Does Insurance Pay For That?

With the cost of health care rising and the number of approved physical therapy visits decreasing, patients often have to be discharged prior to full resolution of symptoms. To be honest, insurance companies don't care if you can't run in that 5k or go ballroom dancing anymore. In their eyes, if you can dress yourself, feed yourself, and walk a few blocks then you don't need physical therapy. To that end, patients can either sit around and complain how unfair insurance is (though writing in to your insurance company/local officials is a good idea) or they can take their health into their own hands, dig a little deeper into their pockets, and get back to EVERY activity that they want to perform.

As previously stated, for most patients, insurance coverage will only take them so far. Insurance will not cover maintenance therapy or sessions to help make you a faster runner. Insurance companies want to see that you can function at a very basic level and could care less about that upcoming golf trip you have planned. The good news is, Duffy & Bracken offers wellness programs that bridge the gap, fill in the holes, and address those issues that insurance companies deem superfluous. Want to PR in your next race? Try our new running program. Consider yourself a runner but don't know what PR means? Even more reason to check out our running program. Want to improve your tennis game? Consider signing up for a sports performance analysis. Want your feet to stop hurting? Definitely invest in our Happy Feet program.

A few months ago, while perched atop my soapbox I wrote an article about what we as physical therapists have to offer. Our unique skill set enables us to create specialized programs that directly address the needs of patients regarding nearly any physical activity. However, this extensive knowledge base only benefits patients when patients realize the value of the service being offered and choose to invest in their well-being. I always find it interesting how willing people are to pay personal trainers hundreds of dollars, yet balk at the idea of having to pay a $25 copay for a physical therapy visit. No judgement, no guilt trip, but the services that good physical therapists offer are worth it. 

The therapists at Duffy & Bracken hold doctoral degrees, personal training certifications, and manual therapy certifications. This advanced training allows us to not only optimize the gains made during the allocated physical therapy visits, but to implement after-care programs that get patients back to 100% functionality. Would it be great if insurance covered visits to make us run faster, jump higher, and drive that golfball farther? Of course. Is that going to happen anytime soon? Absolutely not. That in mind, patients need to invest in themselves and check out the after-care programs that Duffy & Bracken has to offer. We're worth it. Your health is worth it.

C. Shante Cofield, PT, DPT, CSCS

ELIMINATE WORKPLACE ACHES & PAINS!

Please allow me to introduce myself, my name is Julie and I recently joined Duffy and Bracken, PT. I practiced as a physical therapist for 7 years in Seattle Washington before moving to Downtown NYC. One of my specialties in Seattle was workplace modification and 5-hour return to work testing. These included activities such as touring a sawmill to adjust a workstation to accommodate an injured shoulder patient to modifying the internal organization of a police car to accommodate a low back patient. While the average New Yorker I currently treat is not in an industrial occupation, workspace modification is no less important. You spend 8-10+ hours a day at your desk and the more efficiently you set it up, the less stress you will experience on your neck, back and arms.

Here is a little test – can you sit with your back straight and feet flat on the floor for 5 minutes without fidgeting or adjusting and without an increase in pain? If you cannot then your core musculature does not possess the endurance for an 8 hour day in a chair.

Ergonomics strives to keep your joints in a neutral position to minimize the stresses on the muscles and ligaments. People come in different sizes so no two desks should look alike. Here are some suggestions for easy adjustments to your desk:

Adjustable Chair

When you are sitting your knees should be bent at a 90-degree angle with your feet resting on the floor. If you are petite and can lower your desk this is ideal but most desks do not have modifiable heights. If your feet do not touch the floor, bring the floor up to your feet with a footrest or even a small box.

The end of your seat should reach to four finger lengths to the back of your knee. Any farther forward can pinch nerves in your leg and make it uncomfortable to sit. Legroom under your desk should be at least 60 cm to allow for easy foot movement.

The backrest should be adjusted so that there is a convex surface supporting your low back. (If your chair does not have this I would suggest an adjustable lumbar support, which we stock here at Duffy and Bracken).

The arm rests should be positioned so that your elbows are slightly forward and bent at near a 90-degree angle.

With Foot Rest

 I am asked a lot about therapy balls as chairs. While I think this is good for watching TV, spending 8 hours a day on a therapy ball requires a lot of core endurance. If you would like to sit on a ball at work I recommend keeping a chair nearby for when your back becomes fatigued.

Keyboard

When you are typing your wrist should be supported and your elbows should be at a 90-degree angle. Because your arm rests should also support you at a 90-degree elbow angle it sometimes comes in direct conflict with your keyboard. I would suggest table length arm rests (they are shorter and allow you to push your chair up to the desk) on your chair or none at all if you are mostly on the computer or writing while at your desk.

Mouse

A traditional mouse used to control your cursor can add increased stress on your arm and shoulder because you have to elevate your arm for long periods of time. I recommend a trackball mouse. Your hand rests on the mouse and your thumb moves a roller ball that controls the cursor. They are inexpensive and your neck and shoulder will thank you.

Computer Screen

When you sit upright at your desk your eyes should be level with the top line of your screen. It is much easier for your eyes to track inferiorly without affecting your neck posture than it is for your eyes to track superiorly. If your computer screen is too high we tend to push our head forward and angle our head upwards, which tightens the back upper neck musculature. This is a good time to walk around your office and see your co-worker’s computer posture.

If you have a laptop it is harder to modify. I suggest putting it on a pedestal to raise the screen up and buying a wireless keyboard. 

