- Effect of Foot Posture and Inverted Foot Orthoses on Hallux Dorsiflexion
- Effect of Functional Foot Orthoses on First Metatarsophalangeal Joint Dorsiflexion in Stance and Gait
- Foot orthoses affect frequency components of muscle activity in the lower extremity
- Influence of a custom foot orthotic intervention on lower extremity dynamics in healthy runners
Ice or Heat?
Immediately after an injury:
- Apply an ice pack for 15 to 20 minutes every hour or as long as swelling and/or skin temperature is elevated.
- Try an ice massage by rubbing ice directly over the injured area for 3-7 minutes. (Tip: freeze water in a paper cup. Once frozen, peel down the top and apply it to the injured area, holding it from the bottom.)
After the first 48 hours:
- Use a contrast bath by submerging the injured area starting in icy cold water for 30 seconds followed by switching to hot water for 1 minute. Repeat this procedure for 15 minutes and end in cold water.
After 72 hours:
- Assuming the injury is being rested and not re-traumatized; submerge the injured area starting in hot water for 1 minute followed by cold water for 30 seconds; heat 1 minute and cold 30 seconds; continue for 15 minutes ending in hot water.
After 1-week post injury:
- If swelling continues to persist without elevated skin temperature use hot water only for 15 minutes with movement of the injured area.
- If at any time the area is re-injured, begin again with icing.
If you are injured…
Step 1: Follow the schedule outlined in our document for using ice or heat.
Step 2: Schedule a physical therapy evaluation to determine the underlying cause of your injury.
Step 3: Rehabilitate your injury rather than adapting around it.
Step 4: Return to doing what you love pain free.
Five Common Knee Injuries and What to do About Them
Far too often our love of running is impaired by knee pain. Interestingly enough it is not always the knee itself that is responsible for this discomfort. Take a look and see if any of the following apply to you. 1. I have pain when I start running that goes away once I warm up: This a common symptom of tendonitis.
- The secret to healing a tendon is doing exercise that requires low resistance and high repetitions. Cycling is one example of this. Make sure your seat is not too low or positioned too far forward or this will further injure your tendon.
- Stretching and massage of the involved muscle and tendon can also provide relief and facilitate healing.
- You can also alternate ice and heat, which is very effective! Ice for 1 minute and heat for 2 min for a total of 15 minutes.
2. I often have pain while running, especially up hills, but also with climbing stairs and squatting. This classically occurs with a problem with biomechanics. A very common biomechanics issue is over pronation of the foot and ankle affecting the knee.
- If your foot excessively pronates, your foot will roll inward and your arch will drop. If your foot pronates when you run it causes your knee to turn in. This puts tremendous strain on your knee joint, ligaments and tendons as well as your foot and ankle.
- Luckily, excessive pronation can be addressed with orthotics.
- Orthotics are custom made shoe inserts that stabilize and realign your foot, which allow your knees, hips, pelvis and spine to function with proper alignment.
- At New Dimensions Physical Therapy we make orthotics by assessing the following: your running mechanics, your foot, leg and pelvis alignment, and your degree of muscle control.
- Wearing orthotics can take tremendous stress off of your knees.
3. I usually don’t hurt while I am running but my knee aches after I am done. My knee also hurts if I sit for a long time. These are common signs of arthritis.
- The secret here is that the more gentle movement you can do during the day—the better. Cross training with swimming or water exercise is a wonderful option for you. If takes the load off your joint while allowing you to move and strengthen your knee.
- As far as running goes you will get more mileage out of an arthritic knee with interval training. This means interspersing walking with running. If you do this you will be surprised how much farther you will go.
- Using an elastic sleeve on your knee on cold days often helps too.
4. Sometimes my knee actually locks on me and I can’t straighten or bend it: This can actually be due to a meniscus tear.
- Your meniscus is a piece of cartilage within your joint. Left untreated, this tear can wear down your joint prematurely and cause increased pain. Unfortunately the treatment for this is often surgery. If you think your meniscus may be torn, go see an orthopedist for a detailed evaluation of your knee.
- Mensicus tears can be caused by a traumatic event. But if it happened gradually over time then it may be due to stress from faulty alignment. If the latter is the case then you would benefit from a physical therapy evaluation.
5. I often get a sharp pain on the outside of my knee when I run. The structure that is responsible for your pain is your Ilio-tibial (I-T) Band.
- This fascial band begins at your hip and runs down the outside of your leg to your knee.
- We get excellent results with our patients by doing soft tissue mobilization (a specific type of massage) to their I-T bands, hips and pelvis in combination with a doing strengthening and stretching exercises.
