Schedule an Appointment Today

Whether you’re on the path to recovery or striving for injury prevention, our expert team is here to support you every step of the way. Contact us today to schedule your personalized session and take the first step towards a healthier, pain-free life. Don’t miss out on the opportunity to embrace a brighter, more active future with us!

Address: 3534 Bee Caves Rd. #110, West Lake Hills, TX, United States, Texas
Phone: 512-215-4277
Email: info@therapyandpilates.com

About CORE Therapy and Pilates

At our physical therapy clinic in West Lake Hills, Texas, we stand out as a trailblazer in holistic healthcare. With a unique blend of Physical Therapy, Pilates, and GYROTONIC® care, we’re committed to helping you recover from injuries and prevent them from happening in the first place. We prioritize your overall well-being, offering a comprehensive approach that sets us apart.

Disclaimer: Prior to commencing any new fitness regimen, consulting with professionals like Cheryl and Stephen is recommended to ensure that exercises align with your individual needs and objectives.

What are Spinal Stenosis Exercises to Avoid? 

Exercises form a crucial part of managing and preventing the exacerbation of spinal stenosis symptoms. Yet there are certain activities that individuals with this condition should steer clear of. High-impact exercises such as running or jumping can intensify symptoms as they put undue stress on the spinal cord.

Likewise, exercises involving twisting of the spine or heavy lifting can also strain the spine. Instead, gentle, low-impact activities like swimming, cycling, Pilates, or yoga are advisable as they strengthen the supporting muscles without burdening the spine.

Things to Avoid with Spinal Stenosis

Beyond exercise, there are other lifestyle factors that those living with spinal stenosis should remain wary of. Extended periods of standing or walking, bending backwards, and maintaining poor posture can aggravate the condition. Regularly monitoring your body's response to various activities and adjusting habits accordingly is vital to managing spinal stenosis effectively.

What Kind of walking Problems do People with Spinal Stenosis Have?

The narrowing of spinal spaces can cause distinctive walking problems. A common symptom experienced by people with this condition is known as "neurogenic claudication." This issue manifests as pain or cramping in the lower back and legs, which worsens when standing or walking and improves when sitting or leaning forward. Another related walking problem is foot drop, where an individual struggles to lift the front part of their foot, leading to frequent tripping.

How do you Fix Spinal Stenosis without Surgery? 

Fortunately, there are numerous ways to manage spinal stenosis without resorting to surgery. Physical therapy is a cornerstone of managing this condition; it strengthens the muscles that support the back, improving overall stability.

Medical interventions such as pain relievers, anti-inflammatory drugs, and nerve desensitizers can alleviate pain and other symptoms. Additionally, epidural steroid injections have been successful in providing temporary relief for some patients. Complementary therapies, including massage therapy and acupuncture, have also shown promise in managing spinal stenosis symptoms.

Is Spinal Stenosis A Permanent Disability?

Spinal stenosis can significantly impair an individual's quality of life, but it doesn't always qualify as a permanent disability. The severity and progression of the condition vary greatly among patients, and in severe cases, spinal stenosis might be deemed a disability under the Social Security guidelines. However, a comprehensive evaluation by a medical professional is necessary for this classification.

Is Spinal Stenosis Hereditary?

While the origins of spinal stenosis are multifaceted, a hereditary component does exist. A congenitally small spinal canal can make an individual more susceptible to spinal stenosis. However, most cases of spinal stenosis are linked to age-related degenerative changes like osteoarthritis or disc degeneration.

Cervical and Lumbar Spinal Stenosis Are Different

The key difference between cervical and lumbar spinal stenosis lies in the location and the resultant symptoms. Cervical stenosis, occurring in the neck, can lead to symptoms like numbness, weakness, or tingling in a hand, arm, foot, or leg and can interfere with balance and coordination.

Lumbar stenosis, which is more common and located in the lower back, often causes pain or cramping in the legs, especially when standing or walking. Despite the differences, both types of stenosis stem from a common cause: a narrowing of the spaces within the spinal canal that puts undue pressure on the spinal cord or nerve roots. By understanding the nature and nuances of this condition, individuals can manage their symptoms and maintain an active lifestyle.

How is Spinal Stenosis Diagnosed?

Spinal stenosis is diagnosed through a multi-step process, starting with a detailed history and physical examination by a healthcare provider. Patients often describe specific symptoms, such as pain in the neck or back, numbness or tingling in the arms or legs, or problems with walking or balance. During the physical examination, the doctor may test the patient's reflexes, strength, and sensation, and look for signs of neurogenic claudication, a hallmark of spinal stenosis.

