PTAG Blog

Please contact your Georgia State Senator and ask him or her to support Senate Bill 164, sponsored by Senator Fran Millar. This bill will help reduce the out-of-pocket amount a patient has to pay for Physical Therapy, Occupational Therapy and Chiropractic Care by prohibiting a health insurer from charging a copay that is greater than that of a primary care physician or osteopath.

To locate your State Senator, visit the Georgia Secretary of State’s My Voter Page or the Georgia State Senate website.

Read more about the need for Fair Copays in Georgia and how SB 164 helps address this issue …

Background and Problem:

Physical therapy (PT) has been proven to be as effective as surgery for conditions such as meniscal tears knee osteoarthritis, rotator cuff tears, spinal stenosis, and degenerative disk disease.

Further, manual therapy, exercise and education provided by a physical therapist is a proven supplement to prescribing opioids. In fact, the Centers for Disease Control and Prevention (CDC) is urging health care providers to reduce the use of opioids in favor of safe alternatives such as PT, OT, and chiropractic care.

Physical therapy, occupational therapy, and chiropractic services typically fall into the category of “specialist” under most health insurance plans – a classification that is accompanied by higher copayments.

Some areas of specialized care only require a copayment on the first visit – with all follow-up visits covered under the initial copay. However, typical PT, OT, and chiropractic treatment plans require multiple visits, and this higher copay must be paid at each visit – creating a barrier to access for patients.

The number of required visits within a treatment plan is highly variable, and often depends on factors such as diagnosis, severity of impairments, and past medical history – just to name a few. However, it is safe to say that most patients require multiple visits.

Imposing higher copays is a problem for many patients. Insurers are limiting the frequency and duration of care a patient can afford. The Physical Therapy Association of Georgia (PTAG) gathered data to illustrate the financial burden of higher copays for PT – revealing the lowest copay of $30 – and some as high as $75 – with the average copay for PT being $51.25.

Based on this average, a patient required to visit a physical therapist 2 times a week for 4 weeks is paying $410 in out-of-pocket health care expenses. This example is a conservative estimate – as there are many Georgians paying even greater out-of-pocket medical costs. However, if these same patients were paying the average copay for a primary care physician of $25, they would pay only $200 in out-of-pocket expense – a savings of more than $200.

The Solution:

SB 164 seeks to remove the barrier to care created by high copays. This bill prohibits a health insurer from charging a copay for PT, OT, and chiropractic care that is greater than that of a primary care physician or osteopath. SB 164 will do the following to benefit Georgia’s health care consumers:

• Save money by reducing out-of-pocket medical expenses;
• Allow greater compliance with the plan of care leading to improved outcomes and less downstream health care costs for insurers
• Provide a safe alternative for the use of prescribed opioids

High copays are restricting patient access in Georgia. SB 164 will open access and allow Georgians to seek necessary care by reducing high copays.

Some may argue that passing SB 164 will result in insurers raising the copay for primary care physicians. However, there is absolutely no evidence to support the claim that primary care copays would go up – as this has not happened in the eight other states that have enacted similar legislation.

Check out the score board for week three of #ptagURit below. One more week of trivia before PT Day at the Capitol next week!

*1/25 : What is PTAG’s campaign that was unveiled at last year’s PT Day at the Capitol?

*1/26: How many floors is the Georgia Capitol building?

*1/27: Share a PT success story.

*1/28: When does registration for PT Day at the Capitol close?

*1/30: How many days (not including today) until PT Day at the Capitol?

*1/31: Post a picture showing your #ThumbsUpForPT.

There is still time to play #ptagURit up until PT Day at the Capitol on Feb. 7, 2017!

Check out the leader board below:

*1/18 – For 50 points: name 3 PTA programs in the great state of Georgia

*1/19 – For 30 points: what year did Georgia become a state?

*1/20 – For 10 points, name something that physical therapy can prevent.

*1/21 – For 25 points: name a DPT program in Georgia.

