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FAQ

Q:What happens during my first visit?

During your first visit you can expect the following:

  • Arrive at your appointment with your paperwork completed (you can download it from our website - see the patient forms link) (or arrive 10 minutes early and fill out the forms before your appointment).
  • You will be seen for the initial evaluation by your therapist.
  • Your therapist will discuss the following:
    1. Your medical history.
    2. Your current problems/complaints.
    3. Pain intensity, what aggravates and eases the problem.
    4. How this is impacting your daily activities or your functional limitations.
    5. Your goals with treatment.
    6. Medications, tests, and procedures related to your health.
  • Your therapist will then perform the objective evaluation which may include some of the following:
    1. Palpation - touching around the area of the pain/problem. This is done to check for the presence of tenderness, swelling, soft tissue integrity, tissue temperature, inflammation, etc.
    2. Range of Motion (ROM) - the therapist will move the joint(s) to check for the quality of movement and any restrictions.
    3. Muscle Testing - the therapist is checking for strength and the quality of the muscle contraction. Pain and weakness may be noted. Often the muscle strength is graded. This is also part of a neurological screening.
    4. Neurological Screening - the therapist may check to see how the nerves are communicating with the muscles, sensing touch, pain, vibration, or temperature. Reflexes may be assessed as well.
    5. Special Tests - the therapist may perform special tests to confirm/rule out the presence of additional problems.
    6. Posture Assessment - the positions of joints relative to ideal and each other may be assessed.

The therapist will then formulate a list of problems you are having, and how to treat those problems. A plan is subsequently developed with the patient's input. This includes how often you should see the therapist, how many weeks you will need treatment, home programs, patient education, short-term/long-term goals, and what is expected after discharge from treatment. This plan is created from input from you, your therapist, and your doctor.

Q:What do I need to bring with me?

Bring your referral from your doctor (if your doctor has given you one). If you are covered by auto insurance (because you were in a car accident) bring your insurance company name, claim number, policy number, adjuster's name and telephone number.

You should bring (or wear) a pair of gym shorts/yoga pants and t-shirt.

Q:How should I dress?

ou should wear (or bring) a pair of gym shorts/yoga pants and t-shirt. For example, if you have a knee problem, it is best to wear shorts. For a shoulder problem, a tank top is a good choice, and for low back problems, wear a loose fitting shirt and pants, again so we can perform a thorough examination.

Q:How long will each treatment last?

Treatment sessions typically last 30 to 90 minutes per visit, however this will vary on the type of treatment you are receiving and the nature of your injury.

Q:How many visits will I need?

This is highly variable. You may need one visit or you may need months of care. It depends on your diagnosis, the severity of your impairments, your past medical history, etc. At your first visit your therapist will be able to determine the number and frequency of your visits. You will be re-evaluated frequently by your therapist to closely monitor your progress and adjust your treatment plan as needed.

Q:Why is physiotherapy a good choice

Although more than half of all Canadians are suffering from pain, many do not know that physiotherapists are well equipped to not only treat pain but also its source.

Physiotherapists are experts at treating muscle and joint problems as well as movement disorders. Pain often accompanies a movement disorder, and physiotherapists can help correct the disorder and relieve the pain.

Q:What do physiotherapists do

You have probably heard of the profession of physiotherapy. Maybe you have had a conversation with a friend about how physiotherapy helped get rid of his or her back pain, or you might know someone who needed physiotherapy after an injury. You might even have been treated by a physiotherapist yourself. But have you ever wondered about physiotherapists--who they are and what they do? Many people are familiar with physiotherapists' work helping patients with orthopedic problems, such as low back pain or knee surgeries, to reduce pain and regain function. Others may be aware of the treatment that physiotherapists provide to assist patients recovering from a stroke (e.g., assisting them with recovering use of their limbs and walking again).

The ability to maintain an upright posture and to move your arms and legs to perform all sorts of tasks and activities is an important component of your health. Most of us can learn to live with the various medical conditions that we may develop, but only if we are able to continue at our jobs, take care of our families, and enjoy important occasions with family and friends. All of these activities require the ability to move without difficulty or pain.

Because physiotherapists are experts in movement and function, they do not confine their talents to treating people who are ill. A large part of a physiotherapist's program is directed at preventing injury, loss of movement, and even surgery. Physiotherapists work as consultants in industrial settings to improve the design of the workplace and reduce the risk of workers overusing certain muscles or developing low back pain. They also provide services to athletes at all levels to screen for potential problems and institute preventive exercise programs. With the boom in the golf and fitness industries, a number of physiotherapists are engaged in consulting with recreational golfers and fitness clubs to develop workouts that are safe and effective, especially for people who already know that they have a problem with their joints or their backs.

