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Q: Who is a candidate for a Structural Elements® Treatment?

A: Our focus is on musculoskeletal alignment and soft tissue health. By balancing the structures of the body, all systems function more efficiently.

Most patients seek treatment because of pain or a reduction in athletic performance. Back pain, knee pain, shoulder pain and neck pain are the most common complaints we see; however, our solutions are not limited to the area of the complaint. We do not typically attract patients whose primary complaints are related to allergies, digestive problems, sleep disorders or other internal conditions; however, many of these symptoms can be improved through balancing the structures of the body.

Our approach, regardless of condition, will still be heavily focused on structural alignment and soft tissue health.

Q: What should I expect on my Initial Visit?

A: Your first visit will include a complete health history, as well as an (se)® Treatment or (se)® Deep Tissue Restoration. Every visit includes postural assessment before and after intervention. Every visit will also include hands-on manual therapy, which relates to any modality that uses the hands or tools to manipulate the length and tension of the myofascial, muscles, tendons and ligaments.

Through change in the tension and length of these structures, skeletal alignment, as well as postural balance, is achieved. Simple exercises are often suggested to facilitate sustained change to these structures.

Q: What is the difference between a Structural Elements® Treatment and what other Physical Therapists do?

A: Many physical therapy clinics are primarily focused on therapeutic exercise and the use of applied modalities (heat/cold, ultrasound and estim [electrical stimulation]). Our clinics are heavily focused on manual therapy. Every patient gets one on one time with our therapists in a private treatment room and receives individualized care.

Because we are a “cash-based” practice, we are able to treat the whole body as the unique dynamic system that it is, rather than being limited to the site of pain and restricted to only applying modalities that will be reimbursed by insurance. For example, we often find solutions for low back pain by treating the foot and ankle. We find solutions for foot and ankle pain by correcting the alignment of the pelvis.

Structural Elements® is more than a place; it is an approach to correcting compromised biomechanics. Because we can improve function, we have several patients whose primary goal of treatment is to improve athletic performance or to stay healthy.

Q: What is the difference between an (se)® Treatment and an (se)® Deep Tissue Restoration?

A: Both (se)® Treatments and (se)® Deep Tissue Restoration focus on improving the structures of the body and improving soft tissue health.

Typically, a patient would seek (se)® Deep Tissue Restoration if the compromise to alignment was secondary to the compromise of the soft tissue health. (se)® Treatments incorporate the use of needles to target small focal adhesions in the connective tissue that form secondary to skeletal imbalance, for the purpose of decompressing the system to allow for easier skeletal correction.

(se)® Treatments are performed by a therapist who is licensed to perform the needling and the manual therapy, typically a physical therapist or licensed acupuncturist. (se)® Deep Tissue Restoration does not include the use of needles to release focal adhesions - it uses hands-on manipulation of soft tissue to improve mobility and elasticity of the tissue. (se)® Deep Tissue Restoration is typically performed by a licensed massage therapist.

Q: Is there any difference between Acupuncture and Dry Needling?

A: No. There is no difference between acupuncture and dry needling. This is a heated debate in the field of physical therapy and acupuncture. The debate, in our opinion, is missing the mark.

Acupuncture is simply the puncturing of the skin with small, solid filiform needles. The intention of why you are puncturing the skin with these needles is the difference. Dry needling is acupuncture. Dry needling is not, however, Traditional Chinese medicine. Dry needling simply refers to the puncture of the skin with small solid filiform needles as opposed to injection therapy, which uses a hypodermic needle to inject a substance. Typically, dry needling is used to target trigger points that are found in the myofascial system, often at the neuromuscular bundle - the same points are needled by acupuncturists for the treatment of musculoskeletal pain.

The differentiation is two fold; we are not needling points because they relate to an internal organ structure or because of their said effects on any energetic system within the body. The use of needles in relation to Structural Elements® is always focused on releasing focal adhesions in the myofascial system or to release a motor point at the neuromuscular bundle, for the purpose of improving musculoskeletal alignment.

Q: Do you accept insurance?

A: We do not accept insurance. We are a “cash-based” practice. This means we collect full payment at the time of service (cash, check or credit card). We will, however, provide our patients with a superbill that they can submit to their insurance company for reimbursement.

The reason we are “cash-based” is that we feel strongly about offering the best care possible. When treating in a traditional “insurance-based” practice, you are limited to only treating according to what modalities will be reimbursed for a given diagnosis. We feel that the body is a whole, intricate and dynamic system. The body functions kinetically and is not a collection of parts that can be isolated and treated independently.

Until insurance reimbursement is based solely on a therapist's ability to differentiate and correct imbalances leading to pain and dysfunction as they see best, we will remain a “cash-based” practice. We treat the patient, not the injury!

Q: How many treatments should I expect to need?

A: A typical course of care would be 3 to 4 treatments at one visit per week for 3 to 4 weeks. Once a patient has stabilized, we recommend ongoing maintenance of at least 1 visit every 3 to 6 weeks. The best results we see are from patients who maintain structural integrity and soft tissue health by committing to 1 (se)® Treatment every 3-6 weeks, 1 (se)® Deep Tissue Restoration visit per month and 1 (se)® LAB visit per month, with each visit separated by 2 weeks.

Q: What is unique about Structural Elements® Custom Orthotics?

A: Quality orthotics are less common than you might think. There are two factors that determine the effectiveness of a custom orthotic, the casting process and the quality of materials.

Structural Elements® Custom Orthotics are casted in a non-weight bearing position with the hindfoot positioned in subtalar neutral position. This positioning corrects the biomechanically compromised alignment of the foot vs. casting in a weight bearing position that will only capture the already compromised alignment. The forefoot is then balanced to insure proper ground contact when the foot is loaded.

We use semi-rigid materials such as cork and foam to achieve support as well as flexibility. It is critical to provide support when the foot is in stance phase, but allow the foot to move naturally into and out of stance phase. Rigid materials, such as hard plastic, do provide support, but lack the flexibility required for natural mechanics. If the materials are too rigid, the foot must adapt by adding external rotation in order to get off of the device. This compensation will show as added stress higher up the chain and places stress on the knees and hips.

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