Frequently Asked Questions (FAQ)

Please arrive 10-15 minutes before your scheduled appointment time in order to register and complete some initial paperwork if you haven't done so online already . Please wear loose, comfortable clothing. If you are seeing the doctor regarding your lower back, hip, or knee, it may be helpful to bring a pair of shorts for the examination. Women who are seeing the doctor regarding a neck or shoulder issue may want to bring a tank top or sports bra. Gowns can be provided if necessary. Please bring the following:

• Any test results including x-ray, MRI, CT scan, or ultrasound
• Previous exercises or information given to you from previous health practitioners
• A list of your current medications
• A list of your goals including functional goals (eg. pain-free stair climbing, return to rugby, etc.) and overall expectations for therapy are often helpful. We can also work together with you to formulate these goals.

The initial assessment is typically one hour long. During this hour, the therapist will discuss the following:

1. 1. Your medical history.
   2. Your current problems/complaints.
   3. Pain intensity, what aggravates and eases the problem.
   4. How this is impacting your daily activities or your functional limitations.
   5. Your goals with physical therapy.
   6. Medications, tests, and procedures related to your health.

The therapist will then perform the objective evaluation which may include some of the following:

1. 1. Palpation - touching around the area of the pain/problem. This is done to check for the presence of tenderness, swelling, soft tissue integrity, tissue temperature, inflammation, etc.
   2. Range of Motion (ROM) - the therapist will move the joint(s) to check for the quality of movement and any restrictions.
   3. Muscle Testing - the therapist may check for strength and the quality of the muscle contraction. Pain and weakness may be noted. Often the muscle strength is graded. This is also part of a neurological screening.
   4. Neurological Screening - the therapist may check to see how the nerves are communicating with the muscles, sensing touch, pain, vibration, or temperature. Reflexes may be assessed as well.
   5. Special Tests - the therapist may perform special tests to confirm/rule out the presence of additional problems.
   6. Posture Assessment - the positions of joints relative to ideal and each other may be assessed.

The therapist will then formulate a list of problems you are having, and how to treat those problems. A plan is subsequently developed with the patient's input. This includes how many times you should see the therapist per week, how many weeks you will need therapy, home programs, patient education, short-term/long-term goals, and what is expected after discharge from therapy. This plan is created with input from you, your therapist, and your doctor.

Make sure you bring your physical therapy referral (provided to you by your doctor) and your payment information. If your insurance is covering the cost of physical therapy, bring your insurance card. If you are covered by Workers' Compensation, bring your claim number and your case manager's contact information. If you are covered by auto insurance or an attorney lien, make sure you bring this information.

You should wear loose-fitting clothing to expose the area that we will be evaluating and treating. For example, if you have a knee problem, it is best to wear shorts. For a shoulder problem, a tank top is a good choice. For low back problems, wear a loose-fitting shirt and pants, again so we can perform a thorough examination.

Treatment sessions typically last 30 to 60 minutes per visit.

This is highly variable. You may need one visit or you may need months of care. It depends on your diagnosis, the severity of your impairments, your past medical history, etc. You will be re-evaluated on a monthly basis and when you see your doctor, we will provide you with a progress report with our recommendations.

More than half of all Americans are suffering from pain. Whether it is a recent episode or chronic, an ABC News/Stanford study revealed that pain in America is a serious problem. However, many do not even know that physical therapists are well equipped to not only treat pain but also its source.

Physical therapists are experts at treating movement and neuro-musculoskeletal disorders. Pain often accompanies a movement disorder, and physical therapists can help correct the disorder and relieve the pain.

You have probably heard of the profession of physical therapy. Maybe you have spoken with a friend about how physical therapy helped get rid of their back pain, or you might know someone who needed physical therapy after an injury. You might even have been treated by a physical therapist yourself. But have you ever wondered about physical therapists--who they are and what they do? Many people are familiar with physical therapists' work helping patients with orthopedic problems, such as low back pain or knee surgeries, reduce pain and regain function. Others may be aware of the treatment that physical therapists provide to assist patients recovering from a stroke (e.g., assisting them with recovering using their limbs and walking again).

The ability to maintain an upright posture and to move your arms and legs to perform all sorts of tasks and activities is an important component of your health. Most of us can learn to live with the various medical conditions that we may develop, but only if we can continue at our jobs, take care of our families, and enjoy important occasions with family and friends. All of these activities require the ability to move without difficulty or pain.