 

Divide Your Desk Into Angles

Items that you use constantly should be within a radius of 50 cm – which means you do not have to reach far or rotate your body to grab them.  Items you use less can be a short reach away. 

Standing Desks

If you do a lot of reading you can make yourself a standing station at your desk. The optimal reading angle is with a 45-degree slanted desk and if you are writing the optimal angle for your elbows is with a 15-degree slanted desk. 

Unslanted Desk

 

Breaks

Most importantly you need to get up and walk around to give your body breaks from being in one position. Most people become so engrossed in what they are doing that they forget so I propose setting your cell phone to go off every 1-2 hours. A 5-minute walk around your office will help clear your head and give your muscles a chance to relax.

If you have any further questions about how to modify your workstation or you want a professional to assess your sitting ability, please do not hesitate to see me here at Duffy and Bracken, PT.

                                                                                                                                  

Julie Garner, DPT, COMT, CCI

julie@duffyandbracken.com

NO PAIN, NO GAIN!

My Duffy & Bracken Physical Therapy one year Anniversary is fast approaching. As the PR & Marketing Director, I wear multiple hats but one hat I didn't see coming was that of (wait for it) ....PATIENT. You see while finishing my Masters Degree, I worked from home for three years. As you can imagine, when I started commuting to Downtown NYC to work and began moving around more and more, I started feeling all sorts of aches and pains in my body. Even though I went to the gym when I could and got a work out in here or there....my mental activity certainly didn't make up for all my physical inactivity.

I figured how convenient for me....I work at a physical therapy clinic so I could just get a quick fix and be on my way. Boy was I wrong...TOTALLY wrong.

Many of you will want to argue with me that the 'No Pain, No Gain' philosophy is actually a myth and pain is not required to have a quality workout. Trust me I get! But I'm not here to argue that point....the truth is that Physical Therapy is unlike any other visit to your doctor's office. It most times will require more than just the quick fix even I expected. Like everyone else I was going to have to put in the work if I wanted to be pain free.

Here is what I learned while walking a mile in your shoes as a PT patient:

1. It may pain you to have manual therapy. Physical Therapy is not like getting a massage at your neighborhood spa. Manual therapy techniques are not as relaxing, it can even be uncomfortable, but trust your therapist to be your guide to long term freedom from pain.

2. It will pain you to do your exercises everyday. No one likes to do them but they are an integral part of your treatment plan....don't neglect them. And if you ever find yourself in pain again after being discharged, the first question you should ask yourself is ...have I been doing my home exercise program.... then make an appointment.

3. It will pain you to carve out a couple of hours a week for 4-6 weeks. Having been in your position, I definitely understand how difficult it can be to make time for treatment. We know your busy but don't be what I like to call a 'Repeat Offender'. Repeat offenders are patients who start feeling better in the middle of their treatment and decide that they don't need therapy anymore. They end up back in therapy because they didn't commit to the process. Would you tell your cardiologist that you don't need your heart medication anymore?

4. It may pain you to dip into your pockets for those co-pays at every visit. Yes, we know it adds up but we didn't make the rules we just enforce them. If you think about it...can we really place a price tag on being pain free and able to live your life to its fullest without physical limitations.

Anyone who has successfully completed their PT treatment plan will tell you that the benefits far out weigh the costs. When it comes to PT...No Pain, No Gain! So yes, it may be a pain in one way or another but most things worth doing are usually not easy. If you are currently in a PT treatment plan, commit to it and if your living in pain, you don't have to....make an appointment today!

Kieffer Pearce

PR & Marketing Director

Overcome Your 'Physical Therapy Blues' at Duffy and Bracken!!

Physical Therapy can bring a variety of emotions to an individual's mind. I have worked in Physical Therapy for seven years and have seen people come in for their initial appointments indecisive, anxious, scared and even some delighted believe it or not. Some have been in pain for days, months, and even years so taking that final step and scheduling an appointment to be treated can be a blissful feeling. Working at Duffy and Bracken, I see a change in patients as they go through their treatment. Many are excited to be able to return to the activities they have had to put on hold and to simply be pain free.

At the front desk I speak with many individuals a day with various injuries and set backs, with the variety comes different attitudes. Many are hesitant to begin their therapy because they have doubts they won't improve. An improvement is possible; it just takes time as well as patience and of course the willingness to spend money on those co-pays. Some patients have wanted to put off therapy because of their co-pays or coinsurance. One should keep in mind that you aren't going to be in therapy forever, taking that 4-6 weeks to commit to your therapy will definitely be money worth spending.

I become used to seeing our dedicated patients every week and when they get discharged, it's bittersweet. Sad because I'll no longer see a patient 2 to 3 times a week but happy because they committed to their therapy and got better with the help of the therapists and aides at Duffy & Bracken. As a patient you are not only committing time and money to improving your injury, you are learning new ways to keep your body strong and healthy....Who wouldn't want that?

Something unique about Duffy and Bracken is that several different programs are available for you, outside of traditional physical therapy treatments. There are specialized programs offered that can help any and everyone from an avid runner to a grandmother and at an affordable price. Visit http://www.duffyandbracken.com for more information. You can purchase a performance package where you learn more specifically about your body and ways to improve it. One reason patients do return back to Physical Therapy (and I've heard this multiple times) is because once they are better they quit doing the things they were taught in treatment. Don't let that be your story. Keeping up with your body is very important and therapy as well as our specialized programs can help you now and in the future.

Vonceia Petteway

Administrative Staff