After a physical examination, if the healthcare provider suspects spinal stenosis, they may order imaging tests for confirmation. These can include X-rays, which can reveal changes associated with osteoarthritis or bone spurs; computed tomography (CT) or CT myelograms, which can provide detailed cross-sectional images of the body and reveal herniated disks, bone spurs, or tumors; and magnetic resonance imaging (MRI), which can provide 3D images of the spine and detect damage to disks and ligaments, as well as the presence of tumors.

What Does Spinal Stenosis Look Like On An MRI?

On an MRI, spinal stenosis appears as a narrowing of the open spaces within the spine. The spinal canal, where the spinal cord or nerve roots travel, may seem constricted. This constriction could be due to various factors, such as bulging discs, thickened ligament tissue, or bone spurs.

The pressure these structures place on the spinal cord or nerve roots may be visible, particularly if the scan is performed with contrast. While interpreting an MRI scan requires specialized training, these are some of the signs a trained radiologist or physician may note when diagnosing spinal stenosis.

What is Congenital Spinal Stenosis?

Congenital spinal stenosis is a form of spinal stenosis that a person is born with. The term "congenital" means that the condition is present at birth. In this case, the individual inherits a smaller than normal spinal canal.

While they may not experience symptoms at a young age, the narrow spinal canal leaves less room for error, making these individuals more susceptible to developing symptoms of spinal stenosis earlier in life, especially if they experience any sort of degenerative changes or trauma to the spine. It's important to note that while congenital spinal stenosis increases the risk, it does not guarantee that the individual will develop symptomatic spinal stenosis.

Schedule an Appointment Today

Whether you’re on the path to recovery or striving for injury prevention, our expert team is here to support you every step of the way. Contact us today to schedule your personalized session and take the first step towards a healthier, pain-free life. Don’t miss out on the opportunity to embrace a brighter, more active future with us!

Address: 3534 Bee Caves Rd. #110, West Lake Hills, TX, United States, Texas
Phone: 512-215-4277
Email: info@therapyandpilates.com

About CORE Therapy and Pilates

At our physical therapy clinic in West Lake Hills, Texas, we stand out as a trailblazer in holistic healthcare. With a unique blend of Physical Therapy, Pilates, and GYROTONIC® care, we’re committed to helping you recover from injuries and prevent them from happening in the first place. We prioritize your overall well-being, offering a comprehensive approach that sets us apart.

Disclaimer: Prior to commencing any new fitness regimen, consulting with professionals like Cheryl and Stephen is recommended to ensure that exercises align with your individual needs and objectives.

What causes poor flexibility?

Poor flexibility can be caused by a number of contributing factors. Possible causes include:

1. Sedentary Lifestyle

Lack of physical activity or inactivity for long periods can cause muscle tightness and stiffness.

2. Age

As we age, our muscles lose elasticity.

3. Inactivity Due to Injury 

Inactivity due to injury or surgery can cause muscle stiffness and reduced flexibility, just as a sedentary lifestyle can. It is best to consult with a healthcare provider for appropriate strengthening and stretching following an injury.

4. Genetics 

Genetics can play a role in determining how flexible someone is.

5. Muscle Imbalance 

Muscle imbalance or weakness can cause poor flexibility. Muscles can be overused and tight or underutilized and weak.

6. Poor Posture 

Poor posture can cause muscle imbalances. It is best to change your posture throughout the day. For example, try to stand at least every other hour if you have a desk job.

7. Chronic Medical Conditions 

Certain medical conditions like arthritis, fibromyalgia, or multiple sclerosis can cause joint stiffness, leading to poor flexibility.

What are ways to improve poor flexibility?

Routine stretching exercises can help improve flexibility. Focus on stretching the muscles that feel tight or restricted, and hold each stretch for at least 30 seconds for a static stretch. 

Static stretching, dynamic stretching, contract-relax stretching (PNF), and passive stretching are all types of stretching. Practicing yoga can help improve flexibility, balance, strength, and relaxation. Starting with a beginner's class or video is recommended to avoid injury. 

Similar to yoga, Pilates is low-impact and places emphasis on core activation, form, and flexibility. It involves a series of exercises that help improve flexibility, strength, and proprioception. Regular massage can help improve flexibility by reducing muscle tension, which can improve range of motion.

Massage can also increase blood flow to a tight muscle or area. Engaging in regular physical activity and avoiding being sedentary can help with overall flexibility and wellbeing. Exercise can improve flexibility and keep your muscles from being tight and weak.

Be conscious of your form and gradually increase the intensity and duration of your flexibility exercises over time.

Overexertion can lead to injury. It's important to consult a physician, physical therapist, or qualified fitness professional before beginning any new exercise program, especially if you have any pre-existing medical conditions.

Do these gentle stretches and range of motion exercises to improve flexibility.

