At Orange Coast Memorial our goal is to provide the highest quality rehabilitation services to enable patients to return to full function as soon as possible. The center is staffed with experienced and compassionate physical and speech therapists who work with each patient's referring physician to ensure that their progress is tracked to meet their rehabilitation goals.
Physical Therapist and Manager of Outpatient Rehabilitation Services at Orange Coast Memorial Medical Center, John Fenger, PT, discusses the benefits of outpatient rehabilitation. From treatment of ailments ranging from fractures to neurological disorders, and cancer rehab to speech and language therapy, there may be a therapy option to help you feel better and enjoy an improved quality of life.
Beyond Stretching: How Outpatient Rehabilitation Can Benefit You
Featured Speaker:
Organization: Orange Coast Memorial Medical Center
Outpatient Rehabilitation & Physical Therapy at Orange Coast Memorial
John Fenger, PT
John received his Bachelor's in Exercise Science from Northern Arizona University. He then attended MGH Institute of Health Professions in Boston, MA, where he earned his Master's in Physical Therapy. John has continued both his academic and clinical pursuits by earning both his Doctorate in Physical Therapy and specialty certifications in sports and orthopedic rehabilitation. John is currently the Manager of Outpatient Rehabilitation Services at Orange Coast Memorial Medical Center. He enjoys spending time with his wife, Melanie, and two children, 4 year-old daughter, Brianna and 1 year-old son, Corey.Organization: Orange Coast Memorial Medical Center
Outpatient Rehabilitation & Physical Therapy at Orange Coast Memorial
Transcription:
Beyond Stretching: How Outpatient Rehabilitation Can Benefit You
Deborah Howell (Host): Hello and welcome to the show. You’re listening to Weekly Dose of Wellness brought to you by MemorialCare Health System. I’m Deborah Howell and today’s guest is John Fenger, a physical therapist and manager of Outpatient Rehabilitation Services at Orange Coast Memorial Medical Center. John received his Bachelor’s in Exercise Science from Northern Arizona University. He then earned his Master’s in Physical Therapy at MGH Institute of Health Professions in Boston. John has continued his academic and clinical pursuits by earning both his Doctorate in Physical Therapy and Specialty Certifications in Sports and Orthopedic Rehabilitation. Welcome, John. Dr. John Fenger (Guest): Hi. How are you doing? Deborah: Good. Today’s show is called, “Beyond Stretching: How Outpatient Rehabilitation Can Benefit You.” So, let’s begin at the beginning. What is outpatient rehabilitation? Dr. Fenger: Well, outpatient rehabilitation is a form of therapy for patients to a clinic or a hospital and attend sessions of therapy, and then return home on the same day. Deborah: What different types of therapy might they receive when they go to these places? Dr. Fenger: Typically, outpatient rehab will include speech, physical or occupational therapy. Deborah: Okay, or all of the above if they..? Dr. Fenger: All of the above. In our clinic, we have speech therapy and physical therapy. That usually can include multiple specialties, such as orthopedic therapy, neuroleptic therapy, aquatic therapy, hand therapy, cancer therapy, pain therapy. In our clinic, we specialize in orthopedics, primarily, a little bit of neuro and speech. Deborah: Okay, let’s talk specifically about each one of those. Orthopedic, what kind of treatments do you perform, or therapy? Dr. Fenger: We’ll typically see patients with headaches, dizziness, poor posture, sprain, strains, any kind of walking or ambulation problem from any surgery, like a total knee replacement or total hip replacement, pain and swelling after surgery; those are some of the ailments that we would treat in that population. Occasionally with our neuro population, we’ll see folks with increased or decreased tone after a stroke and then all of the problems that may come with that particular diagnosis, like poor balance, poor functional mobility. Deborah: And then, speech, of course? Dr. Fenger: With speech, occasionally after a stroke, individuals might have a problem comprehending or actually producing speech, so our speech therapist will help them with that. The individual just may have a problem with stuttering or articulating, so the speech therapist can handle that. Deborah: It’s really retraining the body to do what it’s innately meant to do. Dr. Fenger: Absolutely, very natural, normal process; very, very important. Deborah: I remember, when I had my ACL replaced, I literally had to learn how to walk again. It’s just helping the muscles remember how to do that. Dr. Fenger: Yes, no matter what is ailing an individual, whether it’s a sprain or a strain, or whether they’ve received surgery; it could be anything. Outpatient rehab or physical therapies, in your case, knee ACL reconstruction, has to be a part of the treatment process. On that pie chart of options, it might make up a certain percentage, but it has to be on there, simply because, as you said, it’s just retraining the body to do what it should be doing -- very conservative, very normal modalities. Deborah: You work on people that have progressive diseases, as well as just recovering from a single incident, so you work from anybody with Parkinson’s disease, for example, to someone who has maybe been in a car crash that is having trouble walking or other kinds of movements. Dr. Fenger: Absolutely. An individual with Parkinson’s disease, they present