Because physical therapists are experts in movement and function, they do not confine their talents to treating people who are ill. Preventing injury, loss of movement, and even surgery is a large part of a physical therapist's program. Physical therapists work as consultants in industrial settings to improve the design of the workplace and reduce the risk of workers overusing certain muscles or developing low back pain. They also provide sports therapy and sports performance services for athletes of all levels to screen for potential problems and institute preventive exercise programs. With the boom in the golf and fitness industries, several physical therapists provide consulting services for recreational golfers and fitness clubs to develop safe and effective workouts, especially for people who already know that they have a problem with their joints or backs.

The cornerstones of physical therapy treatment are therapeutic exercise and functional training. In addition to "hands-on" care, physical therapists also educate patients to take care of themselves and perform certain exercises independently. Depending on the particular needs, physical therapists may also "mobilize" a joint (that is, perform certain types of movements at the end of your range of motion) or massage a muscle to promote proper movement and function. Physical therapists also use methods such as ultrasound (which uses high-frequency waves to produce heat), hot packs, and ice.

Although other practitioners may offer some of these treatments as "physical therapy," only qualified physical therapists or physical therapist assistants who must complete a 2-year education program and work only under the direction and supervision of physical therapists can provide physical therapy.

Your insurance will cover most forms of physical therapy treatment, but the coverage will vary with each plan. All 50 states offer direct access to physical therapy, which means that patients are not necessarily required to see their physicians before seeing a physical therapist. In many cases, all you have to do is ask your doctor if physical therapy is right for you. Contact us for more information on direct access.

Reference: APTA

Our Rehab Services are not covered by OHIP. The majority of insurance providers cover our rehab services and are through extended health benefits, including physiotherapy, massage therapy, and chiropractic. As each insurance plan is different, please check with your insurer before your appointment to determine what is covered.

You will be evaluated by one of our licensed and highly trained physical therapists and he/she will also treat you during subsequent visits. Unlike some clinics, where you see someone different each visit, we feel it is very important to develop a one-on-one relationship with you to maintain continuity of care. Since only one physical therapist knows your problems best, he/she is the one that will be working closely with you to speed your recovery.

Orthopedic Physical Therapy - Probably the most common physical therapy specialist is the orthopedic specialist. These specialists care for post-surgical patients, arthritis, tendinitis/tendinosis, fracture rehabilitation, muscle sprains and strains, neck and back pain, hip and knee problems, shoulder, elbow, and wrist conditions. Some are board certified as Orthopedic Certified Specialists (OCS).

Manual Therapy - Manual therapy is a broad term that describes a variety of hands-on treatment techniques that are applied to movement dysfunctions. Grade five mobilizations, Mulligan mobilizations with movement, Maitland and Kaltenborn techniques, functional technique, neural mobilization, joint mobilization, craniosacral therapy, strain/counter strain, myofascial release, etc. These are some of the more popular manual therapy techniques. Many manual therapists will take continuing education courses, obtain certifications in manual therapy, and will sit for board certification from the American Physical Therapy Association and other organizations. Most physical therapists incorporate manual therapy techniques as a part of a complete treatment plan.

Geriatric Physical Therapy - Some therapists specialize in the rehabilitation of seniors. As the body ages, a variety of challenges arise. We stiffen, we lose strength, our balance skills decline, our bones become brittle (osteoporosis), our endurance decreases, and we take longer to recover from injuries. Balance and fall prevention are of paramount importance to the therapist who is working with seniors and some clinics are solely dedicated to caring for those with balance problems. Most physical therapists work with seniors/geriatric patients. Some have obtained additional education, have passed a board examination, and have earned the Geriatric Certified Specialist (GCS) title.

Sports Rehabilitation - Experts in assisting with recovery after injury and surgery. Many sports specialists help with retraining the athlete utilizing running, throwing, jumping, and sport-specific programs to name a few. A therapist with the Sports Certified Specialist (SCS) title has passed a board-certified test.

Fitness and Wellness - Physical therapists are well trained to help with your fitness needs and wellness programs. If you need an exercise program, have trouble with your weight, are concerned about osteoporosis, have an issue with diabetes, or would like to learn how to prevent falls, physical therapists can help. The previous examples are just a few of the many programs physical therapists offer.

