How physical therapy can help after an accident - An interview with physical therapist Tim Eckard

Robert Mansour:  Hello everyone, this is Robert Mansour. I'm an attorney here in Valencia, California and part of my practice is handling personal injury cases and representing people who have been injured in serious automobile accidents, and I have a special guest with me today, Tim Eckard is a physical therapist and also the president and CEO of Kinetix Advanced Physical Therapy here in Valencia at their brand new location, right Tim?

Tim Eckard:  That's right, yeah.

Robert Mansour:  Well today I wanted to spend a little bit of time trying to create something that would help perspective patients, perspective clients who've been involved in serious accidents, and talk a little bit about how physical therapy can help them get on the road to recovery, but before we do that tell me a little bit about this new location you have here in Valencia.

Tim Eckard:    Okay. Yeah, this is a much larger space where we were before, and so we have much more room for privacy. We have for private treatment rooms now, so when we do evaluations or they're certain cases that we need more privacy we have that available. We also have a much larger gym and space to do a lot of the therapeutic type of exercising, working out that we do, and we have the ability to ... The way we set it up the therapists are always available and we can see our patients from where we document, and so it's just the way it's set up is much easier to keep track of all our patients and not let anyone get lost or kind of hidden anywhere, so-

Robert Mansour:    Well the layout is fantastic. I mean I was here for the open house and it just seems like a very inviting space I think it's terrific.

Tim Eckard:   That's what we try to do is create like a warm environment, friendly environment, a safe comfortable environment and it feels that way here and that's what we hear a lot of.

Robert Mansour:    Well I would imagine some patients would be nervous the first time they come.

Tim Eckard:     For sure.

Robert Mansour:   Yeah, and you guys put them at ease.

Tim Eckard:   Oh yeah. We like when they come in ... Well we don't want them to come in nervous but it's neat to see when they come in unsure and then they leave comfortable and smiling and feeling a little bit better about it.

Robert Mansour:   Now if they come here, do ... I've always wondered about this, and maybe our audience is also wondering about this, can people just walk in off the street and say, "Hey, I want physical therapy," or do they have to be referred? How does it work?

Tim Eckard:   Yeah, they can now. It's called direct access and our industry has been fighting for that for some time, so now you can come in off the street and be seen for up to 12 visits, however if we find that upon the evaluation that it's something that's beyond our scope of practice or we think that needs to be checked out medically we certainly would refer that out and then go back to the physician or go to a physician, but typically I would say 90% of our cases are referred by a physician.

Robert Mansour:    Okay, what kind of physicians normally would refer to you?

Tim Eckard:    Normally it's orthopedist, but any mechanical, like a neurosurgeon could refer to us, orthopedic surgeon obviously, but we're trying to inform family practice doctors, they can refer as well, rheumatologist. We do TMJ work so dentist or maxillofacial doctors can refer to us.

Robert Mansour:    Extremities, hand doctors?

Tim Eckard:    Hand doctors, yeah which are typically a specialization of orthopedics. So neurologists, I think I mentioned rheumatologist, sometimes oncologist even could refer, so it's quite a variety of physicians that can send us. If it's an MD they can refer to us, so that's the bulk of it.

Robert Mansour:   So let's say somebody was involved in a serious auto accident and they have cervical complaints, lumbar complaints, maybe something even more serious than that, tell us what the patient can expect on their first visit, walk us through that first visit.

Tim Eckard:     Mm-hmm (affirmative), so typically we set an appointment up over the phone to come see us and we set an hour aside for you, for the patient, and you come in and like every office you're going to have to fill out a little bit of paperwork, but we try to keep it to a minimum we know it's kind of a drag, but we get some pertinent information from you about your condition and so then what happens is you're brought back into one of the private treatment rooms where we do a one-on-one evaluation with the physical therapist, and we essentially we'll kind of sit you down and we'll just start having a little conversation about what's kind of bothering you, a little history of the situation.

Robert Mansour:    How should people dress by the way for this initial visit?

Tim Eckard:     Pretty comfortable-

Robert Mansour:    I mean they dress in a suit?

Tim Eckard:   No, very comfortable clothing, loose clothing is preferable but just however you want to is comfortable.

Robert Mansour:   Okay, so there's no strict dress code?

Tim Eckard:   No.

Robert Mansour:   But it would be nice if it was comfortable in this clothing.

Tim Eckard:    Right, but if someone's coming straight from an office or something and you're wearing what you ... it's fine.

Robert Mansour:    Okay, so you sit them down and?

Tim Eckard:   We sit down, we basically get the history of the situation and then from there we start doing an objective exam which means we will test like range of motion of how far you may be able to move your limb or your spine, your neck. We'll do some strength testing, we'll do palpation which basically means we kind of feel around to where areas might be sensitive or tender. We're trying to find out the kind of the location or where we should start treatment and maybe what some of the sources of pain are coming from. We may do some other special testing to test if there's neurological problems and that type of thing, and then we're always kind of educating as we're evaluating as well, so if we find something that might benefit you with a certain thing you mentioned about what you said or where your desk might be ergonomically or your posture, we can kind of go into some of that.

