We recommend that you wear clothing that allows exposure of the area we are looking at, bring the reports of any imaging you have had done, and bring any prescriptions your doctor gave you for physiotherapy. We don’t require you to receive care, however it is useful to have and allow me to connect with your doctor and send them updates as needed Try to arrive 5-10 minutes early to ensure all paperwork is completed so we can maximize our time together.

History and Medical Screening - We’ll start off with a chat where I’ll ask you a series of questions related to your pain/injury and the events surrounding it. Not all injuries happen at one specific moment. Many aches and pains come on insidiously over weeks to months. It’s important we figure out the aggravating factor and for this we often need to look 4-6 weeks before you first became aware of your symptoms. We’ll also discuss your past medical history and what your do for a living and recreationally in your spare time (this is often the most important information in understanding the why behind your pain or injury and how we’re going to keep it away). Finally we’ll discuss any red flags or things that may tell us you should first consult your physician prior to starting PT. Examination: By this point I will already have a few differential diagnoses running through my head. From here we will run through a series of tests to determine the strength, mobility & stability of the affected and surrounding area(s). Note: special tests used in the examination are designed to be pain provoking…they test out a certain structure to determine if it is causing your symptoms. It is crucial we get this information so we can be sure your treatments are as specific as they can be. Evaluation: Using examination information we can now rule out the different diagnoses until we arrive at our physical therapy diagnosis. For example: every shoulder, elbow, wrist or hand examination will also include a thorough neck screen to rule out cervical spine involvement since it can often refer pain to the arm and hand. Prognosis: At this point we can synthesize all the collected data and take into account comorbidities, the physical demands of your work, lifestyle and any other factors that might affect healing time. I’ll give you an estimate of how many sessions or weeks you should expect to be in PT. My goal is always to get you back to the things you love as soon as possible however when you’re done with PT we want to be sure your not returning a months later for the same thing. Every condition and person is different and my recommendations on frequency and length of appointments will be different for each client.

In this time we’ll be doing a lot of hands-on treatment and teaching you what you need to know to get out of pain. I highly recommend people front load their PT sessions to allow for 2 sessions a week in the first 2-3 weeks. Having this time is valuable as the effects of treatment tend to be outmatched by the weeks, months or years of built up tightness, poor movement patterns and habits that brought you here in the first place. Within the first few sessions you’ll start to see and feel some change as your body adapts to the new movements we’ve been programming in. You’ll be learning a bunch of great exercises and strategies to minimize strain throughout your day. We’ll be reviewing this each session and I always welcome clients to email me anytime with home program questions.

As you progress through your program we will slowly transition the majority of your care from my hands and guidance to your home program and self maintenance. As the frequency of your weekly appointments shift to biweekly then infrequent check-ins you will come out of this experience with relief of your symptoms as well as a new skillset in managing the condition. Some conditions are chronic and require continued care. Many patients with progressed osteoarthritis for example may require ongoing treatment. Often this is a great option to manage pain and even get you as strong as possible leading up to a surgery.

The more accurate the diagnosis the less treatment required. At this point we know where to go and what to work on. Now it’s time to treat! Manual Therapy: I use an array of manual therapy techniques including but not limited to: Joint Mobilization Muscle Energy Techniques Soft Tissue Release Mobilization with Movement Strain/Counterstrain Proprioceptive Neuromuscular Facilitation (PNF) Joint Manipulation Manual Stretching

Many people who come to me work at a desk. It is impossible to treat your injuries without addressing the way you work and postures your in 8-12 hours each day. This may mean assessing your workstation ergonomics, the way your squatting when gardening or adjusting the way you hold your head when texting. This is the key to “curing” many of the conditions we see in physiotherapy.

Upon discharge from PT you’ll be given a final home exercise program and we’ll review any questions you might have. At this point your an expert in managing your injury or pain. If anything returns then you know what to do, if the exercises that once worked don’t seem to work the next time we should evaluate the area to be sure it’s not something different causing the pain.