The cornerstones of physiotherapy treatment are therapeutic exercise and functional training. In addition to "hands-on" care, physiotherapists also educate patients to take care of themselves and to perform certain exercises on their own. Depending on the particular needs of a patient, physiotherapists may also "mobilize" a joint (that is, perform certain types of movements at the end of your range of motion) or massage a muscle to promote proper movement and function. Physiotherapists also use methods such as ultrasound (which uses high frequency waves to produce heat), hot packs, and ice. Although other kinds of practitioners will offer some of these treatments as "physiotherapy," it's important for you to know that physiotherapy can only be provided by qualified physiotherapists or by physiotherapy assistants, who must complete a 2-year education program and who work only under the direction and supervision of physical therapists.

Most extended health benefits packages include coverage for physiotherapy treatment. The extent of coverage varies from one plan to the next. Call your insurance company for details regarding your specific coverage.

You do not require a referral from your doctor to receive physiotherapy treatment, however some insurance companies require a referral before they will reimburse your claim.

Ask your doctor if physiotherapy is right for you.

Q:Why are people referred to physiotherapy

You and others may be referred to physiotherapy because of a movement dysfunction associated with pain. Your difficulty with moving part(s) of your body (like bending at the low back or difficulty sleeping on your shoulder, etc.) very likely results in limitations with your daily activities (e.g. difficulty getting out of a chair, an inability to play sports, or trouble with walking, etc.). Physiotherapists treat these movement dysfunctions and their associated pains and restore your body's ability to move in a normal manner.

Q:Who pays for the treatment

Most extended health insurance plans cover the cost of the services in our clinic. The extent of coverage varies greatly from one plan to another. Call your insurance company to confirm the details of your coverage. Our front desk staff would be pleased to help you with any questions or concerns you may have.

Q:Who will see me


You will be evaluated by one of our licensed and highly trained practitioners and he/she will also treat you during subsequent visits. Unlike some clinics, where you see someone different each visit, we feel it is very important to develop a one-on-one relationship with you to maintain continuity of care.

Your therapist may however identify that your injury/condition requires treatment from another type of practitioner. As a result you may be referred to another practitioner in the to receive that part of your treatment. The practitioners will, with your consent, work closely together to ensure that all your treatment needs are met and that your recovery is swift and complete.

Q:What are physiotherapy specialists

Although it is not possible for physiotherapists in Canada to specialize, it is common for physiotherapists to take continuing education courses to further develop their assessment and treatment skills. Here are some common areas in which physiotherapists can pursue postgraduate courses:

