Frequently Asked Questions

What is Dry Needling and what does it do?

Sterile acupuncture needles are used to address neuromusculoskeletal dysfunctions. A variety of techniques can be utilized depending upon your individual needs.

Does Apex Wellness do the same manipulations as a Chiropractor?

Joint manipulation is a manual skill that can be possessed by a number of medical providers including physical therapists, doctors of osteopathy, chiropractors and others depending upon where you are in the world. Apex Wellness may perform many of the same or similar techniques. The philosophical or diagnostic basis may vary. We base our treatments on neuromusculoskeletal diagnosis and do not attest to the subluxation theory that is the foundation of chiropractic teaching.

Can you send me a receipt for my insurance?

Yes, We provide each patient with an itemized and coded statement that you can submit to your insurance on your own if you choose to do so.

What does an evaluation consist of?

As with all of our appointments, we set aside a private hour to perform a complete history and thorough physical examination that encompasses you as a whole person and not just an injured part. We then discuss our fndings with you and come to an agreement on a plan of care.

If I have several different treatments during my visit, will I be billed more?

Billing at Apex Wellness is calculated based on duration only. Regardless of what treatments you receive, you will only be billed for the amount of time your appointment requires.

What is different about Apex Wellness when it comes to physical therapy?

At Apex Wellness, all appointments are one on one with a Doctor of Physical Therapy. This allows for a full and thorough evaluation to examine you as an entire person as opposed to just one component or body part. We provide comprehensive services that include rehabilitation, nutrition counseling and personal training in addition to physical therapy. Our providers are trained at the highest levels beyond what is found in a typical outpatient orthopedic physical therapy setting.

Why do you not accept insurance?

By removing third-party payers from the equation, we are not limited by them (e.g.: insurance companies) to any certain treatment method or duration. This also means that a physician referral is not needed for you to visit us. The forms and other paperwork required by such providers is also eliminated vastly reducing the amount of resources needed thereby minimizing overhead cost - a savings which we can pass on to you. All of this results in better care within an appropriate time frame for our patients.

Will I have to attend several times a week or for how long will I have to attend?

Duration and frequency of care is unique for each patient and will be determined after a thorough examination. It is our goal to provide the care you need and get you well and back to the lifestyle you enjoy as quickly as possible. We generally don't see patients more than twice per week and will work to reduce frequency as appropriate.

What is the pelvic floor?

The pelvic floor is made up of a group of 3 muscles called Levator Ani. The muscles connect from tailbone to the pubic bone (back to front) and from the two sit bones (side to side).

These muscles contract and relax, just as all the other muscles in the body. When the muscles contract/tighten, the pelvic floor shortens and pulls up inside the pelvis.

The pelvic floor muscles have a very important job. The pelvic floor does the following:

  • Stabilizes the pelvis and hips
  • Helps to distribute abdominal pressure as part of the “core”
  • Supports the pelvic organs (bowel, bladder, uterus, vaginal vault)
  • Creates closure pressure around urethra to keep us continent (able to hold urine)
  • Supports sexual function for pain free and satisfying intercourse

What diagnoses does a pelvic PT treat?

When the pelvic floor is not functioning properly, you can experience some of the following issues:

  • Urinary/fecal incontinence
  • Constipation
  • Pelvic pain
  • Pelvic Organ Prolapse
  • Post-partum issues/birth injuries
  • Urinary Frequency
  • Sexual dysfunction
  • Urinary retention
  • Pain and urinary dysfunction from conditions such as Interstitial Cystitis or Endometriosis

What does an initial evaluation for pelvic floor involve?

An initial appointment with a pelvic floor PT at Apex Wellness involves the following:

  • A detailed history taking, review of symptoms and other ongoing health conditions.
  • In depth education on pelvic anatomy as it relates to your specific symptoms.
  • Comprehensive assessment of  your posture, breathing patterns, core strength, hip and lumbar mechanics.
  • If it is appropriate and you are comfortable moving forward, a pelvic exam. This may involve any combination of the following: perineal observation (no touching), External pelvic/perineal palpation, Internal pelvic floor exam, external and/or internal anorectal exam. *Please note, the clinical relevance to these procedures is thoroughly explained to you in advance and consent is offered or denied by the patient. We will never ask you to do something you are uncomfortable with.*
  • Treatment during the exam, if appropriate. This may involve manual release of musculoskeletal structures, guided breath work, demonstration of proper mechanics or posture, etc.
  • Prescription of a tailored home exercise program to get you started on your pelvic rehab journey! 

Do I have to do the internal pelvic exam?:

At Apex Wellness, you will never be told that you must engage in anything in the clinic that you are not comfortable with.

If the therapist deems it appropriate and helpful to perform a pelvic exam (internal or otherwise), this process will be thoroughly explained to you. You will understand how this exam gives the therapist information specific to your case and how it will help them tailor your treatment plan to your individual needs. However, if you are not comfortable with the type of exam that the therapist is suggesting, it is completely within your right to withhold consent. In this scenario, the therapist will offer alternatives to the type of exam they have initially proposed  so that you are, at all times, feeling comfortable and safe.

Even if you do consent to the exam, it is important to note that you are welcomed and encouraged to end the exam at any time throughout the process if you begin to feel uncomfortable or change your mind. 

What equipment do you use in pelvic floor PT?

At Apex Wellness, we do not rely on any fancy equipment to assess or treat our pelvic patients. Usually treatment involves the patient, the therapist, and the treatment table. We do not use stirrups or a speculum for our internal pelvic exams.

We may suggest using equipment such as massage balls, theraband, kinesiotape, braces, etc. This is not much different than what is used in our other orthopedic physical therapy practice. 

Can I bring my child to my appointment?

We understand it can be difficult to find childcare and there may be times that you need to bring your child to your appointment. This is completely acceptable to us. We are used to children in tow. 

Can I bring my partner to my appointment?

You are welcome to bring your partner to any or all of the appointments. In fact, this can be very helpful!

Your partner can lend a hand to taking care of your child, if accompanying you, while you are being assessed. They can also serve as an extra pair of ears, as the first appointment can be quite education heavy.

For treatment of pelvic pain conditions, we often get the partner involved so that they can better understand your symptoms, triggers, and how to help perform home exercises or self care techniques.

How often do I have to come to pelvic PT?

This is on a case by case basis. On average, pelvic patients are not seen as frequently as orthopedic PT patients. For example, we may see you every 2-4 weeks, as opposed to 1-2x per week. Pelvic physical therapy can often go in episodes of care. We may see you for 4-6 treatments and then see you again months or years later when you are increasing your training demands or have another major life change such as additional pregnancies. 

Is pelvic floor PT coded the same as other types of physical therapy? (Will I be able to submit this to my insurance?)

Physical therapy evaluations and various treatments are the same across specialities. The codes are processed by insurance in the same way it would be as if you were seeking PT for knee or ankle pain.