Frequently Asked Questions (FAQ)

Your First Visit Video

Running time: 3-1/2 Minutes

Why select OrthoBalance PT?

Unlike many other rehabilitation offices, OrthoBalance is an independently owned and operated physical therapy practice, dedicated to providing high quality Physical Therapy care to its patients. We are neither physician nor corporately owned. You will receive physical therapy care designed by a well-credentialed Doctor of Physical Therapy, NYS licensed to practice since 1980, rendered according to contemporary standards of care that are endorsed by the American Physical Therapy Association. Our patients need and can expect from OrthoBalancePT, a one-on-one experience with a seasoned and expertly skilled practitioner, assisted by caring support staff.

Your referring physician and PCP will receive detailed written and/or verbal information on your care; data and results from your physical evaluation, planned therapeutic treatment and rationale, ijn addition to ongoing progress communication as needed.

We make and keep timely appointments in a professionally appointed office. We offer flexible office hours and we are available seven days weekly in the event of urgent care needs. We participate in a wide variety of health insurance plans, as listed elsewhere, which can cover most or all of the cost of services. Our office staff is always available to assist you. Our location is fully handicapped accessible and we are easily accessible by automobile, bus or LIRR service. Ample free indoor covered outdoor parking is available.

“I have provided service to our local Queens/Nassau community since 1990, during which time I have established a sterling reputation for excellence. You have my commitment to ethical, high quality care and service in a facility which is focused on your success”.

What is Physical Therapy?

Physical therapy is a form of medical treatment that is designed to relieve pain, increase function of the joints and return you to your normal activities. It is based on the scientific principles of tissue management and exercise prescription. Physical therapists perform a comprehensive analysis of movement and dysfunction, identifying structural or soft tissue pathologies/impairments and muscular imbalances or inefficiencies contributing to your presenting problem.

We use a combination of treatment devices (we call them modalities), skilled manual orthopaedic techniques or procedures [“hands on” therapy] and therapeutic exercise in order to reduce inflammation and relieve or eliminate pain, improve joint mobility and to increase functional muscle strength, thereby restoring the bodies’ optimal mechanical function. Combining the “science of healing and the art of caring” our goal is to help you return to work, return to play or leisure activity and generally regain your lifestyle.

What education or training do physical therapists have?

All physical therapists practicing in New York State have successfully passed a NYS licensing examination, after obtaining a post graduate Master’s and/or Doctorate degree in physical therapy from and accredited education program. They undergo intensive study of human anatomy and pathophysiology, biomechanics and corrective therapeutic exercise. Their education is steeped in neuromusculoskeletal, cardiopulmonary and general medical disorders and undergo clinical training in the administration of physical treatment modalities and procedures, corrective exercise and manual manipulative therapeutics. Physical therapists are required to undergo continuing education in order to remain current with the latest medical developments, treatment techniques and patient care options.     [What about Dr. Pensavalle?  Click here]

Can my diagnosis be helped with physical therapy?

Physical therapy is designed to cure, improve or manage many nerve, musculoteninous or bone disorders. Neurological disorders such as Stroke, Parkinson’s, Multiple Sclerosis and other movement disorders are well served by physical therapy. Orthopaedic (muscle, bone, joint) disorders, injuries and surgical cases are very amenable to physical therapy treatments and procedures; in fact, physical therapy is usually a standard initial or follow up treatment in many of these cases. Generally, cases of arthritis and structural or neurological mobility disorders are managed well with physical therapy.

Because they require exercise prescription and skilled manual procedures, many other classifications of physical disorders are well managed by physical therapists, such as:

  • Balance impairment and dizziness
  • TemporoMandibular Dysfunction (TMD or TMJ)
  • Pelvic Floor Muscular Dysfucntion (PFMD)
  • Cardiorespiratory Disorders

Probably. Your abilities can be limited due to various causes, which can significantly impact your quality of life. Diagnoses that PT can help significantly include surgery or an injury, stroke or traumatic brain injuries, neurological diseases, and arthritis – situations which can all limit your ability to generate optimal motion.