Tim Eckard:     And so typically the first visit you get the evaluation and we try to give some kind of a treatment that day as well.

Robert Mansour:    So it's not all evaluation in that one hour.

Tim Eckard:    No, and we try to always give you a home program, something that you can start working on at home, and we've got a really cool new system now where we can email you these exercises, and in the email there are videos so you can see the motion of the exercises.

Robert Mansour:    Are you in these videos Tim?

Tim Eckard:   No, these are professional videos shot from the system that we have.

Robert Mansour:    Nice.

Tim Eckard:   And it's kind of cool, yeah, and it's got any exercise you'd want to kind of come up with and then you can specialize in it as well if you want to, but basically it's pretty organized system and it works and we have pictures that we can give you, they're very clear and written out well so that's a very nice tool we have now to use. And then we may treat you for pain or some of the discomfort you may be in for so we can at least help you kind of feel a little bit better at the time and at least get some kind of treatment. But all this would take place in about an hour's time and then we decide how frequently you should come and it may be prescribed specifically by the physician that's referring, two times a week, three times a week, that's a typical amount of therapy that one would have.

Tim Eckard:   But again, we kind of base it on what we feel like is appropriate for you, and then if you're able to that day you go back to where you first checked in to set up your appointment for further follow-up visits, and then a plan is created as to what's going to occur or how we're going to go ahead and start treating your issue, and we carry that out and progress as we feel we can and continue to reassess.

Robert Mansour:  Do you report to the physician who referred the patient?

Tim Eckard:   Yes.

Robert Mansour:  How often do you report to them? How do you keep them aware of what's going on?

Tim Eckard: Right, so from the first visit we'll do an evaluation and that evaluation gets typically efaxed or emailed to the referral position, so it's kind of quick. And we'd like to also, if we can, hand deliver that referral or that report to the physician as well, so they'll have a hard copy as well, we can do that if it's a local doctor, that kind of thing but they at least get a efax to them. And then from there we'll go ahead and do treatment. We don't send them a report every visit but we'll do a progress report that will occur ... If the end of the prescription is done we'll send a progress report indicating if we need to do further visits or we may do a discharge and they will get that as well.

Tim Eckard:  So they're get a evaluation, a progress report and/or a discharge report.

Robert Mansour:  Let's say I was involved in a car accident or a person is involved in a car accident, let's say it's relatively severe, is there any kind of average number of weeks that many doctors prescribe at the very beginning or does it always vary? Do you see an average?

Tim Eckard:   You see an average. I would say it's probably an average of about six weeks.

Robert Mansour:   Okay and at that point-

Tim Eckard:   Four to six, but at that point it's a sufficient amount of visits and treatments to see a difference in your condition, to see an improvement.

Robert Mansour:   What if there is no improvement, what happens then?

Tim Eckard:  Then you refer back to the physician indicating there is no improvement and then they may need to redirect the plan of care, maybe they need to do more diagnostic testing, maybe they need to send to another type of specialist. So there may be another option or another path of treatment if conservative treatment isn't going to be beneficial, maybe they need to see a surgeon or whatever the case may be, it could vary a little bit. But if you see progress, typically you'll see progress, especially for soft tissue injuries which are most common with car accidents you'll see improvement but the goal is to kind of eventually get the patient to manage independently and learn how to do that.

Robert Mansour:  Well it's very interesting you mention that because I've had some clients say, "Well wait a minute, isn't this just massage? Ain't I just getting a massage at the physical therapist?" I don't think a lot of people really grasp what it is that you guys are doing.

Tim Eckard:  Right, so I often will explain to patients some of the conservative options and compare that to what we do as physical therapists. We do some of the massage and manual techniques for sure, and soft tissue work, but I would say the difference with physical therapy is that you're actually making a true correction or a true fix versus just managing the symptoms. So there are symptom managers and that's fine as you're kind of going through the process because it does take some time to make strength changes, mobility changes, and just time for healing. So just doing a massage, yeah, that probably would help make you feel better, relaxed or whatever for the moment but it's not going to necessarily fix the situation.

Robert Mansour:  I see.

Tim Eckard:  And so therapy is more about posture education, mechanic education and then making changes with mobility and strength where then you're truly better and it's just not a temporary situation.

Robert Mansour:  So Tim what I understand then is that you're more about correcting the problem rather than just treating the symptom.

Tim Eckard:   Correct, for sure.

Robert Mansour:  All right, now what kind of physical therapy techniques might you guys use if it's ... So in addition to massage what else would you help the patient with?

Tim Eckard:  So we do have mode what we call modalities which are just types of treatment to work on increasing circulation, decreasing pain and increasing the mobility of the tissue, loosening that it up. Again, those things are kind of temporary at the moment but can help you move and exercise better, so if people are in a great deal of pain then those are good options to help mechanically try to manage this versus chemically trying to manage it i.e. pills and medication, so we're try to get off of those the best that we can, for other medical purposes and side effects and that type of thing.

Tim Eckard:  So we try to ship to a more of a mechanical management basis with those, but then the idea where we make these corrections and fixing the issue, it comes through a variety types of therapeutic activities, therapeutic exercises, neuromuscular exercises, posture exercises, so we guide and we direct a kind of an exercise regime. Most cases we set up like a therapeutic exercise workout for you, we start where we need to start and we progress as we need to progress and there's education and they're still doing your home program.

