should be performed several times per day. In either case you may count the exercises performed at therapy as one of your repetitions.
Should I take my pain medications before coming to physical therapy?
This question is best left up to you, your pharmacist, and your doctor. It is thought that pain meds taken before PT can assist with gaining mobility and tolerances to new activities. If you decide to take the medications it is unlikely that the medications prescribed to you will mask all of your pain and result in further trauma due to overstretching. One must consider if they are driving to/from therapy, their level of alertness and ability to actively exercise, and the timing and dosages of those medications with others they are taking.
When should I ice and when should I use heat?
Still another difficult question. Ice is thought to decrease or eliminate swelling and generally used early after surgery or injury. The truth is that ice reduces blood flow to the site thereby reducing the potential for swelling. Heat on the other hand is thought to loosen things up. Heat causes more blood to flow to the area and potentially can cause more swelling to occur and as a result is suggested not to use for 2-3 days after the injury. The answer is that everyone responds differently and tolerates these temperatures much differently. In general Ice is recommended for migraines, pain originating from nervous tissue, short term for new injuries, and after an activity that slightly caused more pain. Heat should be used on older injuries, over tight muscles, and in cases where relaxation is more beneficial.
After surgery or injury we recommend Ice for 3-5 days after that Ice will not reduce residual swelling and so it is patient and therapist opinion as to what modality to use. One suggestion is to try a combination of both after the first 3-5 days such as 2 minutes of heat, followed by 3 minutes of cold, then 2 minutes of heat, and so on up to 20 minutes.
Residual swelling is eliminated by a combination of compression, elevation, active exercise, medication, massage, blood flow. Over-activity or additional stress such as exercise can add to swelling an may mediate an additional few days of ice.
How do I get an appointment?
Easy question, simply get a referral (prescription) from your family doctor, surgeon, specialist, physician assistant, dentist, or podiatrist and call our office at 231-238-2302 OR 238-4090. Our state laws do not allow chiropractors or nurses to refer patients to us at this time. We will do our best get you in for an evaluation within 2 business days.
What should I bring with me to my first visit?
Please bring your physician referral, insurance card, any claim numbers or other appropriate billing information, any paperwork filled out at home, and personal identification. You may wish to bring a copy of your medications, diagnostic reports, or medical history. In addition please wear clothes that will allow access to your injured site. Feel free to bring glasses, walkers, canes, tennis shoes, etc if you would like to use them.
What is an FCE and how do I get one?
An FCE is a Functional Capacity Examination. It is a tool used to determine
- your tolerance or ability to work,
- potential to work or return to work,
- what you could safely do as an employee.
The test is used by lawyers, physicians, employers, and claims specialists to accurately describe your abilities. The test is generally 3-6 hours and difficult to perform, often accompanied with some degree of soreness. This office has been trained and certified in performing FCE’s using the standardized test by ErgoScience called Physical Work Performance Test.
Are all therapists trained the same?
No! All therapists must be licensed or regulated by their state and as such have a minimum competency. Physical Therapists graduating by 2020 will be required to obtain a doctorate degree. Occasionally, therapists receive additional training or schooling in a variety of sub-specialties. Some of those have residency programs while others just require you to take a test. Many therapists tend to specialize in 1 or more areas depending on their niche or abilities. Mr. Kolly has set himself apart by obtaining:
- a Bachelors Degree and certification in Athletic Training and Sports Medicine;
- two Master’s Degrees (one in Athletic Training and another in Physical Therapy);
- a Doctorate Degree in Physical Therapy;
- a post professional collegiate degree in Orthopedic Manual Physical Therapy;
- board certification as an Orthopaedic Clinical Specialist; and
- several continuing education classes.
With that said, Ben has chosen a confident staff of other Physical Therapists, Certified Athletic Trainers, and Personal Trainers that have joined our team. These clinicians have various interests, certifications, degrees, and continuing education that compliment Ben’s skills and improve your experience at Xcel Physical Therapy. Some of these skills include:women’s health, kinesiotaping, functional training, core training to name just a few.
What should I expect during my initial visit?
As always we have some paperwork which needs to be filled out. You should be able to stop in or download most of this paperwork ahead of time. Our therapist will have a consultation with you, examine you condition, and propose an initial treatment plan. You will have the opportunity to ask any questions you like and will be educated in the risks and benefits of the proposed modalities.
What should I wear?