What are the hours of operation at OrthoBalance PT?

Our facility is open Monday through Friday and by appointment on Saturdays.

Operating hours are 8:00 AM – 7:00 PM.

How long does a therapy session last?

A typical physical therapy session lasts 45 minutes to one hour; however, the appointments vary for each patient. If longer time is required, you will be advised.

What should I wear to my physical therapy appointments?

Your session will run best when you are wearing comfortable clothing that does not restrict movement. If vigorous exercise is planned, requiring athletic wear, you will be advised ahead of time.

What is a joint contracture?

Joint contractures refer to the permanent tightening of non-bony tissues, such as muscles, tendons, ligaments, or skin. It results in a loss of motion in the affected joints.

Contracture is different than spasticity, but they are often related. Spasticity is an abnormal increase in muscle tone. This can worsen the development of contractures.

Causes
Contractures may be caused by abnormalities of the structures surrounding a joint. These include:

  • Deformity
  • Immobility
  • Injury
  • Chronic inflammation

Certain disorders that affect nerves and muscles almost always lead to contractures. For example:

Contractures are often also associated with spasticity resulting from injuries to the central nervous system, such as stroke or brain injury.

What is Bursitis?

Bursitis is the inflammation or irritation of the bursa. The bursa is a sac filled with lubricating fluid, located between tissues such as bone, muscle, tendons, and skin, that decreases rubbing, friction, and irritation.

What Causes Bursitis?
Bursitis is most often caused by repetitive, minor impact on the area, or from a sudden, more serious injury. Age also plays a role. As tendons age they are able to tolerate stress less, are less elastic, and are easier to tear.

Overuse or injury to the joint at work or play can also increase a person’s risk of bursitis. Examples of high-risk activities include gardening, raking, carpentry, shoveling, painting, scrubbing, tennis, golf, skiing, throwing, and pitching. Incorrect posture at work or home and poor stretching or conditioning before exercise can also lead to bursitis.

An abnormal or poorly placed bone or joint (such as length differences in your legs or arthritis in a joint) can put added stress on a bursa sac, causing bursitis. Stress or inflammation from other conditions, such as rheumatoid arthritis, gout, psoriatic arthritis, thyroid disorders, or unusual medication reactions may also increase a person’s risk. In addition, an infection can occasionally lead to inflammation of a bursa.

What is Tendonitis?

Tendonitis (also called tendinitis) is an inflammation or irritation of a tendon, a thick cord that attaches bone to muscle.

What Causes Tendinitis?
Tendinitis is most often caused by repetitive, minor impact on the affected area, or from a sudden more serious injury.

There are many activities that can cause tendinitis, including:

  • Gardening & Raking
  • Carpentry
  • Shoveling
  • Painting
  • Scrubbing
  • Tennis
  • Golf
  • Skiing
  • Throwing and pitching

Incorrect posture at work or home or poor stretching or conditioning before exercise or playing sports also increases a person’s risk.

What is Rheumatoid Arthritis (RA)?

Rheumatoid arthritis (RA) is an autoimmune disease that results in a chronic, systemic inflammatory disorder that may affect many tissues and organs, but principally attacks flexible (synovial) joints. It can be a disabling and painful condition, which can lead to substantial loss of functioning and mobility if not adequately treated.

The process involves an inflammatory response of the capsule around the joints (synovium) secondary to swelling (turgescence) of synovial cells, excess synovial fluid, and the development of fibrous tissue (pannus) in the synovium. The pathology of the disease process often leads to the destruction of articular cartilage and ankylosis (fusion) of the joints. RA can also produce diffuse inflammation in the lungs, the membrane around the heart (pericardium), the membranes of the lung (pleura), and white of the eye (sclera), and also nodular lesions, most common in subcutaneous tissue.