Hand Therapy - Most physical therapists are well trained to treat hand and wrist conditions. Some therapists have taken additional courses and training and have passed a hand therapy certification examination. These therapists are called Certified Hand Therapists (CHTs).

Women's Health - Some therapists specialize in women's issues such as pregnancy problems, pelvic pain, and incontinence. Special treatment is available for women who have these problems. Many that suffer from incontinence do so needlessly. A physical therapist may be able to help.

Industrial Rehabilitation - Specialists in industrial rehabilitation help with those that have suffered on-the-job injuries. Moreover, they will evaluate work tasks, fabricate assistive devices, evaluate your ergonomic situation, and help redesign workflow/tasks to decrease the incidence of injury. Often, industrial rehabilitation specialists will evaluate your ability to perform certain job tasks with a Functional Capacity Evaluation (FCE).

Pediatric Physical Therapy - Pediatric therapists specialize in the rehabilitation of children. They may assist with kids who suffer from cerebral palsy, developmental disorders, neurological disorders, and/or orthopedic problems. A Pediatric Certified Specialist (PCS) is a board certification that some may obtain from the American Physical Therapy Association.

Aquatic Physical Therapy - Aquatic therapy takes advantage of the physical properties of water to assist with the rehabilitative process. Buoyancy, turbulence, hydrostatic pressure, and thermal properties of water can assist with the rehabilitation of a patient. Those suffering from chronic pain, osteoarthritis, fibromyalgia, rheumatoid arthritis, lumbar fusion surgery, or with a limited weight-bearing status are just a few of the many different patient populations that can benefit from aquatic therapy.

Cardiac and Pulmonary Rehabilitation - A small percentage of physical therapists practice in this discipline. Those that pass the board certification have the title of Cardiovascular and Pulmonary Certified Specialist (CCS) work with patients who have had heart attacks, bypass surgeries, angioplasty, breathing problems, emphysema, and other heart/lung related conditions. Physical therapists are well equipped to work with these types of patients because many of them have orthopedic ailments that limit their ability to function. In other words, a physical therapist can address the heart and lung problems as well as the muscle problems that are concurrently present.

Neurological, Spinal Cord Injury, and Traumatic Brain Injury Rehab - A large portion of physical therapists work with patients who suffer from these conditions. Functional retraining including, walking, wheelchair use, getting in and out of bed or chairs (transfer training), moving in bed (bed mobility), and retraining patients to use their shoulders, arms, and hands are just some of the services these therapists provide to those with neurological involvement. A certified specialist holds a Neurologic Certified Specialist title (NCS).

Balance, Dizziness, and Vertigo Rehabilitation - Many suffer from dizziness or BPPV (benign paroxysmal positional vertigo). Some clinics specialize in the rehabilitation of patients with vertigo. Patient education, strengthening, safety awareness, posture and balance exercise, walking exercise, and special techniques that affect sensory and balance centers of the brain and limbs are all important components of a rehabilitation program.

Amputee Rehabilitation - many physical therapists specialize in the rehabilitation of amputees. Caring for the injured limb, functional and walking training, training in the use of assistive devices (crutches, canes, prosthetic limbs, etc.) are all provided by a therapist who specializes in care for amputees.

Wound Care - Some therapists specialize in the treatment and care of wounds. This is accomplished by the removal of unviable tissue (debridement), the application of special dressings and prescription drugs/ointments, and the use of ultrasound, electrical stimulation, and aquatic modalities to promote healing. Exercise and patient education are also routine components of a wound care program.

ECS (Clinical Electrophysiologic Certified Specialist) - A physical therapist who is board certified to perform electroneurophysiology examinations such as nerve conduction studies and electromyography.

Lymphedema Rehabilitation - We take it for granted but a special component of the circulatory system, the lymph system, helps filter and drain fluid from our arms and legs. When this drainage system is damaged, painful swelling can result. Some therapists specialize in the treatment of lymphedema as it is called. Special positioning, massage and bandaging techniques are utilized by the lymphedema specialist.

Osteoporosis Rehabilitation and Prevention - Some practitioners specialize in the evaluation and treatment of osteoporosis patients. Working in concert with your medical doctor, the therapist will often design a specialized weight-bearing and resistance training program for those with this silent disease.