1. Posterior pelvic tilt in supine

• To perform this exercise, lie on your back on a yoga mat or other firm surface with your knees bent and your feet flat on the floor. 
• Think about the points of your pelvis coming towards your ribs.
• Your low back should round down onto the mat or floor, and the space between your pelvis and front ribs should shorten.

2. Cat/Camel or Arch/Curl in quadruped

• To perform this exercise, get on your hands and knees. If you have wrist issues, you can make your hands into a fist and put your knuckles on the floor. 
• To perform the cat portion of the exercise, round your mid and lower back and curl your core in. Look down towards the floor. 
• To perform the camel portion, arch your back, lift your chest, and look forward.
• Alternate between the two for the desired number of sets and reps.

3. Thread the needle

• To perform this exercise, get on your hands and knees. This should be done with both sides leading, but for the purpose of being concise, I will explain this as if the right arm is moving. 
• Keep your left hand on the ground and lift your right arm overhead while twisting at your midback. 
• You should open your chest towards the right side of the area you’re in and look up towards your right hand. Next, bring your right arm back towards your body and bring it across your body towards the left.
• Thread the right arm behind the left arm and twist at your midback to "thread the needle".
• Repeat on the same side for the desired number of sets or reps, then perform on the other side.

4. Lower trunk rotation stretch

• To perform this exercise, lie on your back with your knees bent and your feet on the ground. 
• Exhale as you let both knees fall to one side, inhale and hold, and bring the legs back to the starting position as you exhale again.
• Repeat on the other side and alternate.

6. Arch/Curl in sitting

• Sit in a chair that is low enough for you to be able to place both feet flat on the ground. 
• Feel your weight evenly distributed between your sits bones.
• Feel both of your heels on the ground and act as if a string is pulling the crown of your head towards the ceiling to sit up straight.
• To arch, perform an anterior pelvic tilt.
• Your low back should arch, and your hip pointers should tilt forward and down towards the ground. To curl, perform a posterior pelvic tilt.
• You should feel your low back round, and your hip pointers should go towards your lower ribs to curl.

7. Side stretch in sitting

• Sit with your weight evenly distributed in your sits bones. 
• Place your left hand on either your arm rest or thigh on the same side.
• Reach your right arm overhead and lean towards the left.
• You should feel a stretch in your side.
• Try to avoid lifting your sitting bones off the chair.
• Repeat on the opposite side.

It's important to identify the cause of poor flexibility to fully address it. A qualified fitness professional or healthcare provider can help determine the underlying cause and develop a guided plan to improve flexibility and/or strength, if that is your goal.

Learn more HERE.

Click on our blog to learn 7 stretches with the Stretch Out Strap.

Local to the Austin area? Give us a call at 512-215-4227 to learn more about how we can help you improve your flexibility with our physical therapy, Pilates and Gyrotonic programs.

What are signs of a weak core?

A weak core can have several signs and symptoms, including:

1. Poor Posture

A weak core can cause poor posture, leading to slouching or a hunched-over appearance.

2. Lower Back Pain

A weak core can cause lower back pain or discomfort, as the muscles in the lower back are forced to work harder to compensate for the lack of core strength.

3. Poor Balance

A weak core can lead to poor balance, making it harder to perform daily activities like standing, walking, or climbing stairs.

4. Reduced Flexibility

A weak core can cause reduced flexibility, leading to stiffness or tightness in the hips and lower back.

5. Difficulty Performing Abdominal Exercises

Difficulty performing abdominal exercises like crunches or sit-ups can be a sign of a weak core.

6. Difficulty Breathing

A weak core can make it harder to breathe deeply or fully, as the muscles involved in breathing are interconnected with the core muscles.

If you experience any of these signs or symptoms, it's important to focus on strengthening your core muscles through exercises like planks, bridges, and Pilates. A qualified fitness professional or physical therapist can help develop a plan to improve core strength and reduce these symptoms.

How often should I do core exercises?

The frequency of core exercises depends on individual goals and fitness levels. However, as a rule, it is recommended to perform core exercises at least 2-3 times per week, in addition to other forms of exercise.

For beginners, it's essential to start slowly and gradually increase the intensity and frequency of core exercises. Starting with 1-2 sessions per week can help the body adjust to the exercises and reduce the risk of injury.

For intermediate to advanced exercisers, it's recommended to perform core exercises 3–4 times per week. This frequency can help build strength and endurance in the core muscles. It is important to note that rest and recovery are just as important as exercise itself.

It's recommended to take a day of rest between core exercise sessions to allow the muscles to recover and prevent overuse injuries. It's also essential to vary the types of core exercises performed to target different muscle groups and prevent boredom.