  • Orthopedic Physiotherapy - This refers to the area of physiotherapy that deals with post-surgical patients, arthritis, tendonitis, fracture rehabilitation, muscle sprains and strains, neck and back pain, hip and knee problems, shoulder, elbow, and wrist conditions.
  • Manual Therapy - manual therapy is a broad term that describes a variety of hands-on treatment techniques that are applied to help reduce pain and improve function. Joint manipulation, joint mobilization, craniosacral therapy, myofascial release and muscle energy are some of the more common types of manual therapy techniques. Most physiotherapists incorporate manual therapy techniques (to varying degrees, of course) as a part of a complete treatment plan.
  • Sports Physiotherapy - experts in assisting with recovery after injury and surgery. Physiotherapists are trained to help with retraining the athlete utilizing running, throwing, jumping, and sport-specific programs to name a few.
  • Fitness and Wellness - physiotherapists are well trained to help with your fitness needs and wellness programs. If you need an exercise program, have trouble with your weight, are concerned about osteoporosis, diabetes is an issue, or you would like to learn how to prevent falls, physical therapists can help. The previous examples are just a few of the many programs physical therapists offer.
  • Women's Health - some therapists have taken continuing education courses in women's issues such as pregnancy problems, pelvic pain, and incontinence. Special treatment is available for women that have these problems. Many that suffer from incontinence do so needlessly. A physiotherapist may be able to help.
  • Ergonomics and Workplace Injury Rehabilitation - physiotherapists can help with those that have suffered on-the-job injuries. Moreover, they will evaluate work tasks, fabricate assistive devices, evaluate your ergonomic situation, and help redesign work flow/tasks to decrease the incidence of injury.
  • Osteoporosis Rehabilitation and Prevention - physiotherapists can evaluate and treat of osteoporosis patients. Working in concert with your medical doctor, the therapist will often design a specialized weight-bearing and resistance training program for those with this silent disease.
  • Pediatric Physiotherapy - pediatric therapists help with the rehabilitation of children. They may assist with kids that suffer from cerebral palsy, developmental disorders, neurological disorders, and/or orthopedic problems.
  • Geriatric Physical Therapy - physiotherapists can also be involved in the rehabilitation of seniors. As the body ages, a variety of challenges arise. We stiffen, we lose strength, our balance skills decline, our bones become brittle (osteoporosis), our endurance decreases, and we take longer to recover from injuries. Balance and fall prevention are of paramount importance to the therapist that is working with seniors and some clinics are solely dedicated to caring for those with balance problems. Most physiotherapists work with seniors/geriatric patients.
  • Cardiac and Pulmonary Rehabilitation - this type of physiotherapist works with patients that have had heart attacks, bypass surgeries, angioplasty, breathing problems, emphysema, and other heart/lung related conditions. Physiotherapists are well equipped to work with these types of patients because many of them have orthopedic ailments that limit their ability to function. In other words, a physical therapist can address the heart and lung problems as well as the muscle problems that are concurrently present.
  • Neurological, Spinal Cord Injury, and Traumatic Brain Injury Rehab - a large portion of physiotherapists work with patients that suffer from these conditions. Functional retraining including, walking, wheelchair use, getting in and out of bed or chairs (transfer training), moving in bed (bed mobility), and retraining patients to use their shoulders, arms, and hands are just some of the services these therapists provide to those with neurological involvement.
  • Balance, Dizziness, and Vertigo Rehabilitation - many suffer from dizziness or BPPV (benign paroxysmal positional vertigo). Patient education, strengthening, safety awareness, posture and balance exercise, walking exercise, and special techniques that affect sensory and balance centers of the brain and limbs are all important components of a rehabilitation program.
  • Amputee Rehabilitation - physioyherapists are trained in the rehabilitation of amputees. Caring for the injured limb, functional and walking training, training in the use of assistive devices (crutches, canes, prosthetic limbs, etc.) are all provided by aphysiotherapist that works with amputees.
  • Lymphedema Rehabilitation - we take it for granted but a special component of the circulatory system, the lymph system, helps filter and drain fluid from our arms and legs. When this drainage system is damaged, painful swelling can result. Some therapists have taken continuing education courses in the treatment of lymphedema as it is called. Special positioning, massage and bandaging techniques are utilized by the lymphedema specialist.

Q:Is physiotherapy painful

For many patients, one of the primary objectives is pain relief. This is frequently accomplished with hands-on techniques, modalities such as ultrasound, electrical stimulation, and/or heat or cold therapy. Movement often provides pain relief as well. Your physiotherapist will provide you with the appropriate exercises not only for pain relief but to recover range of motion, strength, and endurance.

In some cases, physiotherapy techniques can be painful. For example, recovering knee range of motion after total knee replacement or shoulder range of motion after shoulder surgery may be painful. Your physiotherapist will utilize a variety of techniques to help maximize your treatment goals. It is important that you communicate the intensity, frequency, and duration of pain to your therapist. Without this information, it is difficult for the therapist to adjust your treatment plan.

For many patients, one of the primary objectives is pain relief. This is frequently accomplished with hands-on techniques, modalities such as ultrasound, electrical stimulation, and/or heat or cold therapy. Movement often provides pain relief as well. Your physiotherapist will provide you with the appropriate exercises not only for pain relief but to recover range of motion, strength, and endurance.

In some cases, physiotherapy techniques can be painful. For example, recovering knee range of motion after total knee replacement or shoulder range of motion after shoulder surgery may be painful. Your physiotherapist will utilize a variety of techniques to help maximize your treatment goals. It is important that you communicate the intensity, frequency, and duration of pain to your therapist. Without this information, it is difficult for the therapist to adjust your treatment plan.

Q:What types of treatments will I receive

There are dozens of different types of treatment interventions. Here is a list of treatment interventions:

Soft Tissue Mobilization - therapeutic massage of body tissue, performed with the hands. Soft tissue mobilization may be used for muscle relaxation, to decrease swelling, to decrease scar tissue adhesions, and for pain relief.

Joint Mobilization - hands-on therapeutic procedures intended to increase soft tissue or joint mobility. Mobilization is usually prescribed to increase mobility, delaying progressive stiffness, and to relieve pain. There are many types of mobilization techniques including Maitland, Kaltenborn, Isometric Mobilizations, etc.

