FAQ's

General Physical Therapy

Q1: How long is a typical physical therapy session? Depending on your injury, each therapy session will typically last between 45 minutes to an hour.
Q2: What do I wear?
Please make sure to arrive in comfortable, loose fitting clothes that will enable the therapist to see/work on the area of treatment easily. We encourage patients to wear comfortable (tennis) shoes as well.
Q3: Do I need a prescription from my doctor to see you?
Patients may receive treatment for up to 30 consecutive days with one of our certified direct access therapists. After those initial 30 days, a script from a physician is required by law for additional treatment.
Q4: What do I need to bring during my first appointment?
Please bring a photo ID, insurance card, doctor’s prescription (and/or PCP referral if required by your insurance) and any additional reports relevant to your treatment (i.e MRI, x-rays,etc.).
Q5: Who do I contact for information regarding my bill or health insurance coverage?
Please contact our Billing Department at 703-239-2300, or you may email us at billing@alliancephysicaltherapyva.com
Q6: What will my treatment consist of?
Upon your first visit to the clinic, you will receive an evaluation from a licensed physical therapist. During that evaluation, several questions will be asked and several measurements will be taken. It is from this information that your physical therapist will devise an appropriate treatment program to specifically address your issues.
Q7: Do I use ice or heat?
The type of injury and time after the injury occurred are important factors in determining whether to use heat or ice. Ice is important to reduce pain and inflammation after an injury that has occurred within the past 48 hours. Heat is effective for relieving joint stiffness, muscle aches and may be used for more chronic conditions. There are benefits to both heat and ice for various injury types. Consult your physical therapist or physician to help decide which modality is appropriate for your injury.
Q8: Do I stretch or not?
It is important to warm up and stretch muscle tissue prior to physical activity. Stretching muscle tissue for 30 seconds and 3 repetitions are adequate. Take your time and stretch for the full 30 seconds with each repetition. It is also beneficial to stretch after physical activity when the muscle is adequately warmed up.
Q9: What is the difference between a ligament and a tendon?
The difference between the two is as follows: tendons connect muscles to bones while ligaments connect bone to bone.
Q10: What is the difference between a sprain and a strain?
The difference lies in the structures involved. Any muscle injury can result in a strain; this means the muscle has been overworked or stressed. A sprain is an injury to the ligament.
Q11: What type of injuries requires Aquatherapy?
Aquatic pools are used for many injuries, including any lower extremity injury that requires the patient to bear less weight. Examples include joint replacements, ligament surgery, sprain or strain. Other conditions that will benefit from aquatics are spinal pain/surgery or any neurological condition affecting walking/balance skills.

Specific Body Part Questions

Low Back

Q1: What exercises are safe to do for my back pain?
Before starting any exercise program, you should first check with your physician. No specific exercises will be provided, but the safest exercises for your back would be stabilization exercises. These exercises will benefit the abdominals and back muscles. The exercises will contract the above-mentioned muscles in a neutral position, strengthening both muscle groups. The stronger the muscles are, the stronger your back will be.
Q2: What is the best sleeping position?
If you can tolerate lying on your back, then you should try this position. You can use rolled towels under your neck and lower back to further support your spine through the night.
Q3: What is the proper lifting technique?
A few tips to remember when lifting an object are:
  1. Bend at your hips and knees while keeping your back as straight as possible.
  2. Kneel on one knee or stagger your feet if space permits.
  3. Pull the object as close to your body as possible before lifting and always use the strength in your legs to stand.
Q4: What is the best posture and how can I achieve it?
The best posture has you sitting or standing with a lumbar lordosis. Lumbar lordosis is a neutral curve in your lower back and by keeping this neutral curve the rest of your spine stays well in alignment. To best find your neutral or lumbar lordosis you will sit and rock your pelvis forward and backward until you find the neutral or ‘happy medium’. This will keep your pelvis neutral and it will allow you to maintain your best posture.

Neck/Upper Back

Q1: What is whiplash?
Often during a motor vehicle accident, the head and spine will thrust forward and backward. This movement may result in internal structural damage. These structures may include muscles, ligaments, nerves, tendons, and bones. Any violent movement of your head will often result in muscle and ligament injury; this injury is referred to as whiplash.
Q2: What is a muscle spasm and why does it seem to be more prevalent in my neck and upper back?
Muscles are comprised of small fibers that glide over one another to create muscle contractions. These components of muscle tissue can become injured, sometimes for unknown reasons. With any muscle injury, inflammation is usually present, the micro-fibers of the muscle become entangled; this is a protective mechanism of the muscle. Once the fibers are entangled, pain is often perceptible. The most common site for this is the upper back and the neck because the majority of stress is placed on these tissues from daily activities. When abnormal stress is placed on us, we tend to elevate and round our shoulders, which in turn places undue stress on already stressed tissues.
Q3: What could be causing pain and/or numbness and tingling into my arm?
Pain, numbness, and tingling can be from nerve related issues. The spine is comprised of bone (vertebrae), support ligaments, intervertebral discs, surrounding muscles, and nervous tissue. Because of the design of the spine, the close proximity of bone and disc to nerve tissue, pressure on the nerves from discs or other tissues may cause pain. The nerves are very pain sensitive structures and any pressure throughout the length of the nerve may cause pain. Another source for creating these symptoms into the arm could be from any muscle, usually in spasm, pinching the nerve as it travels down the arm.

