Did you know you can see a physical therapist without a doctor's referral?

That’s right! You do NOT need a referral to see a physical therapist. Don’t wait…. get started NOW, so you can get back to doing the things you love.

Most insurances (in California) require a doctor’s referral after 45 days OR 12 PT visits, whichever come first. We can let you know if and when a referral is required.

The point of “direct access” is to get you started, so you don’t have to wait to see your doctor THEN make an appoinemnt with us! As physical therapists, we are trained to know if youre injury is appropriate for physical therapy treatments, or if you additionally need to see a doctor for imaging.

Fear Not: A Physical Therapist Can Help You Overcome the Fear of Movement

Do you avoid moving (a little or a lot) because you fear it will hurt? Does the fear of reinjury limit your activity? If so, you may be experiencing kinesiophobia. And you're not alone.

As many as 50%-70% of adults — not just athletes — experience this feeling after an injury, accident, or illness. Kinesiophobia can result from personal experience. It also can be learned by watching or mimicking the behaviors of others.

Fear is a natural response to danger or the potential threat of danger. It causes normal physical changes in the body, such as:

• Increased heart rate.

• Rapid breathing.

• Elevated startle "jump" response.

Fear also can cause anxiety — the emotion felt when we think bad things might happen. And anxiety can cause fear, resulting in a continuing feedback loop. Ultimately, when fear and anxiety affect how we move it’s known as fear avoidance.

People who fear moving can have decreased confidence in doing daily activities and may:

• Change their normal movement to feel safe. Moving in ways we are not meant to — and using muscles or joints the wrong way — can lead to new pain.

• Decide that it is just better not to move at all. An inactive lifestyle can increase your risk of developing heart disease, diabetes, and obesity.

While avoidance tactics may seem to help at first, they can lead to long-term problems if continued. Movement and regular physical activity are essential for our hearts, muscles, joints, lungs, mind, spirit, and overall health.

Help Is Available

Physical therapy plays a vital role in addressing the fear of movement. Physical therapists can identify any contributing factors and teach you how to move safely. They, and the physical therapist assistants they work with, can help you get past your fear of movement.

Physical therapists are movement experts. They improve quality of life through hands-on care, patient education, and prescribed movement.

What to Expect From Physical Therapy

Physical therapy aims to restore function so you can do the activities you need and love to do.

During your initial visit, your physical therapist may:

• Measure your fear of movement or reinjury. The Tampa Scale of Kinesiophobia or a questionnaire can help identify the reasons for your fear. There are a variety of possible causes.

• Evaluate your overall strength, endurance, and balance.

• Ask about your personal goals.

Your physical therapist will use this information to design a personalized treatment plan that may include:

• Gradual exposure to activities that do not cause harm.

• A strength, balance, and endurance exercise program paced for your specific needs.

• Virtual reality activity exposure.

• Adapted yoga.

• Aquatic exercises.

• Patient education. Your physical therapist can help you better understand how your body should move.

• Guiding you through activities so you can focus less on your fear and improve your ability to move.

• Assistance and guidance to help you set quality-of-life goals.

Your physical therapist also may recommend cognitive behavioral therapy. This treatment can help you address fear or anxiety.

Physical therapists use the latest evidence to address each person's needs, challenges, and goals to:

• Improve mobility.

• Manage pain and other conditions.

• Recover from and prevent injury and chronic disease.

Physical therapists and physical therapist assistants empower you to take part in your recovery. They work with each other, other health care providers, and community partners to ensure you receive the best care.

Let a physical therapist help restore your movement so you can regain your physical, mental, and social health. Choose more movement for better health.

What can physical therapy help with?

What Can Physical Therapy Help With?

Physical therapists can provide supplementary treatment to a wide variety of medical conditions, depending on their specialty.

Physical therapists treat musculoskeletal conditions and work to optimize recovery or educate a person on how to optimize their movement patterns.

Some conditions that our physical therapists specializein include:

• Post- op Rehab, including total knee replacements, labrum repairs, menisectomy, spinal fusion.

• Conditions that affect the hand, such as carpal tunnel syndrome, and trigger finger.

• Musculoskeletal dysfunction, including back pain, rotator cuss tears, and knee pain.

• Sports-related injuries, such as tennis elbow, achilles tendonitis, ACL tears.

• Chronic pain.

• Hypermobility, leading to joint instability and pain.

How Long Should We Stretch?

How Long Should We Stretch?

When stretching our muscles, the general consensus is that we should stretch up to 60 seconds per muscle. Whether it is 20 seconds 3 times or 30 seconds 2 times as long as the muscle is stretched for 60 seconds.

There are others however who advocate a different stretch duration and repetition. Thirty years ago a man by the name of Aaron Mattes developed the 2 seconds, 10 times stretch. The premise of this technique is holding a stretch for only 2 seconds inhibits the protective stretch reflex (myotatic reflex).

The stretch reflex inhibits the muscle from lengthening for the stretch after 2 seconds. If the target muscles is indeed being inhibited then true lengthening without soreness will not occur.

The stretch is performed using Active Isolated Stretching. Using the muscle opposite in action to the target muscle to be stretched and only holding for 2 seconds, performing up to 10 repetitions with progressive increase in range of motion will allow progressive lengthening and eliminate overloading the stretched muscle which could cause potential microtears. An example would be contracting your quadriceps muscle to stretch the hamstring. By activating the quadriceps the brain then tells the hamstring to relax thus allowing the stretch.

So does it work? I put AIS to the test with myself and several patients. The muscle to be stretched was the left Middle Scalene which bends the neck to the side and is often a source of neck pain and tightness. I did not experience any rebound tightness later in the day or the following day. The increased ROM persisted for several days. One of my patients did not feel any difference between the 2 second x 10 reps stretch and the traditional 30 seconds x 2 reps stretch. The remaining 3 patients felt less soreness and improved ROM with AIS.

I then tried stretching my painful L Iliopsoas muscle. I had been doing 30 seconds x 2 reps with temporary relief (a few hours). The next day I tried the 2 seconds x 10 reps. I noticed a slight ache post stretch which resolved quickly. The pain and tightness remained improved for at least 2 days. Next, I tried stretching my non painful Hamstrings. I did not notice much of a difference between traditional stretching and AIS for reduction in tightness and duration.

My study is small and limited but it is possible the 2 second stretch works well for a painful muscle which is not responding to traditional stretching and other patient populations which have to be careful with stretching.

So which stretch to use? Check with your physical therapist if you are in rehab or other wellness provider who may be aware of both techniques. Most importantly, stretching should not make you feel worse than when you started and NEVER stretch a cold muscle.

To your health and wellness!

Joann Tippett, PT, MSPT, CKTP, CCI