What is Osteoarthritis (OA)?

Osteoarthritis (OA) is the most common form of arthritis in the U.S. Approximately 27 million adults have reported being diagnosed with OA by their doctor. While the cause of OA is unknown, it occurs when cartilage in joints breaks down over time. Often called “wear and tear” arthritis, OA is most commonly found in the knees, hips, hands, or spine, though it can occur in any joint.

Quick facts about OA

  • One in 2 people in the U.S. will experience some form of OA in their lifetime.
  • OA is much more common in women than men.
  • OA accounts for more than 50% of arthritis cases in the U.S. (nearly 27 million of the 46 million adults who have reported doctor-diagnosed arthritis).
What is a ligament sprain?

A sprain is an overstretch or tear in a ligament (the bands of fibrous tissue that connect our bones at the joints).

How Does a Sprain or Strain Occur?
Sprains usually happen when a person falls, twists, or is hit in a way that forces the body out of its normal position. The most common type of sprain is a sprained ankle; about 25,000 people sprain an ankle every day. Think of a runner who goes over a curb and catches her foot, twisting the ankle; or a baseball player who slides into home plate and twists his knee.

Wrist and thumb sprains are also common, particularly in sports like skiing, where it’s not unusual to fall and land on an outstretched palm.

What is a muscular strain?

A strain is an injury of a muscle and/or tendon. Tendons (fibrous cords of tissue that attach muscles to bone).

Sprains and strains are among the most common injuries in sports, professional, amateur athletes and the general public. You are more at risk for the injury if you have a history of sprains and strains, are overweight, and are in poor physical condition.

Sprains and strains are categorized according to severity:

  • MILD – A muscle is stretched in a mild sprain, but there is no joint loosening.
  • MODERATE – A moderate sprain partially tears the muscle, producing joint instability, and some swelling.
  • SEVERE – A severe sprain produces excruciating pain at the moment of injury, as muscle tear completely, or separate from the bone. The complete rupture makes the joint nonfunctional.

You should seek medical attention if you can’t walk more than four steps without pain, can’t move the affected joint and you have numbness in any part of the injured area.

How is my functioning and mobility affected by a fall?

The absence of a broken hip doesn’t necessarily mean that the consequences of the fall are going to be less severe. In fact, many of the elderly who fall experience injuries serious enough to change their life forever. These elderly gradually become unable to function normally and move around independently. They lose the ability to climb stairs, dress, rise from a chair or bed, cut toenails, walk, and so on. In a study published in the journal Age and Aging by researchers of Vrije University Medical Center, in The Netherlands, functioning decline was observed in more than 35 percent of elderly who had fallen at least once in the previous year. Approximately 15 percent also developed difficulties with walking, cycling, gardening, and doing housework.

What about hip Injuries from falling?

Many of the falls that occur in the elderly result in bruises, head trauma and fractures-mostly of the hips, spine, arms, ankles and legs. Hip injuries are of particular concern. The American Academy of Orthopedic Surgeon reports that 25 percent of those with a hip injury die within one year, whereas 50 percent lose the ability to walk. Another 25 percent need to be admitted to a nursing home, because they are unable to perform daily activities like dressing, eating, bathing and toileting. Note that the likelihood of experiencing a hip injury after a fall increases dramatically with age; to such extent that elderly aged 85 or older are up to 15 times more likely to have one than those aged 60 to 65.

What are the risk Factors for Falls?

Elderly people are more likely to fall if they have one or more of the following risk factors:

  • being on certain medications, such as laxatives, diuretics, antidepressants or sedatives
  • suffering from conditions that affect balance, such as Parkinson’s disease, arthritis, multiple sclerosis and stroke, or that cause sudden drops in blood pressure, like hypotension
  • having medical problems that result in the need to get up from bed at night or rushing, like insomnia and incontinence
  • using a walking aid, like a cane or walker
  • suffering from Alzheimer’s disease or other forms of dementia

Other falls risk factors include insufficient vision, poor hearing, foot problems and wearing inadequate shoes and environmental hazards such as clutter, scattered rugs, loose carpets and wet or slippery floors.

