New York Physical Therapist

female on a table undergoing physical therapy in new york

Physical Therapy

If you have been injured in a car accident, slip and fall, or a work accident, or another unfortunate incident, it can have significant physical repercussions on your body. Whether you have suffered serious, noticeable injuries such as broken bones or are just feeling sore and in pain —it is essential that you seek professional help. A healthcare professional might recommend physical therapy to recover from the disabilities or impairments that result from that incident. A licensed physical therapist will be able to help you get on the road to recovery, so you can start feeling like yourself again. The article below will cover many questions that you might have about Physical Therapy. Accidents or injuries can be incredibly traumatic for a person. Having the best quality information and answered questions can ease this process.

What is Physical Therapy?

Physical therapy is the application of therapeutic exercises, neuromuscular re-education, clinical education, modalities, soft tissue mobilization, electrical stimulation, and functional training to alleviate impairments and functional limitations so a person can get back to the prior level of care. Depending on your injury or situation, a therapist might focus on therapeutic exercises and balance training, as opposed to soft tissue mobilization. However, the therapist will always tailor a program to fit your specific needs. Typically these sessions are done at an outpatient clinic. However, there has been a move to include Physical Therapy in the home, with a therapist coming out to see you.

However, just because a whiplash injury doesn’t present symptoms right away, it doesn’t mean that you aren’t hurt. Many times, it takes days, weeks or even longer for you to feel the pain and injury caused by a serious whiplash injury. However, typical immediate medical attention for injuries such as whiplash involve neck support and painkillers. This will not help repair the underlying issue from your whiplash injury. This is where a professional physical therapist can help.

Why Physical Therapy?

After an injury or car accident, the most critical priority for medical professionals is to make sure that you are medically stable and not at risk of further injury. After that, a person can have an injury that results in long term disability. This disability can include fractures, burns, neurological injury, or major multiple trauma. Some of these injuries can require surgical intervention, with Physical Therapy as a follow-up, while others can be alleviated by PT alone.

What is a Doctor of Physical Therapy (DPT)?

A Doctor of Physical Therapy is a licensed healthcare professional who is trained in Physical Rehabilitation after an injury or disability. The Doctor of Physical therapy is the terminal degree for all physical therapists working in the US. Typically, a person will study for an undergraduate degree and then study for around three years in professional Physical Therapy school. During this time, a student will study anatomy, physiology, neurology, cardiopulmonary rehab, and integumentary (skin) issues. Additionally, the students will study the lifespan of patients, including pediatric (children), young adults, athlete, and geriatric (old) patients. A federal board of education approves most educational programs, and all Physical Therapists have to take an exam for licensure in the United States.

Does Physical Therapy Work?

Since the 1980s, the governing body of Physical Therapy, the APTA, has embraced and evidence-based practice model for all working Physical Therapists. This means that a therapist is educated and instructed to provide therapy which is based on evidence and research. Educational institutions or the APTA itself do most of this research. This research generally focused on clinical outcomes after the skilled application of therapy and what technique or program works for the best diagnosis. Also, it takes into account a wide variety of other factors, including age, socioeconomic status, gender, sex, and activity level. This honing of skilled practice for each individual patient is a hallmark of the ethical and evidenced-based practice.

Furthermore, all practicing Physical Therapists have to attend and complete a set amount of continuing education credits each year, depending on the state. Physical Therapy works for most patients. Around 80% of patients find Physical Therapy effective for neurological, orthopedic, cardiopulmonary and integumentary issues. Despite most patients finding physical therapy to be effective, it is essential that a physical therapist sets realistic goals and plans for the patient to return to an appropriate level of function. For instance, a person who suffers a spinal cord injury from a car accident that is complete, will not be expected to walk again; however, they will most likely be wheelchair mobile.

How does Physical Therapy Work?

Physical therapy works by manually addressing the soft tissues, neuromuscular, and bony tissues in the body. Along with manual therapy, Physical Therapy will address strength, balance, cardiovascular, endurance, and flexibility impairments in a patient after an injury or accident. Usually, this is done through monitored exercises and a home exercise program. Thankfully with the advent of new technologies, home exercise programs are easy to follow, and patients generally adhere to them. As with anything, the more effort you put into it in and outside the clinic will give you greater results.

Why is Physical Therapy important?

