What is happening now? (March 24, 2020)
To our Evolution Physiotherapy clients,
We hope this email finds all of you well. With the escalation of the COVID-19 pandemic, we remain closed, and at this time, we do not have a scheduled date to re-open the clinic. We await guidance from our all levels of Government and our Public Health authorities.
We understand that this closure is disruptive for our clients, and we sincerely apologize for the inconvenience.
We will continue to consider the best way to support you and your health, including virtual/telehealth appointments as an alternative to your regular in-person physiotherapy appointments.
We care deeply about the health of our clients and our wider community, and we thank you very much for your patience and understanding as we do our part to overcome this challenging situation.
You can follow us on Facebook for further updates.
Do I need to see my doctor prior to booking a physiotherapy assessment?
Although physiotherapists are primary care providers, some extended health insurance plans require a doctor’s referral in order to reimburse you for your physiotherapy sessions. Check with your extended health provider.
If your extended health provider does not require a physician referral, it is not necessary to see your doctor prior to having a physiotherapy assessment. However, some clients are more comfortable seeing their doctor first.
If I have already seen my physician for an assessment, why do I need a physical therapy assessment?
Physicians will usually focus on the structural area that is painful. For example, if you are a runner and have knee pain or foot pain related to repetitive activity, you will likely be given a diagnosis of patella-femoral pain syndrome in the knee, or plantar fasciitis in the foot. If you have shoulder pain, you will likely be diagnosed with a rotator cuff problem (irritation, inflammation, tendinopathy, fraying, tearing, etc). One of the key components to treating and improving these conditions is assessing and evaluating each individual to determine WHY that structure is injured. Applying ultrasound and giving you a couple of stretches to do is often not going to help fix your problem. There are many factors that need to be assessed and addressed to determine why that particular structure is breaking down at a rate which is greater than your body’s ability to repair/heal it.
Most physicians have no background in exercise prescription/physical therapy/movement assessment, etc. We are not like pharmacists, who dispense the drugs the physicians prescribe. There are very few (some would argue none) conditions that have a treatment recipe that will work for everyone.
Do I need to wait until I have the results of my diagnostic test (X-ray, MRI, etc) prior to seeing a physical therapist?
In most cases, it is not necessary to have the results of your diagnostic test prior to seeing a physical therapist. One exception is if you are concerned that you have a bone fracture or a muscle/tendon rupture. In most other cases, the results of the diagnostic tests will not change the initial physical therapy treatment plan. Specifically, if you are awaiting MRI results for a knee injury (ligament and/or meniscus), shoulder injury (labrum, rotator cuff tear), or back injury, the results of the test are not necessary to determine the appropriate physical therapy treatment. The test results are important for making surgical decisions, but the physical therapy treatment is based on improving your primary complaints (pain, loss of function, etc).
Does everyone you treat get better?
There are never any guarantees in the health care world. However, if the health care practitioner and the client/patient are committed to working towards common goals, most outcomes are successful.
How many treatments does it take to get better?
This is a common question which no one can answer specifically. No two problems are the same, because every client is unique. This is why having a detailed assessment is so critical to help identify all the factors involved in the problem. Frequent re-assessment and re-evaluation are necessary to evaluate the effectiveness of the treatment interventions as well as to progress the treatment appropriately. Recovery is also affected by client factors such as age, motivation, natural history/progression of the problem, occupation, hobbies and activities, psycho-social factors, etc.
How long will it take?
Every person is unique and every problem is unique. Some of our clients eliminate their pain and restore their function in 2 to 3 weeks. Some problems take 6 to 8 weeks. Unfortunately, some can take a few months, and in rare cases, longer. Treatment should only be continued if it is helping. If our treatment plan isn’t helping, it should be changed. The treatment response is highly variable and depends on:
- How complicated and difficult the problem is
- How did you develop the problem (acute vs chronic)
- How long you have had the problem
- How significant the structural damage is
- How committed you are to solving the problem
- Your motivation
- Your ability/willingness to modify your activities, aggravating factors, etc.
How much will it cost?
Again, this is variable, and it is always important to discuss financial considerations of your treatment with your provider. Cost is based on the total number of treatments required (which is not the same as how long it will take).
Over the past 5 years, we have tracked the average number of treatments required to help our clients achieve their goals (eliminating pain and restoring their function). The average number of treatments is 8. Keep in mind, this is an average. Some clients require less treatment sessions, and some require more.
Our goal is always to provide the solutions in the most time efficient and cost effective manner. If the treatment isn’t working, the plan needs to be changed. In some cases, there are other factors and/or other providers that can help (eg. physicians, massage therapists, psychologists, coaches, etc). Feel free to discuss alternative/additional service providers.
Who is your knee specialist (elbow specialist, shoulder specialist, etc)?
To determine what is causing the pain or functional limitation in a specific area (for example, the knee), it is important to understand the impact of the areas above and below. This important principle is referred to in concepts such as the joint by joint approach, regional interdependence, and the kinetic chain. For many of the knee problems we see, the best treatment solution includes addressing problems (often weakness the client is not aware of) in the hip and/or the foot and ankle. For the low back, addressing problems with the pelvis/hip and the thoracic spine is important.
All our physiotherapists utilize the Selective Functional Movement Assessment (SFMA) to evaluate your movements.
Do you treat clients injured in Motor Vehicle Accidents (MVA’s)?
Yes, we treat clients who have been injured in Motor Vehicle Accidents. This includes cyclists and pedestrians hit by vehicles.
Once you call and report a claim, you will be sent a package from your automobile insurer. This package contains your claim number, date of accident, adjuster’s name, phone number and fax number. This is the information we need to complete the treatment plan that is sent to your car insurance company. You may book an assessment prior to receiving this package, but need to provide us with the information as soon as possible so that you may be approved in a timely manner and begin treatment.
For further information, see our Motor Vehicle Accidents and Injury section under our specialty programs page.
Can you direct bill to Insurance companies/providers?
We can submit your bill on your behalf to the following private insurance companies: CINUP, Chambers of Commerce Group Insurance, Cowan, Desjardins Insurance, First Canadian, Great-West Life, Industrial Alliance, Johnson Inc., Johnston Group Inc., Manulife Financial, Maximum Benefit, Sunlife Financial (excluding Policy 055555 – Federal plan). Please note that we are not set up to have the insurance providers pay us directly, only to submit on your behalf. Most providers will have your claim(s) assessed and funds paid to you within a few days.
Why do you not treat WSIB claimants?
We do not feel that we can provide appropriate treatment to WSIB claimants. If WSIB claimants were free to book regular assessment and treatment sessions with our facility, we would be happy to help them. Unfortunately, WSIB restricts the clinics that their clients can go to, and is not willing to cover reasonable physiotherapy costs that are necessary to provide high quality physiotherapy services. We are not willing to provide inferior physiotherapy service to our clients, as we believe in offering the highest level of physiotherapy services that we can.
How should I prepare for the first appointment?
- Arrive on time. If you are late, you are taking away from your own assessment/treatment time.
- Wear loose fitting, comfortable clothing
- If you have a low back, hip, or knee injury, bring shorts
- If you have a shoulder injury, wear a loose fitting t-shirt or tank top
- If you have a doctor’s referral (particularly after surgery), bring it
- Bring a list of questions you would like to discuss