How can older adults prevent falls?

Older adults can stay independent and reduce their chances of falling. They can:

  • Exercise regularly. It is important that the exercises focus on increasing leg strength and improving balance, and that they get more challenging over time. Tai Chi programs are especially good.
  • Ask their doctor or pharmacist to review their medicines—both prescription and over-the counter—to identify medicines that may cause side effects or interactions such as dizziness or drowsiness.
  • Have their eyes checked by an eye doctor at least once a year and update their eyeglasses to maximize their vision.  Consider getting a pair with single vision distance lenses for some activities such as walking outside.
  • Make their homes safer by reducing tripping hazards, adding grab bars inside and outside the tub or shower and next to the toilet, adding railings on both sides of stairways, and improving the lighting in their homes.

To lower their hip fracture risk, older adults can:

  • Get adequate calcium and vitamin D—from food and/or from supplements.
  • Do weight bearing exercise.
  • Get screened and, if needed, treated for osteoporosis.
Fall Injuries?
  • People age 75 and older who fall are four to five times more likely than those age 65 to 74 to be admitted to a long-term care facility for a year or longer.
  • Rates of fall-related fractures among older women are more than twice those for men.
  • Over 95% of hip fractures are caused by falls.15 In 2010, there were 258,000 hip fractures and the rate for women was almost twice the rate for men.
  • White women have significantly higher hip fracture rates than black women.
How dangerous is falling?

Fall-related Deaths

  • The death rates from falls among older men and women have risen sharply over the past decade.3
  • In 2010, about 21,700 older adults died from unintentional fall injuries.3
  • Men are more likely than women to die from a fall. After taking age into account, the fall death rate in 2010 was 40% higher for men than for women.3
  • Older whites are 2.4 times more likely to die from falls as their black counterparts.3
  • Rates also differ by ethnicity. Older non-Hispanics have higher fatal fall rates than Hispanics.12
What outcomes [or consequenses] are linked to falls?
  • Twenty to thirty percent of people who fall suffer moderate to severe injuries such as lacerations, hip fractures, or head traumas.  These injuries can make it hard to get around or live independently, and increase the risk of early death.
  • Falls are the most common cause of traumatic brain injuries (TBI).
  • In 2000, 46% of fatal falls among older adults were due to TBI.
  • Most fractures among older adults are caused by falls. The most common are fractures of the spine, hip, forearm, leg, ankle, pelvis, upper arm, and hand.
How big of a problem is falling?

How big is the problem?

  • One out of three older adults (those aged 65 or older) falls each year1 but less than half talk to their healthcare providers about it.
  • Among older adults, falls are the leading cause of both fatal and nonfatal injuries.
  • In 2010, 2.3 million nonfatal fall injuries among older adults were treated in emergency departments and more than 662,000 of these patients were hospitalized.
  • In 2010, the direct medical costs of falls, adjusted for inflation, was $30 billion.
What can I do to speed recovery?

The bad news is that there is no medicine which can make the balance system work normally. Your doctor may be able to give you medicines to ease the dizziness and nausea, but these will not cure the problem. Sometimes the dizziness will clear up over a month or two. If this does not happen, then it is likely that your medical doctor will recommend balance re training therapy to help reduce and control the problem before considering unlikely surgical options.

Is dizziness abnormal or harmful?

Although dizziness is not usually a sign of a dangerous illness, it is very unpleasant and frightening and can cause other symptoms; nausea, tiredness and difficulty concentrating. If your balance system is not working normally, you may become dizzy when making quick or unusual movements, such as reaching up or looking behind you. You may also become dizzy when you are moved (e.g. in cars or lifts), or when you are in a situation with a lot of moving lights, objects or people (e.g. in busy traffic).

