Ask Burger FAQs

Why choose to come to Burger?
We pride ourselves in making a positive difference. This means that our goal is for you to experience a value for your time and efforts. Our process is focused on improving mobility and reducing dysfunction. Our Hope is that your life is better after working together.

What can I expect during my first visit?
You will provide us with your prescription for physical therapy. In some cases we may already have it from your Doctor. We will copy your insurance card. We will collect any co-pay or other financial obligation. You will be seen for the initial evaluation by a licensed therapist.

The therapist will discuss the following:

  • Your medical history.
  • Your current problems/complaints.
  • Pain intensity, what aggravates and eases the problem.
  • How this is impacting your daily activities or your functional limitations.
  • Your goals with physical therapy.
  • Medications, tests, and procedures related to your health.

The therapist will then perform the objective evaluation which may include some of the following:

  • 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.
  • Range of Motion (ROM) - the therapist will move the joint(s) to check for the quality of movement and any restrictions.
  • Muscle Testing - the therapist may check for strength and the quality of the muscle contraction. Pain and weakness may be noted. This is also part of a neurological screening.
  • 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.
  • Special Tests - the therapist may perform special tests to confirm/rule out the presence of additional problems.
  • 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 many times you should see the therapist per week, how many weeks you will need therapy, home programs, patient education, short-term/long-term goals, and what is expected after discharge from therapy. This plan is created with input from you, your therapist, and your doctor.

What do I need to bring with me?
Please bring copies of your relevant medical history. This may include surgical reports and recent tests such as X-ray’s, MRI and or CT-scans.

If you are taking a number of medications, it is helpful if you can provide us a list at the time of your first appointment.

Make sure you bring your physical therapy referral (provided to you by your doctor) and your payment information. If your insurance is covering the cost of physical therapy, bring your insurance card. If you are covered by Workers' Compensation, bring your claim number and your case manager's contact information. If you are covered by auto insurance or an attorney lien, make sure you bring this information.

Please bring a photo ID

Lastly, please bring a Smile. We all have a better day when we work together.

How should I dress?
You should wear loose fitting clothing so you can expose the area that we will be evaluating and treating. 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.

Please expect that our licensed clinicians will need to expose the area of your body that you are having us examine. We do this in order to use palpation (hands on examination) to assess the muscles and joint structures.

Please rest assured that your comfort and safety are a primary concern. Some clients prefer to bring a change of clothes for the examination rather than wearing a particular set of clothes to the facility.

If you chose aquatic therapy, please bring a swim suit and or appropriate attire. We do not allow the use of “cut off jeans” in our pool as the torn fibers can clog our filters. It may also be valuable to bring a pair of water shoes to wear not only in the pool but also the locker room area.

How long will each treatment last?
Initial Evaluations may last 30-60 minutes. Follow up sessions typically last 45 to 90 minutes per visit.

Why can the Initial Evaluation last shorter than a follow up treatment?
In reality, it does not. But the time you have with the therapist may feel shorter because after a therapist spends time with you, he/she must take additional time to process the evaluation data, document their findings for your records and produce a written report for you and your referring physician. Typically after you leave our office, a therapist may spend an additional 30 minutes working on your behalf.

How do you store my records and communicate with my Doctor?
We use Electronic Medical Records (EMR) for all of our outpatient documentation. Your information is stored on a secure server onsite at our office.

In communicating with your Doctor, we send a copy of your electronic file / reports to your Doctor’s office. Typically, your Doctor has a copy of your initial evaluation the same day you were treated.

Do you call to remind me of my appointments?
We use a computer system that generates automatic appointment reminder calls. We provide this service as a courtesy. Please let us know if you do not wish to receive these reminder calls.

There may be times out of our control where the system does not call you. Ultimately, keeping your appointment is your responsibility. Please refer to our Cancel/No-Show Policy.

Will I get relief from my first visit?
Each client and experience is different. Typically, our first visit is an evaluation and therefore most of the time and effort is spent organizing your history and putting together a plan for future treatment sessions.

Most clients receive some form of Home Exercise Program / Instruction on the first day.

For less complicated conditions, the therapist may choose to start some treatments. This will vary based on your condition, the severity, and communication between you and your therapist.

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. It may also depend on your insurance, what services are allowed based on your condition and medical necessity.

Why is physical therapy a good choice?
Many people suffer from pain. However, many do not even know that physical therapists are well equipped to not only treat pain but also its source.

Physical therapists are experts at treating movement and neuro-musculoskeletal disorders. Pain often accompanies a movement disorder, and physical therapists can help correct the disorder and relieve the pain.

Physical therapy is a good choice because it is a conservative approach to treating muscle-skeletal pain and dysfunction with minimum risk and without the side effects of medications.