Robert Mansour: Right, you're doing your home program which is based on some of the things that you're doing when you see the patient?

Tim Eckard:  Right.

Robert Mansour:  Okay.

Tim Eckard:   Things that you can do at home we try to let you do them at home and then we complement that or we build off of that with doing other things here in the office that you might not be able to do at home, and again we make the changes or we guide progression and intensity of exercises and that type of thing.

Robert Mansour:  Okay, so you're one of the therapists here, correct?

Tim Eckard:  Yes.

Robert Mansour:  How many therapists do you have available to people when they come and visit?

Tim Eckard:  So including myself there's two other therapists so we have three therapists.

Robert Mansour:   Three altogether.

Tim Eckard:    Right, then we have what we call PT aides who assist us, they're like extra hands for us and they may set the patient up with the heat and maybe electrical stimulation or they may help the patient with exercise because they're trained in knowing how to do the exercises. We determine what they are, we prescribed those and then we create what we call a flow sheet which basically is a guide for the other clinical people either the therapist or the aides who are helping us work with the patient in that, but again we're checking in as therapists with the patient and monitoring their progress and talking to them about their situation and then if we need to make any changes or we kind of stay where we are for the moment we do that but the aides will help us with that.

Robert Mansour:   I have two questions for you, two more questions if you don't mind, and I'm going to put you on the spot so I hope you don't get upset.

Tim Eckard:  All right.

Robert Mansour:   What do you think is the biggest misconception about physical therapy? Do you think that there are any big misconceptions that people have about it?

Tim Eckard:   I think you sort of hit on one word where you just kind of do massage and then that's kind of all you get.

Robert Mansour:   They don't understand the extent of it.

Tim Eckard:   Yeah, but I think maybe the other one is that they put you through so much pain.

Robert Mansour:  Yeah, that's right, some people say, "I don't want to do physical therapy because it's going to be too painful," what do you say to them?

Tim Eckard:   Well I think we're a little different in that because we show people or I myself will kind of give an example of how we all have some limitations of whatever that might be, and we need to stay within those so that we're not over irritating so that means we're not going to put you through things that are going to be painful or really reproduce your problem, however in order to improve and get better we have to kind of hit those edges a little bit and expand and get out of the comfort zone a little bit.

Robert Mansour:  A little bit.

Tim Eckard:  So a certain amount of discomfort may need to occur but we explain to them how that's going to happen, but at the same time we're always working within tolerances of people and those do vary from patient to patient, but we stay within the tolerable amounts of intensity but we try to progress that little by little, but we're not killing them and working way past their abilities or their tolerances so we were really watched for that and I think the misconception is that we're just working past those limits, too far.

Robert Mansour:  So here's another question, another putting you on the spot question and then maybe we'll close with this.

Tim Eckard:  Okay.

Robert Mansour:  Kinetix Physical Therapy here in Valencia, and by the way if people want to learn more about that they can go to, let's see here the website is kinetixapt.com, correct?

Tim Eckard:    Correct.

Robert Mansour:    And the best phone number Tim, for people to reach this facility.

Tim Eckard:   (661) 288-0300.

Robert Mansour:   So here is the ultimate question. How does Kinetix Physical Therapy differ? Or what is unique about Kinetix Physical Therapy that perhaps other physical therapy places in Santa Clarita should strive for, or if you want to keep this a trade secret you're more than welcome to keep it.

Tim Eckard:   No, that's fine. I think the main difference, because we do hear some things from patients who've been to other facilities, and I'm talking negative about anyone else-

Robert Mansour:   It's just what you hear, yeah.

Tim Eckard:   ... but I think the big difference is that we connect with the patients really well. We don't lose them, in a sense you're going to still see a physical therapist every time you're just not passed off to someone else and we lose track of you, so you're going to see a physical therapist every visit, and you're just going to sense there's a deep caringness here. We really do care about your situation and we are here to help-

Robert Mansour:   Personal attention.

Tim Eckard:  Very much, a lot of personal attention, and then we try to create an environment that is inviting, comfortable, relaxed, fun, and because I believe myself that it's people who are trying to get better, they're in pain, they're emotional, status may be a little difficult. If we can give them a good experience overall, just to have them enjoy being here in a sense, I think that is very medicinal and helpful for their condition as well, past the mechanical things that we're trying to do as far as getting them better with their injury, but making it be an enjoyable experience while they're here.

Robert Mansour:  Speaking of enjoyable experiences Tim, I've had a very enjoyable visit with you, and I think I learned a lot even though I've been doing this for 25 years, and so once again if people want to learn more about Kinetix Physical Therapy, they can go to kinetixapt.com. And again, I'm Robert Mansour, my website is valencialawyer.com, and thanks again for visiting with me Tim.

Tim Eckard:  Great, thank you.

Robert Mansour:  Appreciate it.

Tim Eckard:  Yeah, that's cool.

For more information about Kinetix Advanced Physical Therapy, visit www.KinetixAPT.com