Direct Access to Physical Therapy

Case Description: Pt. was a 40 y/o who noted several months of gradual increase in R HS “tightness.” After going to a trampoline park with his kids, he noted that this tightness intensified and he began to experience more and more R sided SIJ region pain with radiating R leg pain/numbness, to the point that it was hard to bend over at all and even moving in bed or putting on socks and shoes was difficult. He had a history of similar symptoms in the past and was usually able to stretch them away. He had not been successful in doing this to date. 

Summary of findings: The patient was seen for 6 physical therapy visits over a 21-day period

Tests and Measures	Initial Evaluation	Day of Discharge from Physical Therapy
VAS for Pain	2-7/10	0-1/10
Modified ODI	58% disability	0% disability
Trunk Mobility (all very hesitant initially)	FLEX 50% expected (radiating R leg pain), EXT to 100%, ROT R to 75%, ROT L to 100%	100% of all planes without hesitation or any complaint of pain
Function	Avoiding bending/reaching tasks, difficulty standing tall, unable to move in bed or get good sleep.	Not limited in any daily activities and had returned to coach young sons soccer practice. Initiating a squat and deadlifting routine at the gym without issue

Direct Access Update: In the state of Michigan, physical therapists are allowed to see and treat patients through direct access (meaning no formal physician prescription is required) for a period of 21 days or 10 visits, whichever comes first.  A thorough physical evaluation is performed and if there are any contraindications to initiating care, they are referred to seek out more formal medical evaluation.  Should care be needed beyond 10 visits or 21 days, physician authorization is required.  

The following link can provide further information on direct access. https://fullpotentialpt.com/faq/what-is-direct-access/

Sincerely,

Luke Vander Zouwen, DPT
Full Potential Physical Therapy