What do physical therapists do?
Physical therapists are experts in movement and function; they do not confine their talents to only treating people who are ill. A large part of a physical therapist's program is directed at preventing injury, loss of movement, and even surgery. The cornerstones of physical therapy treatment are therapeutic exercise and functional training. In addition to "hands-on" care, physical therapists also educate patients to take care of themselves and to perform certain exercises on their own. Physical therapists use a variety of techniques to help facilitate improved function, mobility and reduction of limitations.

Why are people referred to physical / occupational therapy?
You and others may be referred to therapy because of a movement dysfunction associated with pain. Therapists treat these movement dysfunctions and their associated pains and restore your body's ability to move in a normal manner.

The inabilities to sleep on a shoulder, to raise your arm above your head, to bend forward at the waist, to walk up and down stairs, these are examples of movement dysfunctions.

Who pays for the treatment?
In most cases, health insurance will cover your treatment. Make sure you talk to our receptionist so we can help you clarify your insurance coverage.

Can you tell me what my co-pay or financial obligation will be?
In most cases, you will probably already know the answer. Usually, your co-pay is the same as it would be to see your Doctor. Frequently, the co-pay amount will be listed on your insurance card.

Sometimes, we “think” your co-pay is one amount, and find out 60-90 days after you have been seen that your insurance processes the claim differently. We apologize for this inconvenience and therefore encourage you to KNOW your benefits. Ultimately, you are responsible for payment.

In some cases, the information on your card may not be accurate at the time you choose to see us. There are many factors that can cause this. Ultimately it is your responsibility to know what your co-pay and or financial obligation is.

Who will I be treated by?
You will be evaluated by one of our licensed and highly trained Therapists. In many cases you will be able to continue with follow up sessions with the same Therapist who evaluated you. We encourage you to schedule your follow up sessions at times that are the most convenient to you. In some cases, this will result in you possibly seeing a licensed therapy assistant and or a different Therapist.

We encourage you to be self empowered to create a schedule that is most convenient to you and your busy life.

Are there physical / occupational therapy specialists?
Yes, although graduate training continues to be advanced each decade, there are a number of sub specialties within our team. Our team members include clinicians who are considered leaders in their field. Among our team we have the following:

  • Orthopedic Therapy - Probably the most common physical therapy specialist is the orthopedic specialist. These specialists care for post-surgical patients, arthritis, tendinopathy, fracture rehabilitation, muscle sprains and strains, neck and back pain, hip and knee problems, shoulder, elbow, and wrist conditions. Some are board certified as Orthopedic Certified Specialists (OCS).

  • Manual Therapy - Manual therapy is a broad term that describes a variety of hands-on treatment techniques that are applied to movement dysfunctions. Grade five mobilizations, Mulligan mobilizations with movement, Maitland and Kaltenborn techniques, functional technique, neural mobilization, joint mobilization, craniosacral therapy, strain/counter strain, Graston technique, myofascial release, etc. These are some of the more popular manual therapy techniques. Many manual therapists will take continuing education courses, obtain certifications in manual therapy, and will sit for board certification from the American Physical Therapy Association and other organizations. Most physical therapists incorporate manual therapy techniques as a part of a complete treatment plan.

  • Geriatric Therapy - Some therapists specialize 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 who is working with seniors and some clinics are solely dedicated to caring for those with balance problems. Most physical therapists work with seniors/geriatric patients. Some have obtained additional education, have passed a board examination, and have earned the Geriatric Certified Specialist (GCS) title.

  • Sports Rehabilitation - Experts in assisting with recovery after injury and surgery. Many sports specialists help with retraining the athlete utilizing running, throwing, jumping, and sport-specific programs to name a few. A therapist with the Sports Certified Specialist (SCS) title has passed a board certified test. In addition, a number of our physical therapists hold secondary degrees in Athletic Training (ATC).

  • Fitness and Wellness - Physical therapists 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, have an issue with diabetes, 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.

  • Hand Therapy - Most physical therapists are well trained to treat hand and wrist conditions. Some therapists including certified occupational therapists (OT’s) have taken additional courses and training and have passed a hand therapy certification examination. These therapists are called Certified Hand Therapists (CHTs).

  • Women's Health - Some therapists specialize in women's issues such as pregnancy problems, pelvic pain, and incontinence. Special treatment is available for women who have these problems. Many that suffer from incontinence do so needlessly. We are proud to offer these services in our West Sacramento Facility.

  • Industrial Rehabilitation - Specialists in industrial rehabilitation 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. Often, industrial rehabilitation specialists will evaluate your ability to perform certain job tasks with a Functional Capacity Evaluation (FCE).

  • Pediatric Therapy - Pediatric therapists specialize in the rehabilitation of children. They may assist with kids who suffer from cerebral palsy, developmental disorders, neurological disorders, and/or orthopedic problems. A Pediatric Certified Specialist (PCS) is a board certification that some may obtain from the American Physical Therapy Association.

