• Preparing for Your Visit with a Physical Therapist

    Physical therapists are highly educated, licensed health care professionals who help patients improve or restore mobility, and in many cases helping patients reduce pain, and avoid the need for surgery and the long-term use of prescription medications and their side effects.

    Physical therapists examine, evaluate, and treat patients whose conditions limit their ability to move and function in daily life. Your physical therapist's overall goal is to maintain, restore, or improve your mobility and help reduce your pain.

    In most states, you can make an appointment with a physical therapist without a physician referral. Whether this is your first visit or you've been treated by a physical therapist in the past, there are things you can do to make your visit as successful as possible.

    Before Your Visit:

    Make a list of any questions that you have, to make the best use of your time with your physical therapist.

    Write down any symptoms you've been having and for how long. If you have more than one symptom, begin with the one that is the most bothersome to you. For example, is your pain or symptom:

    • Better or worse with certain activities or movements or with certain positions, such as sitting or standing?
    • More noticeable at certain times of day?
    • Relieved or made worse by resting?

    Write down key information about your medical history, even if it seems unrelated to the condition for which you are seeing the physical therapist. For example:

    • Make a list of all prescription and over-the-counter medications, vitamins, and supplements that you are taking.
    • Make a note of any important personal information, including any recent stressful events, injuries, incidents, or environmental factors that you believe might have contributed to your condition.
    • Make a list of any medical conditions of your parents or siblings.
    • Consider taking a family member or trusted friend along to help you remember details from your own health history and to take notes about what is discussed during your visit. Make sure you can see and hear as well as possible. If you wear glasses, take them with you. If you use a hearing aid, make certain that it is working well, and wear it. Tell your physical therapist and clinic staff if you have a hard time seeing or hearing. If available, bring any lab, diagnostic, or medical reports from other health care professionals that may be related to your medical history or who have treated you for your current condition.
    • Bring a list of the names of your physician and other health care professionals that you would like your physical therapist to contact regarding your evaluation and your progress.

    When you call to make your appointment, ask whether you should wear or bring a certain type of clothing when you come for your first visit. You may want to avoid tight or formal clothes, in case the therapist wants you to engage in activities during the first session.

    Financial Considerations

    • Carefully review the clinic's financial policy prior to starting care. Be sure to ask questions if anything is unclear. If the financial policy is not presented at the time of your initial appointment, request it be provided and explained prior to the initiation of treatment.
    • The physical therapy clinic will ask you to sign the financial agreement. Review the agreement carefully and ask questions if anything is unclear.
    • Applicable deductibles and copayments will be requested prior to or upon completion of each appointment. It is important to pay the proper amounts at the time of service. This will help you to better manage your health care costs and avoid a large bill at the end of care.
    • If the frequency of visits needs to be adjusted for financial reasons, discuss this directly with your physical therapist. In partnership with your therapist, you can explore alternatives and develop a workable plan.
    • If you change insurance plans or lose insurance coverage for any reason, be sure to inform your therapist as well as the clinic’s front office staff.

    What to Expect During Your First Visit:

    Your physical therapist will begin by asking you lots of questions about your health and about the specific condition for which you are seeing the physical therapist. Detailed information about you and your condition will help the physical therapist determine whether you are likely to benefit from physical therapy and which treatments are most likely to help you.

    Your physical therapist will perform a detailed examination. Depending on your symptoms and condition, the physical therapist might evaluate your strength, flexibility, balance, coordination, posture, blood pressure, and heart and respiration rates. Your physical therapist might use his or her hands to examine or "palpate" the affected area or to perform a detailed examination of the mobility of your joints, muscles, and other tissues.

    Your physical therapist also might evaluate:

    • How you walk (your "gait")
    • How you get up from a lying position or get in and out of a chair ("functional activities")
    • How you use your body for certain activities, such as bending and lifting ("body mechanics")

    Your physical therapist might ask you specific questions about your home or work environment, your health habits and activity level, and your leisure and recreational interests so that the therapist can help you become as active and independent as possible.