Physical therapy is vital in addressing impairments and functional limitations (such as standing up, walking, doing stairs, and other activities) and allowing them to resolve. Sometimes, medication or surgery alone will not be enough to get a person back to their prior functional level. Medication and surgery can help a person in the immediate term to resolve some deficits that include pain, discomfort, or disability. However, after the surgeries, medication, and immediate medical care, a person can still have difficulties with their activities of daily living or general function. This is where Physical Therapy can assist a person in getting back to their prior level of function and where Physical Therapy is most effective. Below we will look at some case studies and examples of patients that experienced an accident or injury and how Physical Therapy helped them achieve their functional goals. Besides, we will explore the process of Physical Therapy.

How long does Physical Therapy program take?

This question varies widely depending on a multitude of factors including age, diagnosis, motivation to participate in care. For most orthopedic injuries, physical therapy can take 6-8 weeks going 2-3 visits per week. The physical therapist will transition to a home exercise program so that a patient does not have to go to therapy continually. For neurological injuries, such as spinal cord injury, brain injury, or serious orthopedic trauma, physical therapy can take 12-24 weeks at 2-3 visits per week. Usually, this outpatient therapy will be after inpatient rehabilitation, which can take 1-2 months. Again, some of these injuries can result in long term injuries or impairments that require continued Physical Therapy maintenance such as scar tissue buildup after a fractured knee from an accident.

How long is a Physical Therapy session?

Most Physical Therapy sessions will take 45 to 90 minutes, depending on the injury. The more severe the injury, the longer the session will take. A Physical Therapist will do an evaluation at the first session, but after that, it will be mostly treatment. Below we will discuss what is involved in a typical physical therapy session.

What to expect at a Physical Therapy session?

A physical therapy session will involve an initial evaluation and follow-up visits. At the evaluation, a therapist will take subjective, objective measurements, and the associated impairments/functional limitations and then develop a plan. After considering all of these measurements and the interview, the therapist will set realistic, measurable, and achievable goals, both short term and long term. Typically, a patient will be warmed up either with a hot pack or with an active warm-up on a bike or treadmill. After the warm-up, a review of the injury and progress with function will be discussed with the therapist. Then, a therapist will run a patient through some exercises and adjust as appropriate. After adding exercises, which is usually done on a weekly basis, the therapist will apply manual therapy. Types of manual therapy can include soft tissue mobilization, massage, mobilizations of bony tissues, and active stretching. Finally, it is vital that a patient cool-down. This cool-down can include: icing, electrical stimulation, or ultrasound. Icing is usually done for 15-20 minutes, electrical stimulation is done for 15-20 minutes to help reduce pain by overloading pain neurons, and ultrasound is used to reduce swelling. Sometimes icing and electrical stimulation can be done in conjunction with each other to help reduce pain.

Does Physical Therapy hurt?

Sometimes Physical Therapy can cause some pain; however, that pain should be temporary. Stretching scar tissue, mobilization a damaged joint, or strength training can be temporarily painful. However, the icing an electrical stimulation along with over the counter medication, will resolve the pain. You should gradually feel better as you pursue Physical Therapy. It is always essential to reassess with your Physical Therapist on how you are progressing.

What to wear to Physical Therapy?

Comfortable clothing or athletic equipment should be worn to every session. Physical Therapy will need you to wear flexible clothing that you can be active in because you will have to exercise and stretch. Loose fitting clothes and athletic shirts should be worn with comfortable athletic shoes.

How to tell if Physical Therapy is working

As stated above, it is essential to regularly talk with your physical therapist on how you are doing and progressing. You should experience improved strength, balance, activity tolerance, and endurance within the first two weeks. The therapist would have taken objective measurements in terms of the range of motion (ROM), strength, flexibility, and swelling. The therapist will take these measurements at regular intervals. In addition to objective measurements, the Physical Therapist will take subjective reporting from the patient, including pain, function at home, and decreased disability. The therapist will ensure that you set out to achieve the goals that the therapist established an evaluation.

What is the difference between occupational therapy and physical therapy?

While both disciplines overlap, Occupational and Physical Therapy do have significant and measurable differences. Occupational Therapy is a rehabilitation professional that specializes in activities of daily living. These activities can include bathing, dressing, cooking, and fine motors tasks such as writing. In the outpatient setting after an accident or injury, Occupational Therapy focuses on the upper extremities and specifically the hand for improving strength, ROM, and endurance.