People who are dizzy often avoid physical activity and quick movements, and this can lead to other health problems such as a stiff neck, headaches, and general decline in fitness. People suffering from dizziness or imbalance sometimes avoid vital activities, such as working, travelling or going out alone. You need to have good balance as you get older, to reduce the risk of falling and injuring yourself.

What causes dizziness and imbalance?

The balance system can be affected by many different medical problems, and so it is important to see your medical doctor to check which part of the balance system is not working normally. If your symptoms are caused by the balance organ in your ear, your doctor may tell you that you have vertigo, or vestibular imbalance. This can result from a mild virus or ear infection, or sometimes just wear and tear on the balance organ. Sometimes your doctor will not be able to discover why the dizziness started, but balance retraining can still help to speed recovery even when the cause for the dizziness is not known.

How does balance work in the body?

The balance system relies on three different senses. Your eyes tell you where you are and where you are going. Your joint position sensors in your body tell you where you are and how you are moving. And the balance, or vestibular organ in your inner ear senses when and how your head moves. Your brain acts like a computer, combining signals from these three senses to give you a stable picture of the world and control your head, body and eye movements. If any part of this balance system is giving out unusual or faulty information then you may feel dizzy, disoriented or unsteady.

How many sessions will I have?

Each patient’s diagnosis is different, so together with your referring physician, your therapist will develop a plan of care that is right for you. Your plan of care and number of visits will be determined during your first visit, based on clinical findings.

What kind of payment do you accept?

We are required to collect insurance deductibles, copayments and other non-covered charges. We accept cash, check, debit card, and credit card (Visa, MasterCard, Debit Cards). We are happy to discuss payment plan options, as well.

Does insurance cover my treatment?

Yes, in most cases it does. Our office will be happy to assist in contacting your insurance company and determining your coverage based on your individual policy. A list of insurances in which we participate is provided. For more information, please do not hesitate to contact our office.

How can I help my treatment and recovery go smoothly?

There are a few things you can do to help yourself.

First of all, please KEEP and be on time for your scheduled appointments. We try our best to run on time and we don’t like to keep our patients waiting, but sometimes, as in all medical situations, we may be delayed by a medical problem. We ask for your patience. Keeping your scheduled appointments is very important. It is just like the dosage of a medication; when not taken properly it will not be effective. Missed appointments stop progress. If you cannot keep a scheduled appointment, please call ahead to cancel so that we can use the canceled space for another patient.

Second, please follow recovery instructions and do your exercises as prescribed by the physical therapist. We make every effort to select the fewest and simplest effective exercises so that the programs are easy to accomplish – but they are of little value if you don’t do them regularly. They help promote recovery and prevent recurrence of the problem.

What should I wear to my physical therapy appointments?

Dress comfortably. Tight fitting clothes interfere in your movement, positioning and some treatment procedures. High heels, sandals and dress shoes are not ideal for exercise.

What should I bring to my first visit?
  • A prescription for physical therapy from your referring physician, dentist, ARNP, or PA
  • Insurance information; primary and secondary (we will take a copy of your card)
  • Photo ID
  • For No Fault [automobile accident] or worker’s compensation claims, please bring any contact names, phone numbers and claim number.
Will physical therapy hurt?

Most people come to us for pain relief, so our aim is to make you feel better as we guide and promote your healing. As your functional strength and mobility are restored your pain levels often fluctuate. This is a normal response to therapy treatment. Good communication with your therapist will help minimize any discomfort.

What can I expect my first visit?

A thorough medical history will be taken and a problem oriented physical evaluation will be performed.

A complete discussion about your problem and rationale for your treatment options.

Depending on the nature of your case, treatment may be started immediately, or upon subsequent sessions.

How long does a therapy session last?

A typical physical therapy session lasts 45 minutes to one hour; however, the appointments vary for each patient.