with very specific impairments: They have a lot of rigidity; their posture is poor; they have some tone, resting tremors; their posture reactions are a bit delayed; they demonstrate slowness of movement. These are all impairments that we can work on while the disease is progressive, just like aging is progressive, but it doesn’t mean that we can’t address some body impairments that are inherent to either the aging process or cue Parkinson’s disease, and maybe facilitating hands function as the disease progresses or as we get older. In other words, it’s basically: Can we make the person stronger? Can we fix their posture for an increased amount of time and delay what might be inevitable? But in the process, at least enhance the function while it’s happening. Deborah: And that also would give them, I would think, a mental boost, as well. Dr. Fenger: Well, they’re engaged in their own treatment process and they have support. Of course, there’s the realization that if they become weak, they can get strong – period. That has to benefit them, plain and simple. It is very motivating. We see it just subjectively, just pure observation, in our patients. We have a couple of Parkinson’s disease programs here, and they are fully and totally engaged in the process, attend consistently. There’s this little kind of culture that’s been created around the program, where everyone supports one another, they get together after class, and it’s just created a buzz around the program. Deborah: Just like a community. Dr. Fenger: Absolutely, very community-oriented. Deborah: That is wonderful. That cannot hurt. The more mentally fit you are, that certainly helps the physical part, as well. Dr. Fenger: Absolutely. They feed off one another. So, if you’re motivated, you’re going to perform better physically. You’re going to more apt to attend the sessions. And then, just by being involved, just by participating, your body will respond. It’s impossible for it not to. If you’re strengthening something, or if you’re working on your balance, or if you’re walking to the class, that’s going to result in increased fitness level or posture, more strength. That hopefully will translate into function, and then, as you mentioned, a sense of community will bolster the outcome, I think. Deborah: It all feeds into each other; that’s a good thing. How does someone request a certain therapy program from their doctor? Dr. Fenger: It’s very simple. If they simply state the desire to attend therapy, their doctor should write an order, or could write an order for therapy -- not should, but could right an order for therapy. It’s as simple as that. The patient will have to present with some therapy-oriented diagnosis, which pretty much covers most diagnosis out there. We mentioned them earlier. It could be any neurological process, like stroke, Parkinson’s disease. It could be any orthopedic issue, any post-surgical orthopedic issue, ACL reconstruction, rotator cuff repair. It could be a sprain, strain, dizziness, headaches. These are all things that PTs treat. If you have any of those issues, you can receive therapies. You could get an order for therapy. Deborah: Now, a lot of insurance companies do cover outpatient rehab. Is that correct? Dr. Fenger: Absolutely. It’s probably all of them. Deborah: For at least a certain amount of time, anyway. Dr. Fenger: For at least a certain amount of time. Some might put restrictions on that, but generally speaking, insurance companies don’t typically, in my experience, give us a hard time when requesting visits. If the therapist feels that more therapy could help the patient and we can demonstrate that we could prove that with our documentation and the outcomes, will typically get more that are covered. Deborah: Sure. Dr. Fenger: In other words, there are limitations, but you rarely see them if the need is there. Deborah: Okay. Now, for your basic knee patients or surgery, if they don’t go to PT, what are the dangers there? Dr. Fenger: Well, if they don’t -- for like a knee patient? Deborah: Yeah, I’m just taking an example. Dr. Fenger: If they don’t attend therapy, in my opinion, you’ll lose that engagement; you’ll lose the structured, conservative care that would guide your progress. You might delay progress. If you have, let’s say, knee or shoulder surgery, you could develop contractures in that area, and that would basically be the soft tissues would constrict, become hardened, scarred, fibrotic and that can decrease your range of movement. That might require some kind of manipulation under anesthesia. So basically, physical therapy allows us to fully exhaust the entire conservative spectrum of care quickly, immediately and without any kind of obstacle or barriers, so that you could have a nice trajectory of improvement over time. If you delay that or if you choose not to go, you are subject to just continued weakness, decreased range of motions, the contractures that I spoke of. And not to mention that PTs are nice conduits to physicians. Like I say, you exhaust all of the conservative aspects of care, communication with the physician, so you stay part of the rehab medical treatment cycle. Deborah: Thank you so much, John. I’m so afraid that we are out of time, but we really appreciate you talking to us today about the benefits of outpatient rehab. Do your rehab, everybody. It’s very beneficial. It’s been a real pleasure to have you, John. I’m Deborah Howell. Join us again next time as we explore another Weekly Dose of Wellness, brought to you by MemorialCare Health System. Have a wonderful, wonderful day.
