Before Your Visit

• Make a list of any questions you have and want to ask your physical therapist.


• Write down any symptoms you've been having and for how long. If you have more than one area of symptoms, begin with the one that bothers you the most. Describe whether your pain or symptoms are:


• Better or worse with specific movements, activities, or positions such as sitting or standing.
• More noticeable at certain times of the day.
• Relieved or made worse by resting or a specific task or activity.
• Write down key information about your medical history, even if it seems unrelated. For example: 
  • List all prescribed and over-the-counter medicines you take or have taken within the last month. Don't forget to include any vitamins and supplements you take.
  • Make a note of any relevant personal information. Include things that you believe might be linked to your condition, such as:
    • Recent stressful events.
    • Injuries.
    • Incidents or accidents.
    • Your home or work environment.
    • List any medical conditions of your parents or siblings.

If you wear glasses or use a hearing aid, take them with you. Tell your physical therapist and clinic staff if you have a hard time seeing or hearing.

Take any lab, imaging, or reports from other health care providers with you that are related to your medical history or current condition.

Bring a list of your doctors and other health care providers. Your physical therapist can discuss their findings and your progress with them. Physical therapists partner with other health care providers to ensure you get the best possible care.

​When you make your appointment, ask whether you should wear or bring a certain type of clothing for your first visit. Don’t wear clothing that doesn’t stretch. Your physical therapist may have you take part in treatment activities during your first session. 

Financial Considerations

Carefully review the clinic's financial policy. If you do not receive it at your first appointment, ask for a copy. If anything is unclear, ask questions or ask for someone to explain the policy to you before starting treatment.

The physical therapy clinic will ask you to sign the financial agreement. Read it carefully and ask questions if anything is unclear.

The clinic staff will request payment of any deductibles and copayments before or after each visit. Paying these at the time of service will help you better manage health care costs and avoid a large bill after treatment ends.

If you need to change how often you have physical therapy for financial reasons, discuss this with your physical therapist. They can explore options and develop a workable plan to help you get the care you need.

If you change or lose your insurance coverage, be sure to inform your physical therapist and the clinic's front office staff.

What To Expect During Your First Visit

Your physical therapist will begin by asking you lots of questions about your health. These will include specific questions about your condition and any symptoms that led you to see them. The details you give will help your physical therapist assess whether you are likely to benefit from physical therapy. It also will help them choose the treatments that are most likely to help you.
 
Your physical therapist also will ask you specific questions about your home or work setting, your health habits and activity level, and your leisure and sports interests. Their goal is to help you become as active and independent as possible and return to the activities you enjoy.
 
Your physical therapist will perform a detailed exam. Depending on your symptoms and condition, your physical therapist may evaluate your:

• Strength.
• Flexibility.
• Balance.
• Coordination.
• Posture

 
Your physical therapist may use their hands to examine or feel on or around the area of concern. They also will assess the motion and function of your joints, muscles, and other tissues.
 
Your physical therapist also may check:

• How you walk (your gait).
• How you get up from a lying position or get in and out of a chair (functional activities).
• How you use your body for certain activities, such as bending and lifting (body mechanics).

Your physical therapist will work with you to determine your goals for physical therapy. Then, they will create a treatment plan for your specific condition and goals. In many cases, the physical therapist will diagnose your condition and begin treatment right away.
 
A main goal of treatment is to improve or maintain your ability to do daily tasks and activities. Your physical therapist may address pain, swelling, weakness, and limited motion to help you reach this goal. They will check your response to each treatment and make changes as often as needed. Physical therapy treatment also may speed your recovery.
 
Education is an important aspect of your physical therapy treatment. Your physical therapist may teach you special exercises to do at home. They also may show you different ways to do your work and home activities. The goal is to lessen or get rid of the problem believed to be the reason for your pain, strain, or injury and show you ways to stay healthy.
 
Your physical therapist will assess your need for special equipment. For example, they may suggest special footwear, splints, or crutches. They also may advise that you use special devices to help make your home a safer place for you, especially if they find that you are at an increased risk of falling. They will determine what equipment you need based on your situation. They may either provide it for you or tell you where you can find it. If you do need special equipment, your physical therapist can show you how to use it properly.
 
Your physical therapist will share important information with your doctor and other health care providers at your request.
 
