On Monday, May 4th we will be reopening the doors of the Body Tuning studio to accept in-office patients. We will be operating by appointment only and with limited staff of Dr. Tatz and Daniel. So please leave a message when you call the office and it will be returned as soon as we can.

Safety is everyone’s number one priority as we start to weigh the risk of exposure vs value when leaving the home.

Here’s what we are doing to protect you and ourselves:

• Wearing masks to limit air contamination.
• Washing hands before and after each treatment.
• Scheduling patients in 1 hour intervals to avoid any overlap between patients. You and your therapist will have the entire office to yourselves.
• Sanitize the office between each appointment. This includes high touch areas, individual treatment rooms and tables, and any equipment that you may come in contact with.
• Our building sanitizes all hallways and door knobs regularly and requires a mask and gloves for entrance to protect contamination of public spaces.

We are doing everything we can to reduce everyone’s level of exposure. If you have any concerns, or recommendations, about our safety protocols please feel free to reply to this email so we can continue to help and support each other during this reopening transition.  

We are here for you when you are ready. 

When you decide to go to a physical therapist, you have taken the first step toward feeling better. Admitting you need help with your body from a professional is a big decision — but then what?

You ask Google who the best therapist is. You turn to friends and family for suggestions. Maybe you even call a few places to see if your insurance covers treatment there. Sooner or later you find the great divide in our healthcare system. Do I stay in network or do I go out of network?

When most people hear “out of network” there is a cringe response followed by dollar signs fading into the distance. This gut reaction exists because information on how insurance companies can dictate your treatment is largely swept under the carpet, leaving the consumer undereducated and under-served.

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If you are suffering from an injury, have pain or discomfort in your body you should do the appropriate research to find “the right” treatment and physical therapist to cure your ailments.

In other words, lets say you have injured your shoulder/rotator cuff and all basic movement such as raising your arm above your head, putting your t-shirt on or shampooing your hair hurts. You have done your research and found that there are many options of treatments, such as message therapy, acupuncture, traditional physical therapy and alternative physical therapy. Keep in mind you could research forever and in a city like New York there is a world of options.

A friend can give advice and make recommendations for treatments, but only you can know what you feel and what works for your body. Allow your self the time to listen to your body and commit to one style of treatment, try to avoid going to various practitioners and receiving different sessions because both the practitioner and you, the patient, will lose the notion of which treatment really worked and which did not. At a certain point you will not have the ability to judge which treatment had the best effect on your body.

Once you found a practitioner/specialist that is helping, you should commit to the treatment for an extended period of time. It is not beneficial to jump from treatment to treatment or from modality to modality. You should have at least 10-20 appointments, in order to reap the benefits. The idea is for you, the patient, to walk away feeling really good.

You really need to give your shoulder the time to heal and be patient with yourself and the treatment. After a number of sessions you should see improvements in your shoulder and feel the benefits in your body. Remember to be kind to yourself and acknowledge that recovering from a shoulder injury is not easy and can be frustrating, but that with a dedicated alternative physical therapist working with you, you will get better and be happier.

In traditional Physical Therapy programs a student is taught 10-15 conventional approaches to be utilized in Hospitals and Medical Centers. These facilities have very strict rules regarding modalities permitted to be used for treatment. For this reason teachers and professors mostly teach traditional therapies and modalities which in turn are FDA approved for Hospitals. An interesting point to emphasize is that all machines used for physical therapy in a hospital need FDA approval. In turn the insurance companies have assigned codes to each therapy and they will only approve the treatment/machine with the proper code number. Most code numbers were done 30-40 years ago and it now takes 5 or more years to get a new code number which discourages a hospital or medical center to venture into new territory for physical therapy because they will not get paid for a long time.

In a private practice the physical therapist can use any modality that he or she thinks could work for the patient. A physical therapist that is working independently of medical centers, hospitals and insurance companies has the flexibility to utilize a variety of techniques and no limitation of time.

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The Perils of Toughing It Out http://t.co/MbTVudAmVm

— NYTimes Well (@nytimeswell) March 3, 2014

Dear Jane,

I just finished reading your most recent article and was pleased to see that you mention the importance of physical therapy.  For the past 30 years I have really enjoyed reading your articles and found them informative. I have been a physical therapist for over 40 years and witnessed the growth and need for physical therapy in our society.  More and more people are suffering from chronic pains especially in the back, knees, shoulders and neck and are searching for answers to cure their pain.  Unfortunately, recently I have been experiencing less and less support for physical therapy from the medical establishment and insurance companies. For this reason Physical Therapy has become less and less effective, most of the attention is placed on saving money and restricting treatments from the number allotted to the length of the session. In my professional opinion the patient should come first, not the insurance company. So, I would like to ask you what insurance company would accept that a doctor of physical therapy focus their full attention on a patient for at least 45min if not longer?