Beyond Stretching: How Outpatient Rehabilitation Can Benefit You
Deborah Howell (Host): Hello and welcome to the show. You’re listening to Weekly Dose of Wellness brought to you by MemorialCare Health System. I’m Deborah Howell and today’s guest is John Fenger, a physical therapist and manager of Outpatient Rehabilitation Services at Orange Coast Memorial Medical Center. John received his Bachelor’s in Exercise Science from Northern Arizona University. He then earned his Master’s in Physical Therapy at MGH Institute of Health Professions in Boston. John has continued his academic and clinical pursuits by earning both his Doctorate in Physical Therapy and Specialty Certifications in Sports and Orthopedic Rehabilitation. Welcome, John. Dr. John Fenger (Guest): Hi. How are you doing? Deborah: Good. Today’s show is called, “Beyond Stretching: How Outpatient Rehabilitation Can Benefit You.” So, let’s begin at the beginning. What is outpatient rehabilitation? Dr. Fenger: Well, outpatient rehabilitation is a form of therapy for patients to a clinic or a hospital and attend sessions of therapy, and then return home on the same day. Deborah: What different types of therapy might they receive when they go to these places? Dr. Fenger: Typically, outpatient rehab will include speech, physical or occupational therapy. Deborah: Okay, or all of the above if they..? Dr. Fenger: All of the above. In our clinic, we have speech therapy and physical therapy. That usually can include multiple specialties, such as orthopedic therapy, neuroleptic therapy, aquatic therapy, hand therapy, cancer therapy, pain therapy. In our clinic, we specialize in orthopedics, primarily, a little bit of neuro and speech. Deborah: Okay, let’s talk specifically about each one of those. Orthopedic, what kind of treatments do you perform, or therapy? Dr. Fenger: We’ll typically see patients with headaches, dizziness, poor posture, sprain, strains, any kind of walking or ambulation problem from any surgery, like a total knee replacement or total hip replacement, pain and swelling after surgery; those are some of the ailments that we would treat in that population. Occasionally with our neuro population, we’ll see folks with increased or decreased tone after a stroke and then all of the problems that may come with that particular diagnosis, like poor balance, poor functional mobility. Deborah: And then, speech, of course? Dr. Fenger: With speech, occasionally after a stroke, individuals might have a problem comprehending or actually producing speech, so our speech therapist will help them with that. The individual just may have a problem with stuttering or articulating, so the speech therapist can handle that. Deborah: It’s really retraining the body to do what it’s innately meant to do. Dr. Fenger: Absolutely, very natural, normal process; very, very important. Deborah: I remember, when I had my ACL replaced, I literally had to learn how to walk again. It’s just helping the muscles remember how to do that. Dr. Fenger: Yes, no matter what is ailing an individual, whether it’s a sprain or a strain, or whether they’ve received surgery; it could be anything. Outpatient rehab or physical therapies, in your case, knee ACL reconstruction, has to be a part of the treatment process. On that pie chart of options, it might make up a certain percentage, but it has to be on there, simply because, as you said, it’s just retraining the body to do what it should be doing -- very conservative, very normal modalities. Deborah: You work on people that have progressive diseases, as well as just recovering from a single incident, so you work from anybody with Parkinson’s disease, for example, to someone who has maybe been in a car crash that is having trouble walking or other kinds of movements. Dr. Fenger: Absolutely. An individual with Parkinson’s disease, they present with very specific impairments: They have a lot of rigidity; their posture is poor; they have some tone, resting tremors; their posture reactions are a bit delayed; they demonstrate slowness of movement. These are all impairments that we can work on while the disease is progressive, just like aging is progressive, but it doesn’t mean that we can’t address some body impairments that are inherent to either the aging process or cue Parkinson’s disease, and maybe facilitating hands function as the disease progresses or as we get older. In other words, it’s basically: Can we make the person stronger? Can we fix their posture for an increased amount of time and delay what might be inevitable? But in the process, at least enhance the function while it’s happening. Deborah: And that also would give them, I would think, a mental boost, as well. Dr. Fenger: Well, they’re engaged in their own treatment process and they have support. Of course, there’s the realization that if they become weak, they can get strong – period. That has to benefit them, plain and simple. It is very motivating. We see it just subjectively, just pure observation, in our patients. We have a couple of Parkinson’s disease programs here, and they are fully and totally engaged in the process, attend consistently. There’s this little kind of culture that’s been created around the program, where everyone supports one another, they get together after class, and it’s just created a buzz around the program. Deborah: Just like a community. Dr. Fenger: Absolutely, very community-oriented. Deborah: That is wonderful. That cannot hurt. The more mentally fit you are, that certainly helps the physical part, as well. Dr. Fenger: Absolutely. They feed off one another. So, if you’re motivated, you’re going to perform better physically. You’re going to more apt to attend the sessions. And then, just by being involved, just by participating, your body will respond. It’s impossible for it not to. If you’re strengthening something, or if you’re working on your balance, or if you’re walking to the class, that’s going to result in increased fitness level or posture, more strength. That hopefully will translate into function, and then, as you mentioned, a sense of community will bolster the outcome, I think. Deborah: It all feeds into each other; that’s a good thing. How does someone request a certain therapy program from their doctor? Dr. Fenger: It’s very simple. If they simply state the desire to attend therapy, their doctor should write an order, or could write an order for therapy -- not should, but could right an order for therapy. It’s as simple as that. The patient will have to present with some therapy-oriented diagnosis, which pretty much covers most diagnosis out there. We mentioned them earlier. It could be any neurological process, like stroke, Parkinson’s disease. It could be any orthopedic issue, any post-surgical orthopedic issue, ACL reconstruction, rotator cuff repair. It could be a sprain, strain, dizziness, headaches. These are all things that PTs treat. If you have any of those issues, you can receive therapies. You could get an order for therapy. Deborah: Now, a lot of insurance companies do cover outpatient rehab. Is that correct? Dr. Fenger: Absolutely. It’s probably all of them. Deborah: For at least a certain amount of time, anyway. Dr. Fenger: For at least a certain amount of time. Some might put restrictions on that, but generally speaking, insurance companies don’t typically, in my experience, give us a hard time when requesting visits. If the therapist feels that more therapy could help the patient and we can demonstrate that we could prove that with our documentation and the outcomes, will typically get more that are covered. Deborah: Sure. Dr. Fenger: In other words, there are limitations, but you rarely see them if the need is there. Deborah: Okay. Now, for your basic knee patients or surgery, if they don’t go to PT, what are the dangers there? Dr. Fenger: Well, if they don’t -- for like a knee patient? Deborah: Yeah, I’m just taking an example. Dr. Fenger: If they don’t attend therapy, in my opinion, you’ll lose that engagement; you’ll lose the structured, conservative care that would guide your progress. You might delay progress. If you have, let’s say, knee or shoulder surgery, you could develop contractures in that area, and that would basically be the soft tissues would constrict, become hardened, scarred, fibrotic and that can decrease your range of movement. That might require some kind of manipulation under anesthesia. So basically, physical therapy allows us to fully exhaust the entire conservative spectrum of care quickly, immediately and without any kind of obstacle or barriers, so that you could have a nice trajectory of improvement over time. If you delay that or if you choose not to go, you are subject to just continued weakness, decreased range of motions, the contractures that I spoke of. And not to mention that PTs are nice conduits to physicians. Like I say, you exhaust all of the conservative aspects of care, communication with the physician, so you stay part of the rehab medical treatment cycle. Deborah: Thank you so much, John. I’m so afraid that we are out of time, but we really appreciate you talking to us today about the benefits of outpatient rehab. Do your rehab, everybody. It’s very beneficial. It’s been a real pleasure to have you, John. I’m Deborah Howell. Join us again next time as we explore another Weekly Dose of Wellness, brought to you by MemorialCare Health System. Have a wonderful, wonderful day.