Your physical therapist will recheck your progress often throughout your plan of care. They will work with you to plan for your discharge from physical therapy when you are ready. Make sure to talk with your physical therapist about what to do if you have questions after discharge or if your symptoms or condition worsens.
 
Your physical therapy visit may include working with a physical therapist assistant on exercises prescribed by your physical therapist. Physical therapists and PTAs work together and with other health care providers to make sure you get the care you need.
 
Get the Most Out of Physical Therapy
You will get out of your physical therapy sessions what you put into them. It will take a certain amount of effort on your part, as agreed between you and your physical therapist, to get the most benefit from each session. Here are four tips to help you get the most out of physical therapy:

1. Keep Your Appointments: Arrive for your sessions on time or a few minutes early. Being late may reduce your one-on-one time with your physical therapist and affect other patients. Engage in the discussion to decide how often you will see your physical therapist and determine your treatment goals. Then, work with your physical therapist to meet your goals.
2. Attend your appointments: Missing appointments can delay your recovery. Failing to show without canceling in advance may result in a fee and disrupts the physical therapist's schedule. If an emergency keeps you from going, try to give notice as soon as possible. Review the facility's financial and cancellation policy before you begin treatment.  If you plan to stop therapy or change how often you receive treatment for personal or financial reasons, discuss this with your physical therapist.
3. Follow Your Physical Therapist's Instructions: It is essential to follow your physical therapist's guidance. They may recommend that you modify an activity or avoid certain movements.  Ignoring these precautions may lead to injury or delay your recovery.
4. Do Your Home Exercise Program: Doing your home program as often as prescribed by your physical therapist is essential to your recovery. If the instructions are unclear, ask your physical therapist to explain them to you. Only do exercises that your physical therapist prescribed.  
5. Continue Your After-Care Plan: After you have finished formal physical therapy, you'll want to keep the gains you made. Make sure to continue your home exercise plan. Follow all instructions given to you by your physical therapist after you are discharged.

 
Your physical therapist also may determine that you might benefit from seeing another specialist or health care provider. They may recommend doing so in addition to having physical therapy or before starting physical therapy treatment.
 
Some physical therapists also provide annual visits to promote health and wellness. They may ask you to return for a follow-up or yearly visit.
 
You can contact a physical therapist directly for an evaluation. 

The following is a condensed article from ChoosePT and can be fount at Preparing for Your Visit | Choose PT

I love a quick, effective exercise bundle that targets specific muscle groups.  It just fits in so well with the chaotic lives we all are living :)  Try these 3 shoulder exercises.  10-20 reps each, one after the other.  Rest after each set and get through 3 sets.  Equipment: resistance band and weights.  To progress or REgress the exercise, all you need to do is lower the resistance of the band and/or lighten the weights!!

​SHOULDER FLEXION
Start with the band around both wrists and pull apart, shoulder width apart.  Grab your weights (not necessarily needed) and lift arms up just past 90 degrees and return.  10 reps.

BICEPS CURLS
Start with the band around both wrists and pull apart, shoulder width apart.  Grab your weights (necessary) and perform a biceps curl MAINTAINING your hands hip width apart and return.  10 reps.

SHOULDER EXTERNAL ROTATION
Start with the band around both wrists and pull apart, shoulder width apart.  Grab your weights (not necessarily needed) and bend elbows to 90 degree. While keeping your elbows bent pull the band apart and return.  10 reps.​

Again, 10-20 reps each, 3 sets.  Easier: lighten band, lower weight.  Harder: stronger resistance, heavier weight.

I hope you enjoy this little burner and have a great weekend!!

​Dominick

The overhead shoulder press is a GREAT exercise that helps strengthen many muscles in the shoulder, back, and core buuuuuut that comes with a few caveats.  First, you need to see if you have enough range of motion (ROM) to do the exercise in the first place.

Once you are good there, you want to make sure your are performing the exercise correctly, finishing in the proper shoulder slot. Too often we see the overhead press look like:

The weight is away from your center of gravity, putting excessive pressure on the shoulder joint and the anterior structures.

