We want you to be as comfortable as possible when coming in to see us.

Here is an outline of what you can expect.

Initial Visit
The first thing you will do is fill out our three page intake form. This asks about your current problem, personal health history, surgery, medications, and family health history. Please be aware of these aspects and bring any necessary medical records, MRI reports, X-ray reports, etc. with you. You will also want to bring shorts or a tank top with you.

History
We will begin by asking you to tell us your story: what happened, when, under what conditions, treatment you have had, and your response to treatment. We will also ask very specific and individualized questions to understand how your problem happened. This is an important part of solving your problem.

Exam
The history lets us know where to start with the exam. The exam consists of functional tests, orthopedic tests, neurological tests, soft tissue assessment, and joint assessment. We combine this data to figure out what’s wrong.

If possible, we find a test (motion or position) that reproduces your symptoms. Based on this position and/or posture, we know what structure is overloaded. For example, if while watching you lunge we see you lean forward, we will suspect weak hamstrings. If this also causes knee pain, a link has been established between weak hamstrings and your knee pain.

Diagnosis
Pertinent facts gathered in the history and exam are like puzzle pieces. To determine an accurate diagnosis, we must get enough pieces and put them in the right place. Gathering the pieces requires objective, critical thinking and a great deal of experience with soft tissue problems. What we come up with is a four-part diagnosis as follows:

1. Determine exactly what structure is responsible for your pain.
We need to know exactly what part of what tissue is irritated or damaged and in what way. For example, knee pain can be caused by many structures; the patellar tendon is one possibility. If this were the case, we would also need to determine if the tendon is inflamed, degenerated, or both.

2. Determine what has gone wrong to overload that structure.
Knowing your knee hurts is one thing; knowing why is another. If your knee hurts, there is a good reason for it. Something in the knee is getting overloaded and has been damaged. It is critical we figure out where the overload is coming from. Usually, there is scar tissue, weakness, or nerve entrapment altering movement and load patterns. We look for these problems.

3. Identify perpetuating factors.
We also need to address if there is anything else that is contributing to your pain. Stress, posture, exercise, structural problems, diet, etc. all should be identified as early as possible.

4. Attach a common, recognizable name.
The above example might be called patellar tendonitis, when in reality a complete and accurate diagnosis requires much more than the recognizable name.

Explanation
Once we've determined your diagnosis, we explain it to you in a detailed way you can understand. It is really important to us and your progress that you understand what’s wrong and how we are going to fix it. We will let you know how many treatments we think it will take to solve your problem. Usually treatment isn’t performed on the initial visit.    

Follow-up Visit
Before beginning, we will ask if you have any questions about your problem or proposed treatment. Each visit is a diagnostic and treatment process. We constantly monitor your situation and adjust treatment as necessary. See the treatment section for specific treatment information. Follow-up visits take approximately 15 minutes. 

Progress Report
Every few visits we ask you to fill out a short progress report. We use this as a tool to formally track your progress to make sure we’re on the same page.

Discharge
When your problem has been resolved, you will be discharged from care. At that time we will review what you had and what you need to do to minimize your chances of the problem recurring.

Maintenance
Not all problems get 100% better, particularly if there is too much continued load (i.e. work demands) or underlying pathology. If this is the case, maintenance treatment may be necessary. Maintenance schedules vary widely from patient to patient. We do everything we can to avoid this possibility.