*1/22 – For 75 points: name some of the board-approved clinical specialties in physical therapy.

*1/23 – For 25 points: comment the name of Georgia’s official song.

*1/24 – For 50 points: the statue on top of Georgia’s capitol is often called Miss __________.

It’s time to get ready for the 2017 Physical Therapy Day at the Georgia State Capitol on February 7 from 7:30 a.m. – 2 p.m. Join us beforehand to play another game of #ptagURit trivia!

What is it #ptagURit?

#ptagURit is a combination trivia game and scavenger hunt to kick-off 2017 Physical Therapy Day at the Capitol, which is on February 7.

How do I play?

Beginning Wednesday, January 11, trivia questions, scavenger hunt items and other “tasks” will be posted to the PTAG Facebook and PTAG Twitter pages. These same assignments will be sent out once per week – on Wednesdays – via eblast.

You simply post your answer, photo of your item or proof of the completed task to the PTAG Twitter page or PTAG Facebook page. You must have #ptagURit in your answer for your post to be accounted for.

Each trivia question, scavenger hunt item or task will be worth a specified number of points.

Additionally, at the Physical Therapy Day at the Capitol morning breakfast on February 7, a list of trivia questions, scavenger hunt items and tasks will be distributed which gives PTAG members the chance to win additional points.

Winners will be announced at the closing of Physical Therapy Day at the Capitol on February 7.

If you aren’t already a member of PTAG’s social media network, join or follow at:

Facebook: https://www.facebook.com/PTAGinfo

Twitter: https://twitter.com/ptaginfo

Remember: no matter how you send in your response, include #ptagURit.

Twitter:               Use #ptagURit in your response

Facebook:           Use #ptagURit at the beginning of your response

What if I am not on social media or don’t have time to check it every day?

If you aren’t a social media aficionado, you may also play via email. Simply email your answers.

Email to: ptag@duffey.com  – Use #ptagURit in subject line

How do you know who I am if I’m playing via text or if my Twitter handle doesn’t include my full name?

If your Twitter handle, Facebook page or email address is not obviously identifiable, let us know via email at ptag@duffey.com.  Just send us your name, along with your Twitter handle, email address or other online identity so we can tally points accurately. If you text, make sure you include your name – or send the information to us via email.

How do I win – and what do I win?

The two PTAG members with the most points at the end of Physical Therapy Day at the Capitol on February 7 will receive a 30 oz. YETI® Rambler Tumbler and the second place winner will receive a 20 oz. YETI® Rambler Tumbler.

How will I know if I am winning or if I need to step up my game?

Points will be tallied at the end of each week and posted to the #ptagURit scorecard, which will be posted on the Facebook and Twitter pages and sent out via the Wednesday eblast.

Who do I contact if I have more questions?

Call or email Haley Sheram:

404-446-1665

hsheram@duffey.com

Warm-Up and Cool-Down: the Bookends of Your Race

Warm-Up: To improve performance and reduce the risk of injury, you should always warm up before running and especially before running at a higher intensity or racing.

• Begin with 5-10 minutes of brisk walking or light jogging: your pace should be EASY (about 50% effort) and much slower than your race pace. The goal: to break a sweat.
• Next you will need to focus on targeting specific muscles and ranges of motion (flexibility) required for running. You can actually target both with the right series of functional movements.

Lunge Matrix [Activates hip and thigh muscles, loosens hips]

-Perform 4 different lunges: forward, forward with a twist, side, and back; 3-5 reps each on each side (Don’t try these for the first time on race day, and keep them small at first to avoid overdoing it!)