Incorporating a variety of exercises such as planks, bridges, crunches, and Pilates can help achieve the best results.

How do you know if your core is getting stronger?

There are a few signs and indicators that your core is getting stronger. A stronger core can lead to better posture, as the muscles in the core support the spine and help maintain proper alignment. A stronger core can lead to improved balance, making it easier to perform activities that require stability, such as yoga, running, or weightlifting.

As your core muscles get stronger, you may notice that you can maintain abdominal exercises like planks or sit-ups for longer periods of time, indicating increased muscular endurance. A stronger core can help relieve lower back pain or discomfort, as the muscles in the core can better support the spine and reduce the load on the lower back.

Improved athletic performance can also be noted, as the muscles in the core play a critical role in many sports and activities. The muscles involved in respiration are interconnected with the core muscles and can lead to improved breathing.

If you notice any of these signs or symptoms, it's a good indication that your core is getting stronger. Keep in mind that core strength takes time and consistency to develop, so it's essential to stick to a regular exercise routine and gradually increase the intensity of your workouts over time.

What happens when core muscles are weak?

When the core muscles are weak, it can lead to a range of issues and symptoms. Poor posture is one sign. The core muscles help support the spine, and weak core muscles can lead to poor posture, causing the body to slouch or hunch over. Weak core muscles can cause lower back pain, as the muscles in the lower back have to work harder to compensate for the lack of core strength.

The core muscles play a crucial role in maintaining balance and stability, and weak core muscles can lead to reduced balance and coordination. An increased risk of injury is another possible side effect of a weak core. Weak core muscles can increase the risk of injury, as the body is less able to support itself during physical activity.

Limited flexibility can also be a result, as the muscles in the hips and lower back may become stiff or tight. Weak core muscles can make it harder to breathe deeply or fully as well. If you experience any of these symptoms, it's essential to focus on strengthening your core muscles through exercises like planks, bridges, and Pilates. A qualified fitness professional or physical therapist can help develop a plan to improve core strength and reduce these symptoms.

How can I prevent this? What core exercises should I do?

As a Pilates Physical Therapist, I want to share a few Pilates moves to start.

• The Hundred / 100
• Roll Up
• Roll Over
• Criss Cross
• Rolling like a Ball
• Swimming

Next, I want to share some more traditional Physical Therapy exercises to improve core strength.

• Bridging
• Dead Bug
• Quadruped alternating arm and leg lift
• Prone alternating arm and leg lift
• Side plank

To summarize, our body's core is the central link that connects the upper and lower body and is crucial for balance, posture, and movement. If neglected, a weak core can manifest in several discomforting ways, like poor posture, lower back pain, reduced flexibility, and diminished balance, to name a few.

This blog, penned from a physical therapist's perspective, illuminates the importance of a robust core and answers pertinent questions related to identifying a weak core, understanding the ideal frequency of core exercises, and recognizing signs of improved core strength.

Learn about the potential risks of a weak core as well as a curated selection of Pilates and traditional Physical Therapy exercises to bolster your core strength effectively.

Our expert physical therapist breaks down each exercise, making this guide a handy resource for those starting their journey towards a stronger core as well as for seasoned fitness enthusiasts seeking to enhance their core workout regimen. Empower your fitness journey with this comprehensive guide to core exercises.

Learn more about ways to strengthen your core by clicking HERE.

Read this blog  to learn more about how we help people with back pain by strengthening their core.

All right! So hey guys, what's up? 

It's Stephen Dunn, and today we have Dr. Claire Watkins...

Who is Dr. Claire Watkins?

Hi...She is our new physical therapist, making her our third physical therapist on the team with Dr. Danny and Dr. Andy. She's kind of taking my place, which is really weird because I now don't have a room because we did a little musical chairs with the rooms and Danny has taken Andy's old room. Andy's taking my old room, and now Claire is in Danny's room. 

I know that's a mouthful, so with that said, I just want to do a quick video to really introduce Dr. Claire but also get a little bit of her story, and so some of the story will come up in a little bit and we'll joke and laugh about it, but you're all going to say, "Oh, I now see why you hired her," but I'm going to let that come up naturally. So with that said, the first question is: why did you become a physical therapist? 

Dr. Claire's Story

When I was in high school, I became interested in physical therapy. I was pretty competitive in cheerleading and gymnastics, and when I was a senior in high school, I was trying out for LSU's cheerleading team, and...

That didn't take long, there it is...

Yeah, I ended up doing it for about a year, but in the process, I was overdoing it. 

And then you went to college to prepare for PT school; did you start college with that goal in mind?...

No, from day one I wanted to be an architect, but because I didn't fully realize everything that would entail, I ended up changing my mind and thinking about how much physical therapy had helped me, and just like in my freshman year, I made that decision...