  • Aquatic Therapy - Aquatic therapy takes advantage of the physical properties of water to assist with the rehabilitative process. Buoyancy, turbulence, hydrostatic pressure, and thermal properties of water can assist with the rehabilitation of a patient. Those suffering from chronic pain, osteoarthritis, fibromyalgia, rheumatoid arthritis, lumbar fusion surgery, or with a limited weight-bearing status are just a few of the many different patient populations that can benefit from aquatic therapy.

  • Neurological, Spinal Cord Injury, and Traumatic Brain Injury Rehab - A large portion of physical and occupational therapists work with patients who 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. A certified specialist holds a Neurologic Certified Specialist title (NCS).

  • Balance, Dizziness, and Vertigo Rehabilitation - Many suffer from dizziness or BPPV (benign paroxysmal positional vertigo). Some clinics specialize in the rehabilitation of patients with 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 - many physical therapists specialize 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 a therapist who specializes in care for amputees.

  • Osteoporosis Rehabilitation and Prevention - Some practitioners specialize in the evaluation and treatment 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.

Why choose Physical / Occupational Therapy vs. Chiropractic?
Both Rehabilitation (PT and OT) services and Chiropractic are conservative musculoskeletal treatments. Choosing between PT and Chiropractic services may be influenced by your experiences, those of your physician and feedback from friends and family.

Traditionally, people may choose Chiropractic services when they feel there is a specific joint in their body that is restricted and needs mechanical adjustment/manipulation.

Physical Therapy may include passive range of motion of a joint. This could include joint mobilization. The result is a similarity of services. The added value of Physical Therapy is the emphasis on conditioning of muscles, strengthening and stabilization to prevent reoccurrence of your symptoms.

Are Physical / Occupational therapy 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 therapist will provide you with the appropriate exercises not only for pain relief but to recover range of motion, strength, and endurance.

In some cases, therapy 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 therapist 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.

What types of treatments will I receive?
There are dozens of different types of treatment interventions. Here is a list of possible treatment interventions:

  • 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.

  • 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.

  • 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.

  • 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.

  • 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 - is 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 people 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.

  • Ice 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) - is 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, 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.

  • Iontophoresis - medications are propelled through the skin by use of a specialized “Skin Patch.”

  • Pelvic Traction - the longitudinal/axial pull on the lumbar spine, 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.

Will I get a massage at physical therapy?
Massage may be part of your treatment. Rehabilitation specialists are trained in a variety of techniques that may help with your recovery. Deep tissue techniques may be part of the rehabilitative process.

The massage that we typically do is local to one joint or a small group of specific muscles. Typical massage may be short in duration lasting from 5-15 minutes.

If you are in need of a full body and or more of a relaxation type of massage, we encourage you to seek out the help of a licensed massage therapist.

What happens if my problem or pain returns?
Flare ups are not uncommon. If you have a flare up (exacerbation), give us a call. We may suggest you come back to see us, return to your doctor, or simply modify your daily activities or exercise routine.

Can I go to any physical therapy clinic?
In most cases, you have the right to choose any physical therapy clinic. Our practice is a provider for many different insurance plans. 

Can I go directly to my physical therapist? Do I need to see my Doctor first?
This is one of these questions with a yes and a no answer.

In California, you are allowed to directly access a physical therapist for your care provided you have a medical diagnosis for your condition in the past two (2) years. Unfortunately in most cases, your insurance will not cover the visit(s) unless you have recently seen your medical Doctor first.

If you are not utilizing insurance, you may choose to come see us first to receive care more quickly. Rest assured that we will encourage the communication of our efforts with your Doctor of choice.

Can my therapist provide me with a diagnosis?
In most states, physical therapists cannot make a medical diagnosis. This is something that your medical doctor will provide for you. Physical therapists are important members of your medical team. At this point in time, physicians are typically the health care providers that will provide you with a medical diagnosis.

How does the billing process work?
Billing for physical therapy services is similar to what happens at your doctor's office. When you are seen for treatment, the following occurs:

  • The physical / occupational / and or Speech therapist bills your insurance company, Workers' Comp, or charges you based on Common Procedure Terminology (CPT) codes.

  • Those codes are transferred to a billing form that is either mailed or electronically communicated to the payer.

  • The payer processes this information and makes payments according to an agreed upon fee schedule.

  • An Explanation of Benefits (EOB) is generated and sent to the patient and the physical therapy clinic with a check for payment and a balance due by the patient.

  • The patient is expected to make the payment on the balance if any.

It is important to understand that there are many small steps (beyond the outline provided above) within the process. Exceptions are common to the above example as well. At any time along the way, information may be missing, miscommunicated, or misunderstood. This can delay the payment process. While it is common for the payment process to be completed in 90 days or less, it is not uncommon for the physical therapy clinic to receive payment as long as six months after the treatment date.

What will I have to do after physical therapy?
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.

Is my therapist licensed?
Physical therapists (PTs) and physical therapist assistants (PTAs) are licensed by their respective states. Occupational (OT) and Speech (SP) therapists are also licensed in the state of California.

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