We have private changing areas available if you do not want to arrive in your “therapy” clothes. Our therapists will need to thoroughly examine the body parts they are treating. Therefore you may need shorts, sweats, sports bras, tank tops, etc. that can unveil specific body parts being treated. Please dress comfortably and know that we only need to expose a small part of your body.
How long is each visit?
Your visit will typically last 30 to 60 minutes. After your first visit, your therapist will be able to better suggest a treatment time based on tolerances to new exercises, your physical problem, transportation issues, etc.
What is my responsibility in physical therapy?
Typically patients are seen for up to 3 hours per week in physical therapy where they can be continually evaluated and progressed with exercises and manual therapies. Unfortunately this is not enough as there is 168 hours per week. Thus we are assisting with your progress or goals for less than 2% of your week. I relate this to any other lifestyle or medical change. You would not successfully lose weight if you only dieted 2% of the week nor would you be able to quit smoking through meditation for 2% of the week or even lower your blood pressure by taking a medication that is effective 2% of the week. Ultimately, it comes down to you. We provide you with the tools but you have to make a good effort individually at home. You also have to want to make a change in your posture, habits, body mechanics, pain control, etc. We will be glad to help you through this but definitely need your 100% commitment and cooperation.
Who chooses which physical therapist I go to?
Ultimately, the decision as to where you receive your Physical Therapy is up to you. Occasionally, your physician will recommend a facility or provide a listing of physical therapy clinics in your area. It is recommended that you tour the facilities, speak with the therapists, and look at their credentials as well as their availability. Choose which facility works for you and which can provide the quality of care you deserve.
Why choose us?
For many reasons:
- We believe that we have the most experienced, trained, and educated therapists in Northern Michigan and pride ourselves in offering great continuing education policies for our staff.
- The owner resides in Indian River, unlike the other facilities, so your money stays in town.
- Our facility offers state of the art equipment and easy access parking.
- We value quality of care and customer satisfaction greater than quantity of services or high billing.
- Your therapist treats you everyday and does not pass your treatment on to unlicensed or non-certified staff.
- Xcel Physical Therapy is invested in this area and promises to offer community services as the business grows.
Will you let my doctor know how I am doing?
We are required to send to your doctor a copy of our initial findings at which point he/she will authorize treatments for this. We typically re-evaluate your progress every thirty days and at that time will also provide your doctor with a copy. If you are scheduled to see the doctor we would like to provide him/her with a brief update so we would appreciate advanced knowledge. Otherwise, if you are progressing as expected and there is nothing alarming or out of the ordinary we will not bother them.
How much does my insurance cover? What will it cost?
This is by far the most difficult question. Insurances typically cover Physical Therapy but your specific plan will have deductibles and co-payments that must be met. Generally
- Traditional insurances such as BCBS, Aetna, and Priority Health have co-payments or deductibles for which you are responsible for,
- Medicare typically covers 80% of costs and a secondary insurance (if you have one) picks up the remaining. However, Medicare Advantage and Medicare Plus Blue often have a patient responsibility of 20%
Often time there are limits to the number of treatments or number of consecutive days you can attend. Insurance companies will typically reimburse us if you are progressing, the service is medically necessary, and the clinician appropriately documents and codes correctly for these services. I would recommend that you call the number on the back of your insurance card to find out what is covered and to what extent if you have any questions or concerns.
We are reimbursed for not only what we do duing each session but how long we perfom those services. Unlike a physician visit which may just be an office call we may charge your insurance company for 2 or 3 or more things in one session (this overall charge is likely less than what your physician makes). I tell you this because I can not tell you what you may owe as we may charge differently on different treatment sessions. Further, your insurance will “adjust” this charge to what they call customary and reasonable and we can only collect from thei adjusted rate.
For those on a very tight budget, where insurance does not pick up the entire amount, there are alternatives; please contact our office.
PT: Physical Therapist
MPT: Masters in Physical Therapy
DPT: Doctorate Physical Therapist
OT: Occupational Therapist
OTR: Occupational Therapist, Registered
ATC: Athletic Trainer, Certified
OCS: Orthopaedic Clinical Specialist (Physical Therapist)
OMPT: Orthopaedic Manual Physical Therapist
Board certification promotes the highest level of enhanced diagnostic skills and specialty care for individuals seeking physical therapy. They have demonstrated specialized knowledge in their specialty (orhopaedics) and advanced clinical proficiency. (Reproduced from APTA Board of Specialties, 2010)