Now, she's already mentioned LSU and that she was a cheerleader, which I think is cool, but the fact that she went to LSU got Cheryl and me excited. Cheryl, who also attended LSU, and I'll tell you a quick story about her, was going to be on the cheerleading squad but then decided she just wanted to have a little more fun in school. Claire went the other route; she was on the cheerleading squad for a year and then decided she wanted to focus on her grades...

I'm not going to make a career out of cheerleading...

That makes sense. Yeah, that makes a lot of sense. Now you're originally from Lake Charles, correct?...

Yes...

And then you went to LSU for undergrad. Now tell us the journey that got you to Austin...

So basically, being from Louisiana, I got sick of the hurricanes and decided to pick a place that I would have been interested in. So when I was in college, we actually came to Austin and did lots of hiking for one of our spring breaks, and I just really enjoyed the whole experience. I looked into PT schools in the Austin area and was able to make it work. And then after PT school, I fell in love with it further and decided to stay...

That's great; I didn't realize you came here first and then tried to get into school here, as opposed to getting into school here. I knew you went to school here in Austin, but I thought you went to school and stayed instead...

I applied here on purpose...

Yeah, that's awesome, and it's very different coming from Louisiana to Austin; the hills, the scenery, it's just very, very different in a lot of ways...

There are no potholes in the roads; you can see through the water to the bottom of it, so you know it's not brown mud water. After moving to California and Texas, I'll never swim in Louisiana again. When I lived there in 1998, I used to swim there, but when I moved away, I was like, "Oh my gosh, I saw clear water, yeah, I'm never going to swim in those swamp waters again."

I grew up tubing in Lake Charles Lake, and there are probably gators down there...

Oh, there's no doubt about it, they're alligators...

I'm lucky to have all of my toes...

The importance of one-on-one treatment with patients.

The next question I have is, "What made you want to leave where you were working and come work with us?" We're not going to say any names or anything, but let the people know why you wanted to work with us...

Yeah, so I've always been interested in and have liked doing Pilates; that's what initially caught my eye, but the big thing out of everything, like my number one kind of non-negotiable after being in busier clinics, was the one-on-one treatment with patients. In my previous clinics, I was working normal hours but seeing two to three patients per hour with a minimum of two new evaluations per day, and it just felt like a mill. It was busy, busy, busy, and I just felt like I wasn't able to provide the care that each patient deserved because of the way it was set up.

Difference of work at previous clinics and current clinic.

So with that being done, I decided to make it a priority to seek out something that prioritized one-on-one treatment because I just felt like that was the best for everybody involved...

And that's a great point, and we've built our clinic on one-on-one care for the entire time we've been here, and some people don't realize the difference, right? Patients don't realize the difference, but all of the therapists who work here know the difference because we've all worked in the places she's describing.

Cheryl and Stephen's reason for building the clinic.

This is why Cheryl and I built this place the way we did, because it was based on what we didn't want to do. So now that you've been here a couple weeks,  tell me what's been your favorite thing about spending more individual time with people...

Just getting to know everyone on a much deeper, more personal level It just makes me feel like I'm able to provide so much better care. I'm able to problem-solve and troubleshoot at the moment without having to take a step away to care for another patient. It's good, so I'm going to be with one person, and I just feel like I'm able to provide a more thorough treatment and a better experience for the both of us...

So it's a much more focused approach, and I always say when therapists come to work with us, you know your skills aren't going to just change overnight; you're not going to just become a better therapist because you have one-on-one time, but you are exactly right when focused on only one person, so it makes you an incredibly better therapist...

No distractions...

The distractions aren't exactly there, and getting to know someone on a deeper level means they don't always tell you the stuff we want to know, but you start figuring it out a little bit by playing detective with that one-on-one time and not being a detective in a sly way, right? I think just kind of problem-solving is the best way to do what you said a moment ago.

Now, one of the things that got me excited about Claire coming on board was that she does some things similar to us.

The school she went to is really heavy on manual therapy. The guy who started St. Augustine was a manual therapist, Stanley Paris. So she's gotten out of school using her hands a lot, whereas at the school I went to because of one of my teachers, I got a lot of training in manual therapy, but as soon as that guy left, that wasn't the case anymore.

It was kind of hit or miss. So I got a lot of manual therapy training in school, and she got a lot of manual therapy training in school, just like Andy, who went to the same school, but the campus was in Florida. Something that she does that I don't know anything about and that people ask me all the time about is dry needling.

Dr. Claire has done some dry needling training since she's been out of school, and I just want you to tell us a little bit about what dry needling is and how you use it in therapy...  