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In general patients should be aware that having a physical therapist license does not mean one automatically gets good results. The patient should always do their research before choosing the appropriate physical therapist and then request the full attention and the best possible treatment. Many of the patients that I currently treat have gone to other physical therapists before eventually coming to see me.

Rarely do I receive a patient with an ailment in the body that has been treated by a physical therapist that has spent the appropriate time working on them. By this I mean if one has tendinitis in the shoulder or knee, the physical therapist should concentrate on the tendon using a hands on technique for about a half hour, applying the right amount of force, without causing too much discomfort. The patient should never feel so much pain that they want to jump off the table or tense another part of their body, but they should feel a release and relief during the session. One should see the physical therapist’s hands moving slowly and intensely, not hurting the patient but listening to the body and tendon in order respond and aid in the healing process. There should be communication and understanding between patient and physical therapist. The goal of the physical therapist should be to change the position of the tendon and put it back into the right place. This is not an easy task nor does it happen in one treatment. The most important part of the process is to work with an experienced and talented physical therapist.

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Everyone experiences muscular or skeletal problems in their lives, no matter what their lifestyle. A dancer will have back problems, as will a couch potato, albeit through very different mechanisms. These aches and pains are part of life. What is worrying however is the number of people who choose to ignore these signs from their bodies and continue as if nothing is wrong, or even worse, mask the pain with drugs so they can continue doing the things that caused the pain in the first instance.

The Sticking Plaster Approach

It is very easy to take painkillers. Just wash them down with a glass of water and the pain will subside within a few minutes. But it is worryingly common for people to become addicted to these painkillers through continued use. As the cause of the pain is not being treated, it persists. Moreover, it gets worse as the individual continues performing the same movements that initially caused the injury. They increase the dose to deal with the extra pain then, when OTC drugs no longer hide the pain, they move on to harder prescription medication and the cycle starts again. By this point they cannot dance, play, run or perform without the use of the painkillers and addiction has set in. At some point even the strongest painkillers will no longer mask the pain so the person will just be left with a drug addiction and pain. Alongside their addictive properties, pain relievers such as oxycodone and codeine have a number of nasty side-effects that could lead to coma or death even in otherwise healthy individuals. Eventually, if the individual does realize they have a problem, they may phone a help line or check into rehab to mitigate the problems. Unfortunately, the injury and its pain that started the whole thing will still be there, waiting for real treatment.

What these people really need is physical therapy. The actual manipulation and massage of the muscles or joints that are causing the pain will, with time, actually treat the injury not the symptoms.

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Physical therapy prices depend on several factors including the type of practice, the physical therapist’s experience and reputation, and, of course, the location of the clinic.

The most common physical therapy practice is medium to large sized clinic with many physical therapists and a gym like atmosphere where the majority of professionals are young and inexperienced. Patients receive little hands on treatment and are quickly dispatched to do exercises on their own. A physical therapist at such a clinic can see four to five patients per hour. However, major health insurance is likely accepted and the patrons are asked to pay a copay of about $50.

On the other hand, with some research one can find a boutique physical therapy practice with a different feel. A clinic with a few experienced physical therapists who spend at least half an hour hands on with a patient and integrate a variety of modalities like laser and magnetic therapy and whole body vibration among others. At a practice like this, attention is focused on the therapeutic approach rather than the tedious process of insurance reimbursement therefore major health insurance may be accepted only with out of network benefits. Here, the initial evaluation and treatment may cost upwards of $300 with follow up treatments at a slightly smaller premium and discounts for multiple session packages. Treatment may be covered 70% or more for those with good health insurance plans.

Lastly, there are special plans offered for students and artists who labor with their bodies everyday. In such cases, the discounts range between 20% and 33%. At the end of the day, our responsibility as health professionals is to teach the importance of maintaining overall health.

Do you know when to use heat or cold therapy for an injury? If not, a recent review article by two University of Washington sports doctors, Matthew Karl, MD, and Stanley Herring, MD, can be your guide.

Drs. Karl and Herring point out that the application of superficial heat to your body can improve the flexibility of your tendons and ligaments, reduce muscle spasms, alleviate pain, elevate blood flow and boost metabolism. The mechanism by which heat relieves pain is not exactly known, although researchers believe that heat inactivates nerve fibers, which can force muscles into irritating spasms, and that heat may induce the release of endorphins, powerful opiate-like chemicals that block pain transmission.

Increased blood flow occurs in heated parts of the body because heat tends to relax the walls of blood vessels. That’s one reason why sports doctors recommend you steer clear of the practice of heating up already inflamed joints. Heat appears to be best for untightening muscles and increasing overall flexibility; the proper tissue temperature for vigorous heating is probably 104 to 113 degrees Fahrenheit (40 to 45 degrees Celsius) and the correct duration of temperature elevation is about five to 30 minutes. Although heating can reduce muscle spasms after a back injury, heat should not be used on sprained ankles.

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