Pedal Pushers [Dynamic calf stretching]

-In either a downward dog or traditional wall stretch position, pedal your heels back and forth: 5x with knees straight, 5x with knees bent, 5x with heels angled out, and 5x with heels angled in

Leg Swings with Abdominal Bracing [Hip opener with core activation]

-With a hand on a wall, fence or other support:

Swing the leg at the hip to the front and back while contracting your abdominal muscles (don’t hold your breath though). Use your abs to avoid letting your back arch when your leg goes behind you. 5-10x each leg

Swing the leg at the hip side to side while contracting your abdominal muscles (across the front of the body and then out to the side) 5-10x each leg

• If you have traditional static stretches in your normal pre-run ritual, now is a great time for them.
• If you’re getting ready for a high intensity race, drills such as skips, high knees, butt kicks, grape vines, bounds and strides are good to do in those last few minutes before the gun! Otherwise, try to keep moving, stay loose and rest assured you’ve taken smart steps towards a better, healthier race performance!

Cool-Down and Recovery: As much as you may want to collapse to the ground once you’ve scored your finisher’s medal and some H₂O, your body needs you to stay on your feet for an active recovery!

• Avoid sitting down or standing still for at least 10 minutes after you finish; if possible, keep moving by walking or light jogging (slow, easy pace). You may be uncomfortable at first, but your body often starts to feel better at this slower recovery pace. Take the opportunity for a victory lap!
• After 10 minutes of active recovery, GENTLE static stretches may be performed at 3 x 30 seconds for major muscles groups such as the calves, quads, hamstrings, inner thighs, hip flexors, deep hip rotators and lower back. Stretch to the point of light resistance. This should not be painful! Coordinate deep breathing with your stretches for improved muscular relaxation.
• Light self-massage with a foam roller, “stick,” tennis ball or other tool may also be helpful to relax tired, overworked muscles.
• Be sure to replace the fluid, electrolytes and nutrients you lost. Make this a priority, especially if you’re feeling weak!
• Pat yourself on the back and enjoy the sweet exhaustion that follows a race well run!

Only one in three adults receives the recommended amount of physical activity each week, according the President’s Council on Fitness, Sports and Nutrition. There are countless benefits to maintaining an active lifestyle – reducing risk of heart disease, diabetes, cancer, obesity. The list goes on, but many Georgians struggle to find the time or energy.

A daily walk is a simple way to incorporate regular exercise into your routine and move your way into a healthier lifestyle. A 30 minute walk is proven to elevate moods, increase energy and creativity and prevent chronic diseases. Something as simple as throwing on your tennis shoes during your lunch break or skipping the sitcom before dinner can drastically alter not only your shape, but also improve your mood and overall health.

To encourage this active lifestyle and educate Georgians about the benefits of physical therapy, PT Move Better, Feel Better, Live Better is hosting the first annual Walk with a PT on Oct. 22 in cities across Georgia, as part of National Physical Therapy Awareness Month.

Georgians are invited to join PT Move Better, Feel Better, Live Better and local physical therapists to walk their way to a healthier life, all while consulting PTs who can give them tips and tricks for proper form to maximize the benefits.

Walk With a PT will take place in Atlanta, Augusta and Gainesville. For more information, check Facebook.com/PTMoveBetter and @PTMoveBetterGA or email info@ptagonline.org.

When Doug Deadwyler returned home for lunch on Dec. 1, 2006, he recalls feeling that “something was not quite right.” As he sat down to eat, his intuition kicked in and he placed the cordless phone next to him as a precaution. As he went to dial his parents’ number, however, Doug realized that something was very wrong.

Doug was in the early stages of an AV fistula – a type of stroke that affects the parietal and occipital lobes of his brain. His motor skills quickly become compromised, and while he could still think and speak clearly, he was only able to dial “0” for the operator to connect him with emergency responders. Doug stayed on the phone while paramedics broke down his door.

The last thing Doug remembers was the cold air as the paramedics wheeled him out of his house. He was transported to Emory, where he underwent two lifesaving surgeries and began a long recovery process. After 23 days in the Intensive Care Unit, Doug was deemed stable enough to move into in-patient rehab. His first memory is of Christmas Day when a physical therapist came in with reindeer antlers on to perform his evaluation.