For many patients, one of the primary objectives is pain relief. This is frequently accomplished with hands-on techniques, modalities such as ultrasound, electrical stimulation, and/or heat or cold therapy. Movement often provides pain relief as well. Your physical therapist will provide you with the appropriate exercises not only for pain relief but to recover range of motion, strength, and endurance.

In some cases, physical therapy techniques can be painful. For example, recovering knee range of motion after total knee replacement or shoulder range of motion after shoulder surgery may be painful. Your physical therapist will utilize a variety of techniques to help maximize your treatment goals. It is important that you communicate the intensity, frequency, and duration of pain to your therapist. Without this information, it is difficult for the therapist to adjust your treatment plan.

There are dozens of different types of treatment interventions. Here is a list of treatment interventions:

Active Range of Motion (AROM) - the patient lifts or moves a body part through range of motion against gravity. AROM is usually one of the first modalities prescribed for arthritis.

Active Assistive Range of Motion (AAROM) - therapist-assisted active range of motion. This is usually prescribed for gentle stretching or strengthening for a very weak body part.

Gait or Walking Training - the analysis of walking problems by visually examining the interaction of the low back and the joints of the thighs, legs, and feet during the various stages of walking, including initial contact, loading response, mid stance, terminal stance, pre swing, mid swing, and terminal swing. Many back, thigh, leg, ankle, and foot problems may be caused by or manifest themselves in subtle gait abnormalities.

Isometrics - muscle contraction without joint movement. This is usually prescribed for strengthening without stressing or damaging the joint (e.g., arthritis, or exercises to be performed in a cast, or right after surgery if recommended by the therapist/doctor).

Isotonics - muscle(s) contracting through the ROM with resistance. This is usually prescribed for strengthening.

Soft Tissue Mobilization - therapeutic massage of body tissue performed with the hands. Soft tissue mobilization may be used for muscle relaxation, to decrease swelling, to decrease scar tissue adhesions, and for pain relief.

Mobilization - hands-on therapeutic procedures intended to increase soft tissue or joint mobility. Mobilization is usually prescribed to increase mobility, delaying progressive stiffness, and to relieve pain. There are many types of mobilization techniques including Maitland, Kaltenborn, Isometric Mobilizations, etc.

Proprioceptive Neuromuscular Facilitation (PNF) - a system of manually resisted exercises performed in diagonal patterns that mimic functional movements. PNF was initially used in developmentally and neurologically impaired patients but now is used in almost every aspect of neuromuscular retraining from athletes in sports facilities to the very weak in hospitals and nursing homes.

Posture Training - instruction in the correct biomechanical alignment of the body to reduce undue strain on muscles, joints, ligaments, discs, and other soft tissues. Stretching and strengthening exercises may be prescribed to facilitate postural improvement and to prevent further disability and future recurrences of problems.

Progressive Resistive Exercises (PRE) - exercises that gradually increase in resistance (weights) and in repetitions. PRE is usually prescribed for reeducation of muscles and strengthening. Weights, rubber bands, and body weight can be used as resistance.

Passive Range of Motion (PROM) - the patient or therapist moves the body part through a range of motion without the use of the muscles that "actively" move the joint(s).

Stretching/Flexibility Exercise - exercise designed to lengthen muscle(s) or soft tissue. Stretching exercises are usually prescribed to improve the flexibility of muscles that have tightened due to disuse or in compensation to pain, spasm or immobilization.

Neuromuscular Electrical Stimulation (NMES) - the application of electrical stimulation to aid in improving strength (e.g., the quadriceps muscle after knee surgery or injury). NMES is also used to decrease pain and swelling and to relieve muscle spasm.

Neck Traction - a gentle longitudinal/axial pull on the neck, either manual or mechanical, intermittent or continuous for relief of neck pain, to decrease muscle spasm and facilitate unloading of the spine.

Pelvic Traction - the longitudinal/axial pull on the lumbar spine, either manual or mechanical, intermittent or continuous. Pelvic traction may be helpful for the relief of low back pain and muscle spasm.

Transcutaneous Electrical Nerve Stimulation (TENS) - a relatively low voltage applied over painful areas through small self-adhesive electrodes. The electrical stimulation "disguises" or "overrides" the sensation of pain. It is a small, portable unit, used in intervals, to control pain and reduce dependence on drugs. It is usually prescribed for relief of pain.