I usually use it when I think it's a completely appropriate intervention for the person. I usually like to start with more traditional manual techniques, like joint mobilizations and soft tissue work, and if that doesn't seem to be helping, I usually try to use dry needling as an additional tool. So, basically, the idea behind dry needling is that you will stick a needle into a soft tissue such as a muscle belly, a tendon, or fascia to help relieve a trigger point, which is commonly recognized as a knot or a tight spot, usually in the muscle belly.

Dry needling is used to create a healing response at the physiological level, and this healing response is usually triggered by creating a micro-trauma with the needle. These are super-thin needles of varying lengths; they're usually one to three inches long, depending on what tissue you're treating and how deep it needs to go. The needle creates a micro-trauma and initiates a natural healing response that would normally occur if you had any other type of trauma, like a cut or something like that...

Should someone try dry needling if they are scared of needles? 

Is the size of a dry needle the same as the size of a syringe a doctor would give you a shot with? ...

It varies in thickness depending on the application. It's not delivering any medicine, so it doesn't have the hollowness of a needle that you would get an injection with. It's usually a quick, in-and-out technique. It doesn't take very long, depending on how many areas you're treating and what else is going on. I'm not injecting anything into anybody. If you are afraid of needles, then it wouldn't be something that I would recommend...

I got it, I comprehended it, and it makes sense.

So with that said,  we're super happy to bring Dr. Claire on to the team. It's our first female therapist in quite some time, so I'm excited about that. It brings a completely different energy, so Dr. Claire from Louisiana, who went to LSU and then went to PT school here in South Austin, has stayed around since working at a few places and seeing a different side of therapy and is now working with us in a place where our side just spends time with people. 

That's the difference, and we're not better, we're just different, and by saying that, we really focus on you, the client, not on us and our skills or what we do, but on what you need, finding what that is, and delivering it for you. So with that said, thanks for watching and reading, guys. Thanks for being on board, and we look forward to having you around for a long time...

I'm excited to meet you guys!

To learn more about why Dr. Claire left the Orthopedic owned physical therapy clinic to work at a physical therapist owned clinic…

Hey, hey, hey! What's cracking, folks?

Stephen Dunn, owner of CORE Therapy & Pilates in Austin, Texas, here with a little review for my two rockstar therapists who helped me get ready for a snowboarding trip over spring break.

So, picture this: I'm all geared up to hit the slopes with the family, but my toe injury from seven years ago decides to make an unwelcome comeback. It had been giving me trouble for a while, and I'd been doing my best to prepare with balance work and strengthening exercises.  But when it came down to it, I needed a little extra help from the pros.

Enter Dr. Claire, our new physical therapist, who worked her magic on my toe and heel and even found some other problem areas up the chain.

I was feeling better than ever after a few sessions with her... until my back started acting up. Of course, it had to happen right before a big trip, because why not, right? But that's where Dr. Danny came in and saved the day. He worked his magic on my back and the nerve symptoms shooting down my leg, and just like that, I was ready to hit the road.

Now, let me tell you, snowboarding in the powder is no joke.  But thanks to the care I received from my therapists, I was able to tear it up for three whole days with no pain or injuries.  I even took a little tumble trying to keep up with my youngest kiddo, but that's just par for the course.  And the best part?  I made it through a grueling 15-hour drive back home with no issues.

So, what's the moral of the story here? 

Don't be afraid to seek out professional help when you need it. Whether you're a seasoned athlete or just trying to get back into a favorite hobby, there's no shame in admitting you need a little extra support. If you're in the Austin area, come check out CORE Therapy & Pilates and let our expert team get you back to doing what you love. Peace out!

See what the May Clinic has to say about toe injuries...

Learn more about Dr. Claire and why she joined our team.

What are your goals? What do you want to get back to doing? What are you not able to do?  For me, I was most concerned about how snowboarding, the drive, and what snowboarding would do to my foot, toe, and back.

Call 512-215-4227 to tell us your story and what you want to get back to safely...

Doctor/Physician-owned versus Physical Therapist-owned Physical Therapy Clinic

(SD) It's Stephen Dunn and Dr. Claire Watkins from CORE Therapy and Pilates, and today I just want to go over some really quick information about working at a clinic where you get one-on-one care, like what we do here, versus working at a clinic where you see two, three, or however many patients at a time, where you're kind of scrambling and running around like a chicken with your head cut off working with many patients.

Now any therapist has been there in the outpatient setting; I've been there, but for me, it's just been since 2003. So it's been a long time since I've been in that situation. Claire is new to us but has been in that situation more recently. So a lot of my patients will ask, "What's the difference between going to the clinic that my doctor owns after I have my surgery and going to a clinic like CORE?" So what would you say for that answer because you've been in both of those situations recently?