Finish the exercise by pressing the weight  directly overhead, imagining pushing it through the ceiling.  This will force you to use the muscles around your shoulder blade to stabilize the arm in place.  Make sure your elbow is fully straight, letting the triceps join the party :)

If you have any questions, please let us know!
dominick@sanramonvalleypt.com

A couple other ways and places to schedule (and feedback from patients has been better with these locations!)

SAFEWAY: https://www.safeway.com/pharmacy/covid-19.html

You can put in your zip code and will get you to the closest Safeway that offers the vaccine.

SAN RAMON FD: https://www.firedepartment.org/.../Compo.../News/News/240/17

Hope this helps!

1/15/2020:  Registration Instructions to Receive the Vaccine
To our knowledge, at this point, there are 3 ways to get the vaccine.

First, through Kaiser if you are a patient with Kaiser insurance.

Second, through John Muir Health. Per a email blast from John Muir Health, if you have a John Muir Health account, they will contact you in a 'variety of ways including MyChart messages, email, text messages and phone calls.' They are going to start with patients 75 years and older and then work their way down.

Third, through Contra Costa County Health Services, which is how employees from SRVPT scheduled their vaccinations. Many of us have already had the first shot and most of us will have had it by the end of next week!

For those residents 65 and older please click below to register to get the vaccine from Contra Costa County Public Health website. After you complete the online registration form the county will determine if you qualify for the vaccine and send you an invitation to make an appointment.

https://forms.microsoft.com/Pages/ResponsePage.aspx...
​
The CDC has a lot of great resources about the vaccine as well as the Contra Costa County Health Services page. Certainly, consult with your doctor if you have any questions.
Registration Instructions to Receive the Vaccine
https://www.cdc.gov/coronav.../2019-ncov/vaccines/index.html
https://www.coronavirus.cchealth.org/vaccine

There are many uses for the foam roll; from soft tissue release techniques, to stretching, and even taking up space in the corner of a room!

Dust off your foam roll, lay on it, any try this easy and effective neck stretch...especially after a long day.

First: lay on the foam roll with your head, neck, AND butt, all fitting on the foam roll.  The short rollers will not work for this exercise.

​Second: When turning your head to the right, first slide your head slightly off to the left side.  This keeps the integrity of your neck bio mechanics when going through the stretch.  Not doing this step would allow for your head to roll off to the right of the foam roll, making it a pointless exercise.

​Third: Rotate your head, pivoting off of the foam roll, angling your nose to the ground.  As you can tell, there is a straight line through the top of my head, down my spine, though the middle of my body.  

Hold this position 3-5 seconds and perform 5-10x each side.  This is a big stretch targeting  the upper half of the neck.

Hope you enjoy! Let me know if you have any questions.

​Dominick

Your hamstrings are such an important muscle that provide tons of stability in walking, running, bending over, etc.  They are often overlooked with the glutes and quads typically getting all the love.  It is good to have a few go-to hamstring exercises at home.  Here is one of my favorites: the hamstring bridge curl.

To start, you need something that will slide on your floor.  In the Danville clinic, we use old school furniture sliders, as you'll see below.  In San Ramon, we have sliders meant for floor workouts which can be found on Amazon.  In my garage, I use pieces of cardboard that seem to slide on the garage floor just fine (I know, I should probably upgrade).

Here is a video of it in action.

We hope you have a wonderful, safe, and healthy holiday and wish you a Happy New Year!

Dominick and the SRVPT family

Good Morning! Time to get up and get the day started!  Gotta warm up the body and the Bretzel is a great way to get that accomplished.

The next thing is to stretch the other side!

Hope you enjoy the Bretzel!

​Dominick

Many exercise routines and strength regimes tend to incorporate of some sort of pressing overhead.  Alternating arms, both arms, military press, even overhead triceps work, and the list can go on and on.  It is a GREAT way to target multiple muscles in the shoulder BUT (a BIG but) you MUST make sure you have enough shoulder range of motion (ROM) to complete the task.  If you cannot complete the motion withOUT weight, what makes you think you can do it WITH weight?  Here is the check:

Start by laying on your back, knees bent and hands by your sides.  Next, arch your arm overhead.

You should be able to have your hand and arm touch the ground overhead with 

• no pain
• no arching low back

If you can, GREAT.  You are all set.  If not, there are many things that you can do to improve that ROM.

If you have any questions, please let us know.
Dominick
dominick@sanramonvalleypt.com