The Initial Evaluation w/a Professional Rehabilitation Licensed Physical Therapist

PRS understands that not everyone has experienced Physical Therapy before, and we further understand that not all Physical Therapy is the same. Even if you have had treatment elsewhere before, your experience with PRS will be a new experience. Many patient's positively say, "Why didn't they [other facilities] do this with me before?"

To better understand the initial evaluation, the beginning of your experience with us, we want you to know what to expect.

Generally speaking, the initial examination will take approximately 45-60 minutes and will cost around $100 - $150 (any additional treatment after the initial exam will be an additional cost). And this is what you get:

1. Health History Questionnaire

This is a form that gives the Licensed Physical Therapist important information about your pain or problem to help better determine the potential structures involved and to develop a sound and efficient exam. Please complete this thoroughly.

2. Subjective Exam

The Licensed Physical Therapist will dialogue with you even further to get straight to the source of your problem. Some of the topics covered may be:

1. Past Medical History (PMH) and/or medications
2. Description of the pain and problem
3. Mechanism (cause) of the injury
4. Aggravating factors (what effects it and makes it worse)
5. Easing factors (what makes it better)

This is a good time to tell your PRS Therapist anything you may think is important or relevant to your pain or problem.

3. Objective Testing (Hands-On)

Once the Licensed Physical Therapist has a good "picture" of your pain and the understanding of potential causes and sources, he or she will begin the process of "verifying" the exact structures involved. Some of the procedures may include:

1. Disrobing: Typically the therapist will need to check for possible swelling, discoloration, or deformity so you may be asked to expose the affected area(s). We ask that you wear loose clothing, which allows easy access to the affected area, however, we supply gowns for your convenience as well.
2. Active Movement: To check for weakness, compensation, or disease, the therapist may ask you to perform movements such as bending, twisting, lifting, climbing etc.
3. Mobilization: To check for any potential loss of integrity, the therapist may move certain joints, tendons, or ligaments while you are in a relaxed position.
4. Pressure: To check for potential tears or dysfunction of tissues, the therapist may put forceful pressure on certain muscles, bones, or tendons.

The Licensed Physical Therapist is a highly trained medical professional and will not harm you in any way. It is common, however, to experience an increase in pain or soreness after your examination for up to 48-72 hours. This is necessary in order to properly assess the structures involved and to come to an exact conclusion.

4. Explanation (on the exact cause of pain)

All the testing won't be for nothing. Once completed, the Licensed Physical Therapist will have a good picture of exactly what's wrong and he or she will make sure you know and understand it also. This is a good time to ask any questions to get a clear picture.

5. Precautions

Now you are on the road to success. There are four stages to your rehabilitative program. We call it the C-A-I-R™ steps. They are:

1. Controlling destructive forces
2. Applying appropriate forces
3. Imposing challenging forces
4. Restoring "everyday" functional forces

The goal of most rehabilitation programs is to restore you to the prior functional level you were before pain or injury. PRS attempts to bring you to a HIGHER LEVEL than you were before the pain began. The PRS Therapist will explain to you each step at the time of exam, however, let's go over the first one now.

"Controlling destructive forces". Your success starts with your ability to remove destructive forces from the affected structures by modifying your daily or work activities, or habitual movement patterns. The injured tissues need a good environment free of harm in order to maximally heal. This step is so important that your success literally depends on it. For example, let's say you have lower back pain and the Licensed Physical Therapist determines that the main cause of your problem is too much pressure on to your discs (shock absorbers in your spine), and the cause of that excessive pressure is from too much sitting. If you are not able to limit your sit time or take frequent breaks by getting out of that position regularly, the chances of you getting better is slim. After each therapy session you may "feel" better but since the destructive forces aren't able to be removed the pain will typically come right back.

In the above scenario, therapy acts sort of as a band aid--we put it on your injury, but you rub it right off again by imposing destructive forces. Experience tells us there is not much success in this. In the event you are not able to participate and complete the very first step of the program, the Licensed Physical Therapist may design only a home and self care program for you to follow until you can.

6. Goals

If you are able to participate in the rehabilitative program there are certain goals we want to define and achieve. They are usually and simply YOUR wants and wishes. What do you hope to gain by being in physical therapy? To walk better ? Be able to reach overhead better? Sleep without pain again? Etc.

7. Treatment Plan

The Licensed Physical Therapist will design a treatment plan geared to help you reach your goals. There are a variety of treatments available to you at PRS and the Licensed Physical Therapist will choose the ones most appropriate for you. You may have been told by others that you "need" certain things but the Licensed Physical Therapist truly understands your needs and has your goals in mind and will choose only those things he or she knows will bring you long-term success.

Here is a list of just some of our special treatments available:

1. Manual Therapy
2. Contract-Relax Stretching
3. Joint mobilization
4. Soft-tissue mobilization
5. Ultrasound
6. Biomechanical Correction
7. Pelvic floor Strengthening
8. Electrical Muscle Stimulation
9. Dry Needling

Ask your therapist for more information on any one of these treatments.

8. Report to Referring Physician

Although your time with the Licensed Physical Therapist may be concluded, the Physical Therapist is not done. Typically, your referring physician or insurance company requests a written report detailing the results of the examination and in order to be accurate and thorough it may take the Licensed Physical Therapist up to 45 more minutes to complete the process of handling your initial visit.

We hope that this brief outline helps you better understand what to expect with your upcoming exam with a PRS Licensed Physical Therapist. For any questions feel free to call us anytime at any of our offices listed below.

We look forward to seeing you soon!

** The C.A.I.R. approach was originally developed and trademarked by James Ko, a renowned PT and clinic owner from California and founder of a great organization for PT's called Indefree. PRS PT believes this approach gives the greatest benefits for their patients and is proud to utilize its methodology.