One-on-one physical therapy care at CORE Therapy & Pilates

(CW) I'd say the difference is pretty huge. I'll just go through what my day-to-day would look like at a busier clinic than this one. So at busier clinics, you would normally be seen by your therapist in chunks of time when they could get to you with the help of other support staff.

The PT would be nearby to supervise, but I would not be able to be with my patients directly the whole time, which was really difficult because I wanted and felt like I wasn't providing the care that I should be.

A day in the life at a busy PT clinic with multiple patients at once

(SD) When you say support staff, do you mean the physical therapy assistants or technicians/aides?

What is the difference between a physical therapy assistant (PTA) and a technician or aide?

(CW) A technician is someone who has not been to school. A PT assistant has been to school just to clarify that. So a PT assistant or PTA has been to school and does have a license, but a technician or aide is not licensed. Techs or aides are people who have not been to PT or PTA school yet but are interested and want to go there.

Who makes the clinical decisions at a busy PT clinic, the PT or the technician?

(SD) We've started there too. I was a tech once, back in 1994. So we've all been there for both the tech situation and the working in a busy clinic situation. So you would oversee a lot but not necessarily be the person delivering the care?

(CW) Right, and I would still be able to do manual therapy and go over exercises and do cueing with the patients, do some hands-on, but it wasn't for the whole session. It was set up for the patient to see me for a few minutes and the tech for the majority of the time. I would be running around with weights, making sure they were okay. I would make sure to do the best I could in a little time and then run to the next patient.

(SD) You didn't have the time to watch, make the modifications, and give the verbal and tactile cues.

(CW) Not always, for sure.

(SD) That makes a lot of sense. At one point, I was seeing 50 patients a day in a workers compensation clinic. It was insane, and I wouldn't recommend it. I only made it for a few months, but it is what pushed me into opening my own business and why I have this place and Claire can work in this place. I'm thankful for that place in a weird way.

(CW) I'm thankful for all my experiences, for sure.

(SD) When you get that time, you're like, "Wow, that’s really amazing to get to spend time with people and get to know them not only on a personal level but also on a really different level because of how much time you spend with them." Right. I just wanted to share that because one of the things a lot of our patients will ask is, "Hey, I'm going to have surgery; my doctor wants me to see their physical therapist.

Do I have to go there, or can I come to CORE?" The doctors can't force you to see their physical therapist; it's against the law. You can see any physical therapist with a written physical therapy referral. If the doctor writes you a referral that has the name of their clinic or the name of any clinic on it, you can take that referral anywhere; you don't have to take it to the place that it's written to. No one knows this when the doctor says, "Go to my PT."

How much does it cost to see a physical therapist at a doctor-owned clinic called a mill?

One thing I want to ask is: did you ever catch the cost of what a session was in a place where you used to work? I'm just curious if you knew what they were charging to have four or five people running around in the room at the same time.

(CW) I'm not 100 percent sure; it would vary based on insurance, and I know we did have at my last place a self-pay option. They would always have at least some kind of copay, and sometimes those copays were up to $100 or $200.

(SD) We see a lot of our Medicare patients that are working with us, and then they end up having some kind of surgery, whatever that surgery is, and their doctors want them to go work with their physical therapist under the pretense that "You're going to see my therapist. I can communicate directly with them." Let me ask you: did you ever communicate with those doctors who you worked for?

(CW) Sometimes. If I felt like it was necessary, I would reach out, email, or call.

(SD) Got it. I was always wondering if that was really something that happened. All right, so with that said, thanks a lot for helping us with that today. Thanks for watching, and I will see you all at the studio.

Learn more about the cost of physical therapy by reading this blog:

What is the Cost of Physical Therapy?

Read here for more information on physician-owned physical therapy services (POPTS) at Everything You Need to Know About POPTS

Call 512-215-4227 to learn more about CORE Therapy & Pilates and how we can help you. 

Physical Therapy Cost

Physical therapy costs can vary greatly depending on where you see a physical therapist. You can see a PT in the hospital, the outpatient clinic, inpatient rehab, wound centers, K–12 schools, and so on. 

For today's discussion, I will be writing about the outpatient orthopedic setting. The first thing to discuss when talking about the cost of physical therapy is: who is the insurance provider? Are they "in-network" or "out of network" with that provider? Are you 65, and do you have Medicare? Let's break these down for a better understanding of what the cost of physical therapy will be in an outpatient clinic.

What is “In Network”?

"In network" basically means that the physical therapy provider has a contract with that insurance company and is obligated to accept the agreed-upon rates in the contract.

Your "in-network" insurance will pay a certain percentage or set fee per session for PT after the deductible is met. Deductibles are higher than ever now, so they can range from $500 to $10,000. 

