Physical therapy is a healthcare specialty that includes the evaluation, assessment, and treatment of individuals with limitations in functional mobility. Physical therapy services are provided by physical therapists, who are professionals licensed by the state in which they work. Physical Therapists are experts in movement and function and assist patients with preventing injury, recovering from loss of movement, and rehabilitating surgical procedures. Physical therapists evaluate patients’ conditions after they are referred by a physician and then put together a plan of care with the patient and his/her physician. Physical therapists are trained in therapeutic exercise programs, functional training, manual therapy, joint mobilization, mechanical traction, ultrasound therapy, TENs units, and more. Physical Therapists are health care professionals who treat individuals of all ages. 


Physical Therapists do not only assist people for a variety of conditions that are painful and limiting but also help individuals who are interested in preventing injury, preparing for surgery, or who are interested in general health and wellness. More than half of all Americans are suffering from pain. Whether it is a recent episode or chronic, an ABC News/Stanford study revealed that pain in America is a serious problem. However, many do not even know that physical therapists are well equipped to not only treat pain but also its source. Physical therapists are experts at treating movement and neuro-musculoskeletal disorders. Pain often accompanies a movement disorder, and physical therapists can help correct the disorder and relieve the pain.

We are thankful that the healthcare system includes many individuals that are experts in different specialty areas. This allows each patient to receive the best care for their appropriate condition. PTs are experts relating to movement, dysfunction, as well as anatomy.

In a majority of situations, pain is related to a movement dysfunction and having a profound understanding of anatomy helps to be able to identify the cause of the problem as well as implement a plan to address that problem. When the patient’s treatment plan addresses all components of their problem including physical, emotional, and medical, the results for those patients are superior to any one treatment alone.

According to the Journal of Orthopedic and Sports Physical Therapy, fewer visits are needed at less cost when Orthopedic Certified Specialists are involved. In today’s economy, patients need to consider out-of-pocket expenses and working with a therapist who has an effective, efficient approach is one way to do so.

1. Mitchell, J., Scott, E., Physician Ownership of Physical Therapy Services: Effects on Charges, Utilization, Profits, and Service Characteristics, Journal of the American Medical Association, 1992.
2. "Joint Ventures Among Health Care Providers in Florida," State of Florida Health Care Cost Containment Board, 1991.
3. Domholdt E, Durchholz AG. Direct access use by experienced therapists in states with direct access. Phys Ther. 1992 Aug;72(8):569-74.
4. Federal Office of the Inspector General May 1, 2006 - This report calls into question billing processes done by non-physical therapist owned practices.

Exercise:
Physical therapy almost always involves exercise of some kind that is designed for your injury, illness, condition, or to help prevent future health problems. Exercise is anything you do in addition to your regular daily activity that improves your flexibility, strength, coordination, or endurance. Exercise may include stretching exercises to reduce stress on joints or core stability exercises to strengthen the muscles in your back, abdomen and/or hips.

Manual Therapy:
Physical therapy may involve manual therapy which is a general term for treatment performed mostly with the hands. Manual therapy may include massage, mobilization, or manipulation.

Education:
Typically, physical therapy almost always includes education and training in areas including performing daily tasks safely protecting joints to avoid re-injury using assistive devices such as crutches canes, or braces doing home exercises to assist with your injury or condition making your home more safe to assist you if you have strength or balance problems.

We treat a wide variety of orthopedic conditions and high-level neurological diseases and specialize in the following:

1. 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).
2. Manual Therapy - Manual therapy is a broad term that describes a variety of hands-on treatment techniques that are applied to movement dysfunctions. Most physical therapists incorporate manual therapy techniques as a part of a complete treatment plan.
3. Geriatric Physical Therapy - 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.
4. Sports Rehabilitation - Helping to retrain the athlete utilizing running, throwing, jumping, and sport-specific programs in hopes to enable athletes to return to their support.
5. 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.
6. Hand Therapy - Trained to treat hand and wrist conditions.
7. 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).
8. Neurological, Spinal Cord Injury, and Traumatic Brain Injury Rehab - 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 provided to those with neurological involvement.
9. Balance, Dizziness, and Vertigo Rehabilitation - 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.
10. 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.