What are the hours of operation?

Office operating hours are Monday through Friday 8:00 AM – 7:00 PM.

and by appointment on Saturdays.

Can my diagnosis be helped with physical therapy?

Probably. Your physical abilities can be limited due to various causes, which can significantly impact your ability to work and your quality of life. Diagnoses that PT can help significantly include neuromusculoskeletal injury or surgery, stroke or traumatic brain injuries, neurological diseases, disorders of balance and dizziness and various forms of arthritis – situations which can all limit your ability to generate optimal motion and impair your functional capabilities.

Why select OrthoBalance PT?

Our patients need and can expect from OrthoBalancePT, a one-on-one experience with a seasoned and expertly skilled NYS licensed Doctor of Physical Therapy, supported by skilled and caring support staff. We make and keep timely appointments in a professionally appointed office. We offer flexible office hours and we are available seven days weekly in the event of urgent care needs.

Treatment is based on scientific data acquired during your initial evaluation, a review of your past medical history and integration of diagnostic testing ordered by any managing physicians. Treatment design and planning is guided by your recovery goals and functional expectations, enabled by a blend of both traditional and contemporary evidence based care standards.

We participate in a wide variety of health insurance plans, as listed elsewhere, which can cover most or all of the cost of services. Our office staff is always available to assist you. Ample free indoor and covered outdoor parking is available.

Our location is fully handicapped accessible and we are easily accessible by automobile, bus or LIRR service.

What education do physical therapists accomplish?

As licensed health care professionals, Physical Therapists must obtain a Master and/or Doctorate of Physical Therapy from an accredited education program before practicing, and pass their respective state board examinations to receive their licenses. They will have mastered education and training in anatomy, physiology, biomechanics, orthopaedic and neurological sciences, disease and injury pathophysiology in addition to the application of skilled therapeutic intervention treatments. Physical therapists attend continuing education courses to stay abreast of the latest medical developments and treatment approaches.

What is Physical Therapy?

Physical therapy is a form of medical treatment that is designed to relieve pain, increase function of the joints and return you to your normal activities. It is based on the scientific principles of tissue management and exercise prescription. Physical therapists perform a comprehensive analysis of movement and dysfunction, identifying structural or soft tissue pathologies/impairments and muscular imbalances or inefficiencies contributing to your presenting problem.

We use a combination of treatment devices (we call them modalities), skilled manual orthopaedic techniques or procedures [“hands on” therapy] and therapeutic exercise in order to reduce inflammation and relieve or eliminate pain, improve joint mobility and to increase functional muscle strength, thereby restoring the bodies’ optimal mechanical function. Combining the “science of healing and the art of caring” our goal is to help you return to work, return to play or leisure activity and generally regain your lifestyle.

What Kind of Treatment Will I Receive?

Your treatment will be determined based on information that is gathered during your first session with us. The physical therapist will ask you questions about your problem, review the medical chart and perform a detailed physical therapy evaluation. Based on this information, a course of treatment will be designed for you to help achieve the fastest, most complete recovery. It is important that you follow through with the treatment program in order to gain the most benefit.

How can I Help You to Make Me Better and Help Things Go Well?

There are a few things that you can do to help yourself.

First of all, please KEEP and be on time for your scheduled appointments. We try our best to run on time and we don’t like to keep our patients waiting, but sometimes, as in all medical situations, we may be delayed by a medical problem. We ask for your patience. Keeping your scheduled appointments is very important. It is just like the dosage of a medication; when not taken properly it will not be effective. Missed appointments stop progress. If you cannot keep a scheduled appointment, please call ahead to cancel so that we can use the canceled space for another patient.

Second, please follow recovery instructions and do your exercises as prescribed by the physical therapist. We make every effort to select the fewest and simplest exercises so that the programs are easy to accomplish – but they are of little value if you don’t do them regularly. They help promote recovery and prevent recurrence of the problem.

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