If your deductible is $2000 and you have met that deductible, then your session will typically cost around $10–50, depending on your co-pay or co-insurance. The co-insurance is typically 10–30%, and the copay is a predetermined amount.

You will have either a co-pay or co-insurance but not both; this is plan-dependent. If your deductible is not met, you will pay anywhere from $75 to $200 per session for a PT session until that deductible is met. Deductibles can be met by seeing specialists, having procedures, surgeries, MRIs, etc.

What is “Out of Network”?

"Out of network" is a situation when the physical therapist is not contracted with that insurance provider. These therapy companies can charge whatever rate they want, and the "out of network" benefits are typically different percentages for co-pays.

Many "out of network" clinics will charge $150-300 per session and provide superbills to the patients to self-administer to their insurance companies. They might reimburse anywhere from 40 to 70% or credit that percentage to their deductible.

This deductible is different than your "in-network" deductible. Most "out-of-network" deductibles are significantly higher than your "in-network" deductibles.

Medicare is for people over the age of 65 who are no longer working. Medicare has a deductible of around $225 per year, with a slight increase every year. It covers 90% of physical therapy fees, and most people have secondary insurance to pick up the remaining 10%.

The vast majority of Medicare patients at CORE Therapy & Pilates do not pay anything as soon as their deductible is met.

Watch this video to learn more about Medicare.

CORE Therapy & Pilates is a hybrid clinic that is "in-network" with Medicare and Blue Cross Blue Shield. We are "out of network" with all other providers. 

We charge up front for all "Out of Network" clients but we bill for them instead of providing SuperBills for the patient to submit. This takes the responsibility away from the patient, who would otherwise have to deal with their insurance companies on their own.

Here is a blog with more information about Medicare.

How much does physical therapy cost with Medicare?

These are some of the major things that impact the cost of physical therapy in an outpatient clinic. Another thing to consider is if the clinic is affiliated with a hospital. If so, then they will charge significantly more and get paid significantly more than the therapist-owned clinic.

I have had patients report that they would pay a $100 co-pay for PT and then get a bill for $400–500 for the remaining amount for that session to meet their deductible.

Does all insurance cover physical therapy?

This is plan-dependent. Medicare covers physical therapy and is the cheapest option for the consumer by far. However, because not all physical therapy outpatient clinics accept Medicare, it can be difficult for Medicare patients to find physical therapy services in their area.

Private insurances typically cover physical therapy, but not all plans cover "out of network" physical therapy.

Who can a prospective patient speak to about physical therapy costs? 

Prospective patients can call the local outpatient clinic to inquire about costs and insurance benefits. When someone calls our clinic, we ask a few questions about what is going on and what kind of help the prospective patient needs.

From that discussion, we can determine if we are a good fit for each other. Then we obtain the insurance information from the patient and call the provider ourselves to verify the benefits.

Every private plan is different as far as being in or out of network, deductibles, co-pays versus co-insurance percentages, and so on.

Check out this article to learn more about the cost of physical therapy.

Examples of injuries and how much physical therapy is needed?

Now I want to write about a few types of injuries, typical treatment lengths for different ages, and the total cost without insurance.

Low back pain is the most common injury we treat. An active 35-year-old would require 4–7 sessions of PT at a cost of $150–350 per session. A sedentary 55-year-old may require 8–12 sessions at the same cost per session, and the 65-year-old's average length of PT care is 14+ sessions, covered by Medicare.

An ankle sprain for a teenage athlete would take 2–5 sessions to get back to sports, and a 50-year-old who tripped hiking might take 5-10 sessions to get back at it.

An ACL surgery that needs to be rehabbed back to college sports would take 8–10 months of consistent PT, twice a week. The same surgery for the 40-year-old who tore his ACL playing old-man softball would be a completely different rehab process that would take 10-15 months.

A vestibular patient suffering from vertigo will typically respond to PT in 1-3 sessions.

Final Thoughts

The cost of PT depends on many factors. The insurance plan and the specific benefits of each potential patient are the main factors. Is the physical therapy facility cash-only (all out of network), "in network’," taking Medicare, or a hybrid of these models?

Does the physical therapist spend an hour with you one-on-one, or are you in a big treatment room with them juggling four other patients at the same time? Is it a specialty need like pelvic floor PT or vertigo?

I have been a physical therapist since 1998 and opened my first PT business in 2001. My current outpatient clinic is a one-on-one hybrid model, and we have been serving Austin | Westlake Hills since 2005.

Now that you have a better understanding of physical therapy costs, call 512-215-4227 to get started with us at CORE Therapy & Pilates for your physical therapy journey!