As soon as movement was detected, Doug began the long road ahead of relearning how to use both sides of his body. Therapy began with small movements in his hospital bed. And when leg movement was detected several days later, daily PT began.

Doug’s goal was simple: to walk again.

Early therapies – including speech therapy and occupational therapy – concentrated not only on moving his left arm and improving his cognitive abilities, while Doug’s goal to walk again remained steadfast. A physical therapist visited Doug daily to assist with activities and exercises to strengthen his left leg, which he struggled to move at all. He suffered from “left-side neglect,” meaning his brain ignored all stimuli from the left side – creating an interesting challenge as he navigated his way in a wheelchair.

After Doug established his goals, therapy became a routine part of his life. He met with his PT and other members of his therapy team daily, focusing primarily on strengthening his left side to improve his function. He worked in the parallel bars to build his strength and endurance, eventually graduating from the wheelchair to a walker. Doug’s days of out-patient therapy were long and filled with appointments, but also gave him the opportunity to meet others in the same boat – providing him with additional support and appreciation for his family of caregivers.

His physical therapy appointments were one-on-one, consisting of a program designed specifically for not only his activity limitations, but also his strength and goals. Doug practiced using handrails to go up and down stairs. He practiced on ramps and used equipment to continue to strengthen his left side.

Upon “graduating” from out-patient therapy, Doug progressed to forearm crutches, providing him with more flexibility, as well as leading him one step closer to his long-term goal of walking on his own. Finally, Doug was able to move through narrow doorways and navigate a restaurant. He was free to use either bathroom in his home, rather than the one with a wide enough doorframe to accommodate his wheelchair or walker.

With the introduction of aquatic therapy to Doug’s plan, he began to learn to walk again without the use of a walker or forearm crutches. The flexibility that Doug found in the pool where, if he “fell,” it didn’t have any consequences, provided the push, strength and coordination he needed to begin to walk again independently.

While much of his progress in function peaked within the 6 – 12 months following his stroke, today, Doug continues to use physical therapy on an “as-needed” basis for back pain and building strength. He still attends Promotion classes – The Shepherd Center’s fitness center. He still visits his office twice a week, which provides a regular schedule and routine, as well as a piece of what his life was like before his stroke.

People who suffer an AV Fistula like Doug have a 50/50 chance of survival – and among those, only 25 percent have a meaningful recovery and return to a “new” normal life. Doug credits the quick action of his doctors and therapists, as well as his active lifestyle prior to the stroke, for his remarkable recovery. While his priorities and recreational activities have changed, Doug considers his life meaningful. It never crossed his mind that he wouldn’t “get better.”

Click here to learn more about how physical therapy is an integral component of stroke recovery.

Pain management is one of the biggest discussions in the medical community today. The New York Times has dedicated numerous articles to discussing the chronic pain problem plaguing our nation, and campaigns like #ChoosePT serve to educate consumers about the dangers of misdiagnosis and over-prescription of opioid drugs.

This is why we spoke with esteemed physical therapist, Herb Silver, PT, DSc, MBA, to discuss his decades of experience managing – and eliminating his patients’ chronic pain.

According to Herb, many patients often arrive eager to focus on segmented, isolated pain. While, admittedly, his back, head and shoulders also hurt, the patient wants to focus on pain in his neck. Herb aims to eliminate this frame of mind by focusing on the systemic problem of chronic, wide-spread pain. Rather than focus on one area, Herb takes in the big picture with the goal of eliminating the root of his patients’ chronic pain.

A patient should expect his first PT appointment to begin with a standard exam, including an orthopedic, neurological and a manual therapy exam, as well as identifying pieces of patient history that may contribute to chronic pain. Perhaps he struggles with sleeping or anxiety or balancing work and play. Many times, these factors can intensify pain from an injury.

By incorporating a mindfulness of the entire central nervous system, Herb is able to lead his patients into recovery – one free of both pain and pills.