Shoulder

Q1: What is tendonitis?
The prime movers of the body come from the muscular system and each muscle has its specific purpose. The muscle contracts to allow the action to take place at a joint. The contraction only moves the bones because of the muscle attachments to it. These muscle attachments between the bones are called tendons. Every muscle has a tendon to connect each end of itself to the other bones of a joint. When the tendons become injured from micro-trauma or specific injury, pain and swelling can occur. This inflammatory process is referred to as tendonitis.
Q2: What is the rotator cuff?
A rotator cuff is a group of four muscles that support the shoulder and scapula. They are the prime movers of the humerus(upper arm bone) into the rotation. Another prime function of the rotator cuff muscles are to ‘dropthe humerus down’ in the joint and allow abduction(movement of the arm away from the body). The four muscles comprising the rotator cuff are: Subscapularis, Supraspinatus, Infraspinatus, and Teres Minor.
Q3: What movement or positions should I avoid to prevent shoulder problems?
Posture is avoid preventing shoulder problems. Try and keep your shoulders back and down when lifting. It is important to avoid rounded shoulder positions, like sleeping on your shoulder, especially when shoulder pain is present. Heavy overhead lifting, or reaching back and lifting are common causes of shoulder injuries.

Elbow

Q1: What is the difference between tennis elbow and golfer's elbow?
The elbow has a medial and a lateral component, which makes the difference in wrist flexors and extensors. The lateral epicondyle (the outside part of the elbow) is the location of the wrist extensors. These muscles help to raise the wrist back towards you. Any tendon irritation at this site is referred to as lateral epicondylitis or tennis elbow. The medial epicondyle (the inside part of the elbow) is the location of the wrist flexors. These muscles help to lower down the wrist. Any tendon irritation at this site is referred to as medial epicondylitis or golfer's elbow.
Q2: Why is a brace usually used on my forearm for elbow tendonitis?
Any type of brace or support used for this condition is useful to alter the leverage on the forearm muscles and relieve strain on the elbow. The brace can be made of varying fabrics and usually uses velcro to be held in place just below the bones at the elbow. It may also be recommended to use the brace with some forearm injuries.

Wrist Hand

Q1: What is carpal tunnel syndrome and how can I avoid it?
The bones, ligaments and the muscles of the wrist are located in such a way that a tunnel is created for the tendons of the forearm muscles and nerves. When the median nerve becomes entrapped or compressed, the signs and symptoms of carpal tunnel syndrome (CTS) become noticeable. When structures such as tendons and nerves are compressed, inflammation becomes apparent. This inflammation is the usual cause of developing CTS. The best way to avoid or manage CTS is to heat and stretch the involved muscles regularly. A general wrist and hand strengthening program can be beneficial to limit possible tendon injury.

Hip

Q1: Why does hip arthritis cause so much pain?
The hip joint is a major weight-bearing joint. The longest bone in the body is the femur (thigh bone) and makes up the joint along with the pelvis. Only the upper portion(the head of the femur) is in contact with the pelvis to form the hip joint. Often, as individuals’ age, degenerative changes take place in the bones of this joint, which is usually a break-down of the bone surfaces. The thin layer of cartilage wears down and the bones become irritated. The hip is subjected to large mechanical forces, and the presence of any bone or joint defect may contribute to further degenerative changes and ultimately cause pain.

Knee

Q1: What might cause clicking and pain in my knee, usually up and down stairs?
Clicking may be caused by the meniscus. The meniscus is a circular shaped disc that rests on top of the tibia and usually provides some cushion. There is a medial and lateral meniscus. In certain injuries or with time, the meniscus can wear down and tear ultimately. Regardless of how small a tear may be, it will often present with clicking. Any signs/symptoms that are present will be further aggravated by stairs, mostly with descending.
Q2: What is an ACL and why is it so important?
The knee joint is made up of several internal and external joint support structures. The external structures include capsular tissue and collateral ligaments (ligaments that support the knee from the sides). Internal joint supports are also ligamentous which are comprised of the anterior and posterior cruciate ligaments. The anterior cruciate ligament or ACL prevents the femur (upper leg bone) from moving backward on the tibia. This is extremely important in activities that require running and cutting. If the femur moves backward on the tibia in a traumatic fashion, then a tear is possible. Sports such as soccer, basketball, and football are leading activities for such an injury.
Q3: When is a Total Knee Replacement necessary?
The knee joint takes on a fair amount of stress in everyday life. Going up and down stairs, walking, jogging, running and jumping are activities that further stresses the knee. We usually face these activities on a daily basis. Over time, with activity and age factors, the knee can wear down. From a structural standpoint, your knee will not completely breakdown but small amounts of wear and tear may become noticeable, beginning with mild arthritis. As pressure increases on the tissue, more cartilage frays and further injury to the bone may take place. When the bone becomes more involved, the pain usually increases. It is when the pain becomes function limiting and less bearable during daily activities that a surgery may be necessary. The surgery type will be decided by you and your physician.