How to choose between Occupational Therapy and Physical Therapy?

Occupational therapy should be considered if you have an injury to the upper extremities or hands from a car accident or injury. This can include shoulder fractures, nerve injuries, amputation, or burns on the arm. Occupational Therapy should also be pursued if a person is having a problem with fine motor tasks of eating, drinking writing, and hygiene. Physical therapy is the “basic function” of life. This involves helping a person improve in ambulation, stair negotiation, and getting back to work. The physical therapist will help to improve function following a wider variety of injuries. For most injuries in the outpatient setting, physical therapy is the better choice and more broad. However, if you are seriously injured in an accident, and you go to a rehabilitation hospital, you will receive both Occupational and Physical Therapy.

What is the difference between Physiatry and Physical Therapy?

new york man getting his low back pain treated by a doctor after a car accident

Although they sound similar, there are some differences between Physiatry and Physical Therapy. A Physiatrist is a medical doctor (DO or MD), who specializes in the medical aspect of rehabilitation. This can include medication prescription, injections, referral to other specialties, and prosthetic prescription.

A Physical Therapist is a healthcare clinician who specializes in physical rehabilitation and the administration of Physical Therapy techniques. This can include therapeutic exercises, balance training, gait training, patient education, modalities, wound healing, and education. While they are unique, most of the time, the Physiatrist and Physical Therapist will work together to produce the best outcome for the patient, whether you are in inpatient, outpatient, or home care. Along with this, there is a whole team that can provide for you in case of an accident that can include: nursing, social work, occupational therapy, and home health aides.

What is the difference between Chiropractic and Physical Therapy?

Chiropractors are typically outpatient providers of care that help with spinal adjustments, alignment, and limited diagnoses of orthopedic conditions. Physical Therapist has a broader scope of practice that can include orthopedic, neurological, skin, or cardio-pulmonary deficits after an accident. Frequently, chiropractors specialize in the treatment and alleviation of deficits in the spine or neck, so this can be common after a slip and fall or car accident. Sometimes, in the outpatient setting, Chiropractors and Physical Therapists can work in conjunction with each other.

Does insurance cover Physical Therapy?

For most injuries, whether a slip and fall, car accident, workplace accident,  or another injury, your insurance will cover the cost of physical therapy. Sometimes there can be a deductible for the price of getting the Physical Therapy treatment. Deductibles are set amounts that you have to pay through before you can have sometimes covered by insurance. This is used to defer the cost of care from your insurance company and is a component that you agree to when you sign up for an insurance plan. Often the deductible can be 500 to 3,000 dollars depending on the insurance plan that you choose.  Instead of a deductible, some insurances require that you pay a co-pay, to help defer the total cost of insurance. These co-pays can be anywhere between $10 to 100 dollars per visit. If you do not have insurance, and someone or something causes an accident, their car insurance can pay for a portion of your care that a healthcare provider deems appropriate. If the person or institution does not have a liability plan or insurance coverage, legal services may be required to recoup the cost of PT.

Does Medicare pay for Physical Therapy?

Medicare will pay for Physical Therapy if you are over 62 years old, have a disability, or certain diagnoses. Certain diagnoses include kidney failure and end-stage renal disease with dialysis. Medicare is not to be confused with Medicaid, which is insurance for people who do not have the financial means to pay for care. You will have to sign up for Medicaid and be eligible. The auditors determine this by looking at your income level and seeing if you fall below the cut off for income.

Who pays for Physical Therapy after a car accident?

While every accident is different, the most common type of auto-related accident is whiplash. Whiplash injuries happen to more than 1,000,000 people every year and while some of these injuries are quite noticeable and significant—many times, there is no visible sign of injury at the time of the accident. This is why many people who have been injured in an auto accident don’t seek professional help.

However, just because a whiplash injury doesn’t present symptoms right away, it doesn’t mean that you aren’t hurt. Many times, it takes days, weeks or even longer for you to feel the pain and injury caused by a serious whiplash injury. However, typical immediate medical attention for injuries such as whiplash involve neck support and painkillers. This will not help repair the underlying issue from your whiplash injury. This is where a professional physical therapist can help.