Ultrasound - ultrasound uses a high frequency sound wave emitted from the sound head when electricity is passed through a quartz crystal. The sound waves cause the vibration of water molecules deep within tissue causing a heating effect. When the sound waves are pulsed, they cause a vibration of the tissue rather than heating. The stream of sound waves helps with nutrition exchange at the cellular level and healing. Studies have shown that ultrasound is helpful for ligament healing and clinically, for carpal tunnel syndrome, and muscle spasm.

Massage may be part of your treatment. Rehabilitation specialists are trained in a variety of techniques that may help with your recovery. Deep tissue techniques may be part of the rehabilitative process. Massage is used for three reasons typically - to facilitate venous return from a swollen area, to relax a tight muscle, or to relieve pain. Contrary to common thought, massage does not increase circulation.

Flare ups are not uncommon. If you have a flare up (exacerbation), give us a call. We may suggest you come back to see us, return to your doctor, or simply modify your daily activities or exercise routine.

In most cases, you have the right to choose any physical therapy clinic. Our practice is a provider for many different insurance plans.

The best thing to do is give us a call and we will attempt to answer all of your questions.

Yes. In Ontario, you do not need a referral to see a physical therapist.

A doctor's referral is not required to see a Movement Physiotherapist. That being said, some insurance plans do require a physician's referral in order for you to be reimbursed for these services. If you have extended health benefits and your insurance provider requires a referral, please request one at your next doctor's appointment

Yes. Both your physical therapist and medical doctor are able to provide you with a diagnosis in relation to musculoskeletal injury. If your issue falls outside of the diagnostic scope of our treating therapist, we can refer you to our medical team, or consult with your family doctor for further investigations.

We ask all of our patients to pay upfront for services at Movement and request reimbursement through their insurer.

We provide direct-to-insurance billing for some insurers, but not all. For those that we are able to provide this service for, we keep a credit card on file for any additional payments, and will bill any/all of the insurance covered portion of your care to your insurer. You will only be charged the co-pay.

Some patients will need to continue with home exercises. Some may choose to continue with a gym exercise program. Others will complete their rehabilitation and return to normal daily activities. It is important that you communicate your goals to your therapist, so he/she can develop a custom program for you.

All of our therapists are fully licensed professionals in Ontario and have completed rigorous training to meet your needs.

These are some things you may consider when seeking a physical therapy clinic:

• The therapist should be licensed in the state.
• The first visit should include a thorough medical history and physical examination before any treatment is rendered.
• The patient goals should be discussed in detail during the first visit.
• Care should include a variety of techniques which might include hands-on techniques, soft tissue work, therapeutic exercises and in some cases heat, cold, electrical stimulation or ultrasound.
• Do they have a service that can address your problem?
• Do they take your insurance or are they willing to work with you if they are not a preferred provider?
• They should be conveniently located. Since sitting and driving often aggravate orthopedic problems, there should be a very good reason for you to drive a long distance for rehabilitation.
• What are the hours of operation?
• Can they provide satisfaction survey results?
• The therapist should provide the treatment.
• Can you briefly interview the therapist before the first visit?
• Ask your family and friends who they would recommend.

YOUR RIGHT TO A "GOOD FAITH ESTIMATE"

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost. Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
• Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your healthcare provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
• If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
• Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call our number on our website for more information.

Our patients come from all over the GTA and beyond for treatment at Movement Sports Medicine + Physiotherapy. Many of our patients have seen multiple doctors and clinicians elsewhere before arriving at our clinic where they found our clinicians provide exceptional specialized care with positive results.

At Movement Sports Medicine + Physiotherapy our focus is on acute musculoskeletal injuries and dysfunctions, and exercise. We are able to fill out FAF (Functional Ability Forms) for workplace injuries, but are not a registered WSIB service provider​.

We do not use assistants in our treatments, although we do use modalities such as ultrasound and electrical stimulation as a component of our treatment, most of the treatment time is hands-on techniques and education from our highly-trained clinician specialists. These one-on-one private appointments create a consistency of care that you can rely on.

We want you to feel comfortable and excited about your healing journey. Feel free to Contact Us at any time with your questions or explore our Services and About Us Page to find the right fit for you.

We provide direct-to-insurance billing for some insurers, but not all. For those that we are able to provide this service for, we keep a credit card on file for any additional payments, and will bill any/all of the insurance covered portion of your care to your insurer. You will only be charged the co-pay.