Mindfulness does not suggest that pain is just perception. It incorporates shifts in neurotransmitters as well as an injury or an area that physical therapy can address – which is why it is unique. PTs have the tools to treat localized pain while also being mindful of the central nervous system.

And these “mindfulness” techniques are quantifiable.

When treating an issue stemming from the central nervous system without being mindful of the root cause, the “bear” – as Herb describes it – will keep attacking. Patients begin losing sleep, suffering from anxiety. The brain remains in a state of attack. A PT may recommend something as simple as refocusing throughout the day – focusing on breathing, for example – or may even recommend more elaborate lifestyle changes.

When your brain perceives an attack, it reacts. But by incorporating techniques into daily life to eliminate the “bear,” a patient can eliminate the root of his pain.

Moving forward, Herb anticipates a continuous shift in the medical community to incorporating a holistic approach to pain management, one that includes physical therapy in its core. If you suffer from chronic pain, find a physical therapist near you.

When you think aquatic therapy, a picture of an older woman with a flower swim cap and floats is probably what comes to mind. However, aquatic therapy today is considered a safe and effective option for a wide variety of physical therapy patients. From high-functioning, independent patients returning from a sports injury, to 100-percent-dependent, wheelchair-bound patients recovering from a spinal cord injury, and even people living with multiple sclerosis, the “type” of person who may benefit from aquatic PT is endless.

Water’s unique environment enables patients to work on endurance, joint mobilization, stretching, balance, strengthening, gait training and the list goes on – oftentimes with more independence than what he or she may find on dry land. Therapy in the water challenges a patient’s core and stabilizing muscles in a way that may not be activated on the ground.

With the Rio Olympic Games kicking off, and the heat wave to end all bearing down on us, we spoke with Cathy Kramer, PT, an outpatient physical therapist at The Shepherd Center, and Lisa Ruger, the aquatics coordinator at The Shepherd Center, to discuss how patients find relief and recovery in the pool.

Lisa paints a picture of the pool facility at the Shepherd Center, complete with accommodations for nearly all patients and equipped to treat those with huge physical impairments, as well as with adaptive equipment to provide support for the various conditions and wide range of functionality treated.

The pool doesn’t discriminate. From day to day, Cathy may treat a patient who is 100-percent-dependent, hoping to find relief from chronic shoulder or neck pain from sitting in a wheel chair, followed by a teen with a goal of returning to his football team for his senior season.

Aquatic therapy also allows for flexibility in ways many patients or caregivers may not think of – like temperature control. The Shepherd Center’s pool varies in temperature, allowing physical therapists to treat conditions that are temperature sensitive and have different needs, as some patients have conditions that are sensitive to heat and some need the heat to reach their goals.

For patients who are considering PT in the pool, your first appointment likely won’t look too different from another’s – although your treatment plan will be tailored to your specific needs and goals. For example, Cathy explains that she holds the first appointment on land because that is the world we live in, and understanding patients’ limitations on land is key to developing a treatment plan as effective as possible for their everyday lives.

Once in the water, Cathy assesses a patient’s comfort-level as the pool may bring out anxiety in some patients. This may stem from the origin of the injury – a neck injury from diving into the pool, for example – or a drastic change in functionality in some who no longer know how to function in the water.

To prevent over assistance and impairment of natural movements, Cathy starts without equipment. She assesses the patient’s functionality and ability, and from there may add weights to increase ground reaction force or floats if necessary. Sessions and equipment are individualized to each person’s needs.

After determining the best treatment plan to reach a patient’s goals and help him or her gain functionality, Cathy’s focuses on helping the patient feel comfortable enough in the water to work their program on their own or with the assistance of a caregiver.

After reaching their PT goals, patients can continue their time in the pool with community classes. Lisa explains how continuing progress after your PT is “complete” is possible with open swims, community classes and other programs offered at The Shepherd Center. Who knows – you may see a former aquatic therapy patient in Tokyo for the 2020 Olympics.