    Your physical therapist will work with you to determine your goals for physical therapy and will begin to develop a plan for your treatment. In many cases, the physical therapist will make a diagnosis and begin treatment almost immediately.

    One of the main goals of treatment is almost always to improve or maintain your ability to do your daily tasks and activities. To reach this goal, the physical therapist may need to focus on pain, swelling, weakness, or limited motion. Your physical therapist will constantly assess your response to each treatment and will make adjustments as needed.

    In most cases, an important aspect of your physical therapy treatment will be education. Your physical therapist might teach you special exercises to do at home. You might learn new and different ways to perform your activities at work and home. These new techniques can help minimize pain, lessen strain, avoid reinjury, and speed your recovery.

    Your physical therapist will evaluate your need for special equipment, such as special footwear, splints, or crutches. If the evaluation indicates that you are at risk for falling, your physical therapist might recommend simple equipment to help make your home a safer place for you. The therapist will know what equipment you need and can either get it for you or tell you where you can find it. If you do need special equipment, your physical therapist can show you how to use it properly.

    Your physical therapist will communicate the important information from your examination to your physician and to other health care professionals at your request.

    Your physical therapist will continually recheck your progress and work with you to plan for your discharge from physical therapy when you are ready. Make sure you talk with your physical therapist about what you should do after discharge if you have questions, or if your symptoms or condition worsen.

    Keeping Your Appointments

    • Arrive for treatment sessions at the scheduled time or a few minutes early so you are prepared. Late arrival may affect not only your 1-on-1 time with the therapist, but that of other patients in the clinic.
    • Actively participate in the discussion to determine visit frequency and work in partnership with the physical therapist to achieve your treatment goals.
    • Show up for appointments. Failure to show for an appointment and not calling to cancel the visit may result in a fee and is disruptive to the physical therapist’s schedule. If an emergency prevents you from attending, try to provide adequate notice. It is important to review the facility’s financial and cancellation policy prior to the start of treatment.
    • If you plan to discontinue therapy or change the frequency of treatment because of personal or financial considerations, discuss this with your physical therapist.

    You will get out of therapy what you put into it. Sufficient effort, as agreed between you and the physical therapist, is necessary to maximize benefit from each treatment session.

    Observe all precautions as instructed by your physical therapist. This may include modifying an activity, reducing weight on 1 limb while walking, avoiding certain movements, or restricting use of a specific body part. Lack of compliance with treatment precautions may cause injury and result in delayed recovery.

    If special devices such as splints, walkers, canes, or braces are provided for home use, follow the physical therapist’s exact instructions. Be sure to ask questions if you are unclear, as incorrect use may be harmful.

    The therapist may advise physical modifications in your home such as removing throw rugs, rearranging furniture, and installing safety rails. For your safety, it's essential to comply with these recommendations.

    Follow the home program as instructed by the physical therapist. Your ongoing performance and commitment to the home program is essential to your recovery.

    If the instructions are unclear, ask for clarification. Only perform exercises at the therapist-specified repetition, frequency, and resistance (such as weight or resistance band color). More is not always better and may cause injury!

    After your physical therapy care is completed, continue to follow the after-care instructions provided by the physical therapist.

    Changing the Rehabilitation Setting

    Physical therapy can occur in a variety of settings including hospitals, skilled nursing facilities, rehabilitation facilities, at home or in an outpatient clinic. Depending on your condition and recovery, your medical team may recommend your transfer from one setting to another. For example, if you are discharged from the hospital, physical therapy treatment may be continued in an inpatient rehabilitation facility, your home, or an outpatient clinic depending on the level of care you need.

    It is important that your rehabilitation be disrupted as little as possible during the change in setting. Case managers are available in most hospitals and rehabilitation centers to help ensure a smooth transition.

    If you are returning home from another facility, ask the physical therapist what special equipment or family support is needed prior to the transfer.