Since New York is a no-fault state, which means that regardless of who was at fault of causing an accident, your own auto insurance policy will cover the necessary medical bills up to a mandatory minimum of $50,000, including physical therapy. In other, at-fault states, the person who is at fault for a car accident will usually be required to pay for Physical Therapy and rehabilitation. While you can use your own coverage, and then get reimbursed, the person who is at fault will still be paying. Sometimes, your insurance company will pay immediately for your direct care and then look for reimbursement for damages on their own. This can include pursuing legal action against the person who was involved in the accident or subrogating medical costs from the other insurance company whose driver was at fault.

Does Workman’s Comp pay for Physical Therapy?

Workman’s Compensation is an insurance program that is used when a worker or laborer is injured in work-related duties or accidents. In New York, workers’ compensation insurance is mandatory for all employers, and you are automatically covered for all job-related injuries.  When you are injured on the job as it relates to your duties, you will have to give proper notice to your employer, notice the NYS Worker’s Compensation Board and have regular check-ups with a healthcare provider certifying that you are unable to work. If you want your medical and PT bills to be covered by workers’ comp insurance in New York, your treating provider has to be authorized by the NYS Worker’s Compensation Board. You can find NYS WCB Authorized healthcare providers by visiting WCB provider search or Injured Call Today find-a-doctor page. Also, it’s important to undergo a physical readiness test before returning to work to ensure that you are fit to go back to your job duties.

What is orthopedic Physical Therapy?

Orthopedic Physical Therapy is a sub-specialty of physical therapy that is usually provided in the outpatient setting that focuses on the musculoskeletal system. Typically, the therapists will have extra training in this area and focus on this practice. Types of injuries include orthopedic surgeries, broken bones, strained muscles, back/neck pain, and torn ligaments/tendons.

When to start Physical Therapy after a rotator cuff surgery?

Rotator cuff surgeries usually require extensive amounts of rehabilitation and physical therapy. Depending on your surgeon, physical therapy will start 2-4 weeks after the surgery. The initial start of the Physical Therapy treatment will be to reduce swelling and pain in the shoulder.

Also, physical therapy will start with light isometrics that will gradually (over the next 6-8 weeks) move to resistance training and range of motion training. The resistance will increase, range of motion will increase, and then a return to sport or whatever overhead activity the patient is trying to get back to is initiated.

Can Physical Therapy help after a car accident?

When you have been injured in an auto accident, it is important that you see a physical therapist, whether you receive medical attention right away or not. Many times, people who are injured in auto accidents and seek medical treatment immediately think this is all they need to do to recover from their injury.

In order to recover from an injury, you need to engage in physical therapy programs that can help repair and strengthen all of the tissues that were damaged during your auto collision. This can help expedite the healing process and limit excessive scar growth. While most auto accidents and slips and falls are whiplash injuries, not all of them are. The good news is, the right physical therapist will help make sure you have the right diagnosis following your injury and the right program to help you recover.

While every car accident is different, the most common type of auto-related accident is whiplash. Whiplash injuries happen to more than 1,000,000 people every year, and while some of these injuries are quite noticeable and significant—many times, there is no visible sign of injury at the time of the accident. This is why many people who have been injured in an auto accident don’t seek professional help.

However, just because a whiplash injury doesn’t present symptoms right away, it doesn’t mean that you aren’t hurt. Many times, it takes days, weeks or even longer for you to feel the pain and injury caused by a serious whiplash injury. However, typical immediate medical attention for injuries such as whiplash involve neck support and painkillers. This will not help repair the underlying issue from your whiplash injury. This is where a professional physical therapist can help.

Depending on the injury that you sustain, physical therapy can help reduce pain, improve strength, and range of motion in the affected area of injury. Injuries such as whiplash, low back pain, concussions, and broken bones, or associated orthopedic surgery can help with the impairments and functional limitations related to auto injuries. So yes, Physical Therapy can be useful for most car accident victims.

Can Physical Therapy help after a work accident?

Worker’s compensation will help to pay for rehabilitation and Physical Therapy care after a work accident. The most common work accident, low back injuries, can help to be alleviated by improving strength, range of motion, flexibility, reduce swelling, and reducing pain.

Workers’ Comp Physical therapy is helpful after a workplace injury because it focuses on returning a person to a prior functional level, which, is usually whatever that patient does for work.

If you’re injured in a work-related accident, fall, it is typically recommended that you start physical therapy within a week. If it is has been more than a week since your injury, you should still go into a physical therapist as soon as you can.  If you fail to receive proper treatment after an injury, it could result in long-term health issues.