Active Range of Motion (AROM) - the patient lifts or moves a body part through range of motion against gravity. AROM is usually one of the first modalities prescribed for arthritis.

Active Assistive Range of Motion (AAROM) - therapist-assisted active range of motion. This is usually prescribed for gentle stretching or strengthening for a very weak body part.

Stationary Bicycle - with or without resistance. This is usually prescribed for improving the strength and/or range of motion of the back or lower extremities as well as cardio-vascular endurance.

Gait or Walking Training - the analysis of walking problems by visually examining the interaction of the low back and the joints of the thighs, legs, and feet during the various stages of walking, including initial contact, loading response, mid stance, terminal stance, pre swing, mid swing, and terminal swing. Many back, thigh, leg, ankle, and foot problems may be caused by or manifest themselves in subtle gait abnormalities.

Isometrics - muscle contraction without joint movement. This is usually prescribed for strengthening without stressing or damaging the joint (e.g., arthritis, or exercises to be performed in a cast, or right after surgery if recommended by the therapist/doctor).

Isotonics- muscle(s) contracting through the ROM with resistance. This is usually prescribed for strengthening.

Proprioceptive Neuromuscular Facilitation (PNF) - a system of manually resisted exercises performed in diagonal patterns that mimic functional movements. PNF was initially used in developmentally and neurologically impaired patients but now is used in almost every aspect of neuromuscular retraining from athletes in sports facilities to the very weak in hospitals and nursing homes.

Posture Training - instruction in the correct biomechanical alignment of the body to reduce undue strain on muscles, joints, ligaments, discs, and other soft tissues. There is an ideal posture but most do not have ideal posture. Therapists educate patients about the importance of improving posture with daily activities. Stretching and strengthening exercises may be prescribed to facilitate postural improvement and to prevent further disability and future recurrences of problems.

Progressive Resistive Exercises (PRE) - exercises that gradually increase in resistance (weights) and in repetitions. PRE is usually prescribed for reeducation of muscles and strengthening. Weights, rubber bands, and body weight can be used as resistance.

Passive Range of Motion (PROM) - the patient or therapist moves the body part through a range of motion without the use of the muscles that "actively" move the joint(s).

Stretching/Flexibility Exercise - exercise designed to lengthen muscle(s) or soft tissue. Stretching exercises are usually prescribed to improve the flexibility of muscles that have tightened due to disuse or in compensation to pain, spasm or immobilization.

Cryotherapy or Cold Therapy - used to cause vasoconstriction (the blood vessels constrict or decrease their diameter) to reduce the amount of fluid that leaks out of the capillaries into the tissue spaces (swelling) in response to injury of tissue. Ice or cold is used most frequently in acute injuries, but also an effective pain reliever for even the most chronic pain.

Neuromuscular Electrical Stimulation (NMES) - the application of electrical stimulation to aid in improving strength (e.g., the quadriceps muscle after knee surgery or injury). NMES is also used to decrease pain and swelling and to relieve muscle spasm.

Neck Traction - a gentle longitudinal/axial pull on the neck, either manual or mechanical, intermittent or continuous for relief of neck pain, to decrease muscle spasm, and facilitate unloading of the spine.

Heat - heat is recommended to decrease chronic pain, relax muscles, and for pain relief. It should not be used with an acute or "new" injury.

Iontophoresis - medications are propelled through the skin by an electrical charge. This modality works on the physical concept that like charges repel each other, therefore, a positively charged medication will be repelled through the skin to the underlying tissues by the positively charged pad of an iontophoresis machine. Iontophoresis is usually prescribed for injuries such as shoulder or elbow bursitis.

Lumbar Traction - the longitudinal/axial pull on the lumbar spine, either manual or mechanical, intermittent or continuous. Pelvic traction may be helpful for the relief of low back pain and muscle spasm.

Transcutaneous Electrical Nerve Stimulation (TENS) - a relatively low voltage applied over painful areas through small self-adhesive electrodes. The electrical stimulation "disguises" or "overrides" the sensation of pain. It is a small, portable unit, used in intervals, to control pain and reduce dependence on drugs. It is usually prescribed for relief of pain.

Ultrasound - ultrasound uses a high frequency sound wave emitted from the sound head when electricity is passed through a quartz crystal. The sound waves cause the vibration of water molecules deep within tissue causing a heating effect. When the sound waves are pulsed, they cause a vibration of the tissue rather than heating. The stream of sound waves helps with nutrition exchange at the cellular level and healing. Studies have shown that ultrasound is helpful for ligament healing and clinically, for carpal tunnel syndrome, and muscle spasm.