Federal and state guidelines mandate that medical diagnoses be provided by a medical physician. Therefore, all patients must first contact their physician for a prescription for physical therapy treatment. At Mignacca Physical Therapy, Ltd., we recognize the important role we have in your treatment plan and communicate with your referring physician to keep you and your progress toward your goal(s) moving forward.

Please arrive 15 minutes prior to your scheduled appointment to complete paper. (If you would prefer, forms can be printed from our website [Click here] to eliminate the need to arrive as early for your first appointment.)

1. You will provide us with a copy of the prescription for physical therapy from your physician.
2. You will provide us with a copy of your insurance card/information which we will make a copy of for your file.
3. Our front office will collect any payment you are responsible for per your insurance benefits.
4. The therapist will meet with you one:one in a private are of the clinic to review your medical history, ask you questions relevant to your condition or injury, and examine your range of motion, strength testing, flexibility, soft tissue mobility, joint mobility, and/or neurological screening if appropriate.
5. As a result, your therapist will set up a treatment plan specific to your needs and set and review with you realistic expectations based on the initial evaluation.
Your therapist will communicate the plan of care to your physician as well as monitor and communicate your progress throughout the course of your therapy.

Please bring the prescription for physical therapy obtained from your physician, your insurance card/information, and any test results such as x-rays and/or MRI reports that pertain to your injury or condition. If your situation is work-related or related to an automobile accident, please bring the claim and/or authorization information relevant to your case. If you completed the new patient paperwork, please bring that with you as well.

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. For a shoulder problem, a tank top is a good choice, and for low back problems, wear a loose fitting shirt and pants, again so we can perform a thorough examination. Sneakers and comfortable clothing will enable you to perform any required exercises.

This varies drastically depending on the degree of your problem as well as specific diagnosis and can range to one treatment visit to several months of treatment. As a general guideline: the longer that the problem has been present, the longer the rehabilitation. This is the case due to the need to address not only the primary dysfunction but also secondary problems that may have arisen over time (these secondary problems are important to address in order to help increase your long term rehabilitation potential). Also, sometimes it is necessary for patient to attend physical therapy both prior to and following a surgical procedure to help both prepare and recover for surgery.

Your therapist will address this during your initial evaluation as well as present a treatment plan specific to your individual needs. Patients will be re-evaluated as needed during the course of their treatment.

Your initial evaluation will last approximately 60 minutes. Each treatment will generally last between 45 and 60 minutes.

Yes, all initial evaluation and progress information will be sent to your referring physician.

For many patients, one of the primary objectives is pain relief. This is frequently accomplished with hands-on 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. Without this information, it is difficult for the therapist to adjust your treatment plan.

Billing for physical therapy services is similar to what happens at your doctor's office. When you are seen for treatment, the therapist will document what types of procedures /treatment were performed by identifying the appropriate ICD-10 (diagnosis) codes and CPT (Common Procedure Terminology) codes. If your insurance plan identifies a specific copayment, deductible, or coinsurance as your responsibility, our front office staff will collect payment at the time of service. Our billing department will file the claim information to your insurance company. Once your insurance company processes the claim, they will send an Explanation of Benefits to you as well as us in addition to any payment due to us. If your insurance carrier determines additional payment is due by the patient, we will send a statement to you. Though it is common that the billing processes generally completes in 30 days, it can take up to 6 months for processing to be completed if issues arise and/or multiple insurance carriers are involved.

Some patients will need to continue with home exercises. Some may choose to continue with a gym exercise program. 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.

Physical therapy attempts to increase function and decrease pain to the greatest extent possible. In some situations, complete recovery may not be realistic and flare ups may occur. Therapists do their best to assist in the greatest recovery possible and attempt to avoid potential flare-ups. We will also help to establish a home exercise program so that you may continue your rehabilitation even after you are no longer coming to the physical therapy office.

It is important to realize that physical therapy is not a passive treatment approach. In most situations, it is imperative that the patient take an active role in the rehabilitation process. Those patients who take an active role in their treatment program often have better lasting results following discharge from physical therapy.