When you start physical therapy, you may still be sore and uncomfortable following your accident—depending on the extent of your injury. Your therapist will initiate treatment to help control pain and control swelling. From there, they will start introducing small exercises and movements and eventually build up the intensity of your exercises to build strength and range-of-motion.

In addition to one-time events causing injuries, repetitive stress injuries are prevalent. Some repetitive stress injuries include tendonitis, low back strains, muscle tears, and even herniated disc. Most of these injuries are caused by low-load long duration stress on tendons, ligaments, or muscles. Physical therapy will include resolving the injury but will also include an ergonomic or workplace evaluation. This can include better seating, less reaching, changing job positions, and a therapeutic exercise program to stay injury-free. Again, this program will focus on flexibility and strength.

Can Physical Therapy help a herniated disc?

Herniated discs occur when the inner lining of the spinal disc protrudes through the outer lining. This protrusion will impact the nerves that exit the spine — thereby causing pain, numbness, and burning/tingling.

Physical therapy will treat the protrusion by flexibility, improving strength, positional changes, core stability, and hamstring flexibility. Physical Therapy will last 6-12 weeks and 2x per week. The main goal will be to fix and resolve the protrusion and alleviating the pain/nerve compression.

Does Physical Therapy help arthritis?

As people age, arthritis can develop in the major and small joints of the body. Age or injury related arthritis is known as osteoarthritis. A large volume of research has shown that improving the strength, flexibility, and range of motion will help to reduce pain and improve the function related to joint destruction.

A Physical Therapy program can help to improve damage caused by arthritis. Eventually, though, arthritis will become so severe that physical therapy can no longer help. At this time, a surgeon or orthopedist will recommend a joint replacement. Surgeons can replace joints, including shoulders, elbows, hips, knees, and ankles. For the spine, a surgeon can perform laminectomy and even replace some of the vertebrae. Even after all of these surgeries, Physical Therapy is an integral component of recovery from the operation.

What does pelvic floor Physical Therapy entail?

Pelvic floor Physical Therapy involves strengthening the muscles around the lower abdominals and groin area. Pelvic floor therapy is usually done for women after cancer, pregnancy, childbirth, or serious hernias. Physical therapy will involve strengthening, flexibility, and isometric contractions to improve the strength of the muscles of the lower groin.

Additionally, Physical Therapy can apply electrical stimulation, like TENS,  to those muscles to help improve contraction and strength.

When to stop going to Physical Therapy?

Generally, you should stop going to Physical Therapy when you achieved the goals that you and your therapist set, stop seeing improvement, and if it is not working to achieve objective or subjective goals. For some injuries or accidents, Physical Therapy may not help, or you may need more serious medical interventions such as surgery.

Can Physical Therapy help neuropathy?

Neuropathy can be caused by a wide variety of disorders, including diabetes, hypothyroidism, autoimmune disease, alcohol abuse, and kidney/liver disorders. Neuropathy can be helped by medication, vitamins and minerals, proper nutrition, and exercise. Physical Therapy will usually not be used specifically for neuropathy. However, if a disability is keeping a person from exercising, Physical Therapy can help with those impairments.

Does Physical Therapy help nerve damage?

There are different types of nerve damage. Physical Therapy is most effective for nerve plexus injuries. Usually, Physical Therapy involves increasing the strength, range of motion, and flexibility. However, if a nerve is severed or crushed, it will require a more direct medical intervention.

Does Physical Therapy help sciatica nerve pain?

Sciatic nerve pain is usually due to tight muscles, nerve compression, or decreased nerve mobility. For the tight muscles, a physical therapy program will help to improve the flexibility of the soft tissues around the sciatic nerve. This includes the hip muscles, hamstring (back of the leg), and the calf muscles. For nerve compression or mobility, there are nerve mobility techniques called flossing, that help to improve the ability of the nerve to conduct its signals and reduce inflammation or entrapment of the nerve which can result in pain.

Does Physical Therapy work for carpal tunnel?

Physical Therapy is an effective treatment method for carpal tunnel. Usually, it involves nerve mobility, stretching of the flexor tendons on the wrist, and strengthening of the hand muscles using resistance or weights. If the carpal tunnel is severe enough, it can cause weakness and atrophy of the hand muscles.

Citations

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