Q:Do I need a referral from my doctor to receive treatment

You do not require a referral in order to receive treatment. Your insurance company may however require that you submit a referral from your doctor with your claim form. Call your insurance provider to confirm details of your plan.

Q:How does the billing and payment process work

Payment is required at the end of each session. You will be provided with a receipt will all the information regarding your treatment and practitioner. If you have health insurance that covers your treatment you can send your receipt to your insurance company along with a claim form (provided to you by your insurance company). Your insurance provider may also require that you send a referral for treatment from your doctor.

If you do not have health insurance we recommend that you keep your receipts for your income tax purposes.

If you are being treated for injuries sustained in a car accident we do not require payment directly from you. After your initial assessment we will submit a proposed treatment plan to your insurance company and upon approval of the plan we can bill your insurance company directly.

Q:What will I have to do after physiotherapy

Some patients will need to continue with home exercises. Some may choose to continue with a gym exercise program. Others will complete their rehabilitation and return to normal daily activities. It is important that you communicate your goals to your therapist, so he/she can develop a custom program for you.

Q:Is my therapist licensed

All of the health practitioners as Physioplus Health Group are licensed to practice their respective disciplines in Ontario. Furthermore, Physioplus Health Group requires that all practitioners participate in professional development courses and activities to ensure continual growth in skill and knowledge.

Q:How do I choose a physiotherapy clinic

  • The therapist should be licensed in Ontario.
  • The first visit should include a thorough medical history and physical examination before any treatment is rendered.
  • The patient goals should be discussed in detail during the first visit.
  • Care should include a variety of techniques which might include hands-on techniques, soft tissue work, therapeutic exercises and in some cases heat, cold, electrical stimulation or ultrasound.
  • A clinic with a focus on providing hands-on treatment is preferred.
  • Is the therapist taking continuing education courses to further their knowledge and skills?
  • Do they have a service that can address your problem?
  • They should be conveniently located. Since sitting and driving often aggravate orthopedic problems, there should be a very good reason for you to drive a long distance for rehabilitation.
  • Can they provide satisfaction survey results?
  • The therapist should provide the treatment (rather than an assistant or kinesiologists).
  • Can you briefly interview the therapist before the first visit?
  • Ask your family and friends who they would recommend.

Q:What is your privacy policy

Our privacy policy can be read here:

PRIVACY POLICY: COLLECTION, USE, AND DISCLOSURE OF PERSONAL INFORMATION

Privacy of personal information is an important principle to our clinic. We are committed to collecting, using and disclosing personal information responsibly and only to the extent necessary for the services we provide. This document describes how we handle personal information.

WHO WE ARE
PhysioPlus Health Group employs Osteopaths, Manual Physiotherapists, Registered Massage Therapists, and two support staff. The professionals and support staff have access to your personal information, and as such are sensitive to the nature and confidentiality of the information disclosed to us. In this clinic, Alda De Sousa, Office Manager, is also acting as Privacy Information Officer.

HOW INFORMATION IS COLLECTED
Information may be collected by telephone, by filling out forms, by personal interview, from direct examination and recording of services, and/or by transfer of medical information from one health care facility to another.

WHY INFORMATION IS COLLECTED

  • To deliver safe and efficient care, including treatment plans and follow-up care.
  • To document changes that occurs over time or with treatment.
  • To comply with the regulatory requirements of each of the professions and to comply generally with the law under the Regulated Health Professionals Act (RHPA), and for the defence of a legal issue.
  • To contact you, your family members or health care provides if needed.
  • To invoice for services and collect for unpaid accounts.
  • To effectively communicate with other healthcare professionals involved in your care.

PROTECTING PERSONAL INFORMATION
We understand the importance of protecting personal information and have taken the following steps:

  • Paper information is either under supervision or secured in a locked cabinet.
  • Staff is trained to collect, use and disclose personal information only as necessary to fulfill their duties and in accordance with our privacy policy.

QUESTIONS OR COMPLAINTS?
Please contact this clinic to discuss any questions or concerns about your personal information. If we cannot satisfy your concerns, you are entitled to complain to the associated regulatory bodies. More information about Personal Information Protection and Electronic Documents Act, (PIPEDA) can be obtained by contacting the Privacy Commissioner at: 112 Kent Street, Ottawa, ON K1A 1H3 TOLL-FREE 1-800-282-1376 WWW.PRIVCOM.GC.CA

Canadian federal legislation, the PIPEDA, requires us to confirm that we have your consent to the collection, use and disclosure of your personal information. Please review the Privacy Policy and sign the consent for our records.