- We see that the I-T Band becomes very tight and painful when your glutuals and lower abdominals are weak. Here are two strategies to get started on this problem:
Hip Lifts (3 x 10 reps)
1. Lie on back with knees bent, arms by side palms up.
2. Find pelvic neutral and hold this position throughout exercise
3. Squeeze buttocks and lift hips as high as possible off the ground, beginning with your tail bone
4. Keep belly button lower than your tail bone and knees hip width apart
5. Hold for 3 sec
I-T Band Stretch (4 x 15 sec)
1. Stand facing the wall on one leg with your foot turned out
2. Cross opposite leg in front keeping weight on back leg.
3. Keep pelvis facing forward so that it is square with the wall
4. Shift pelvis laterally toward the side that your are weight bearing on
5. Lean trunk away for maximal stretch Come and see us: If your pain does not improve with the above strategies then there is something preventing your tissue from healing. Find out why by coming in for a detailed physical therapy evaluation of your alignment, strength and running mechanics.
Since 1995 New Dimensions Physical Therapy has been a private pay practice rather than contracting with insurance companies. While patients can still file their claims with their insurance for reimbursement, it allows all of the therapists time, energy and attention to be on patient care.
Why choose private pay over an insurance based practice?
This has been our personal experience in working in traditional PT settings and why we do things this way.
In Traditional PT settings the environment is typically fast paced. They have to be to see the volume of patients needed to keep their doors open (insurance reimbursement is at an all time low). Patients are paying high deductibles that could be used for the cost of private pay care where they can get exclusive one on one treatment with their therapist for one hour or more. This allows time for undivided attention, profound attention to detail and thoroughness rather than the common isolated focus on an injury. By the time lots of copays and treatments have added up, patients could have easily paid for our services allowing for less time off work and quicker recovery.
The most frustrating aspect of insurance based settings is that insurance reimbursement dictates the type and length of care (despite your injury and needs). By being private pay, we are not distracted by headaches with billing departments and we are free to provide patient-centered care in an healing environment. We will actually save you money in the long run by getting rapid results, treating the underlying problem of an injury and educating you on what you can do to care for yourself throughout life.
We thank God and the Austin community that we have been able to practice like this for almost 20 years.
- Initial Evaluation: $210 (1 hour)
- Return Visit: $175 (1 hour)
- Dry Needling: $87.50 (30 minutes)
- Co Treatments: $300 per hour (4-handed manual therapy session with a minimum of 2 practitioners)
- Custom Orthotics Evaluation and Casting: $245 (1 hour)
- Custom Orthotics Fitting: $175 (1 hour, this involves modifying the device, movement analysis, shoe selection)
- Custom Orthotics: $190 per pair (click here to learn about our approach)
This includes free orthotic modifications for 4 months to make sure you are completely satisfied.
If your insurance does not cover orthotics, you can plan that your out of pocket expense will be $190. Insurance pays for initial evaluations and return visits and because we are assessing the biomechanics of your entire body—not just the foot and ankle, our patients typically get reimbursed these costs depending on their out of network policy.
Owner Fees – Rebecca Steiner PT, OCS
- Initial Evaluation: $250 for the first hour
- Return Visit: $200 per hour
- Working on scheduled day off: $300 per hour (Occasional Mondays and Saturdays)
Out of state Clients
Plan on booking a 2-3 hour session so that we can not only evaluate but treat and teach you. Multiday intensives can also be arranged. (In 2014 we have treated patients from as far away as New York, Minnesota, Connecticut, Oklahoma, as well as throughout Texas.)
Frequently Asked Questions
Do I need a doctors prescription to come?
Not for the initial evaluation, but you will need one for treatment. A prescription can come from a MD, DO, Chiropractor, Nurse Practitioner, Physician Assistant, Dentist, or a Podiatrist. If you do not have one of these resources Dr. Jim Lay is a chiropractor who been practicing for 17 years who is happy to evaluate our patients for $40, so that they can obtain a prescription to come an see us.
Can I use my Health Savings Account (HSA) or Flex-Spending Card?
Absolutely. These types of accounts function just like credit card or check payments.
Can I use my medical insurance?
We will give you all the documentation you need for an out of network claim, complete with the appropriate codes, to submit to your insurance company for reimbursement.
Will my insurance pay for physical therapy?
Most all of our patients have the following insurance plans and we have included their numbers to help you find out your out-of-network benefit. Reimbursement depends on the plan you have and your out-of-network benefits. Here is a list of contact numbers for the major insurance carriers, so you can call to find out how much you will be reimbursed from your care here at NDPT.
- BCBS – 972-766-6900
- Aetna – 800-872-3862
- Cigna – 877-484-5967
- UHC – 866-633-2446
- Humana – 800-833-6917
- United – (877) 294-1429
- First Health – 1-800-226-5116
- Assurant – 800-553-7654
- Beech Street – 800-877-1444
- Geha – 1-800-821-6136
- Golden Rule -(800) 657-8205
- Guardian – 855-733-6493