Your Insurance, Unraveling some of the Mystery

You may have received a shiny new insurance card from your employer, or you have purchased an individual plan. Either way, how do you know what your insurance will and won’t cover? Well, that is likely a question that will take you some time to understand. Hopefully this will unravel some of the mysteries and confusion about you unique health care plan. Know that when you arrive at your medical providers office, they will be tasked with confirming your unique plans benefits and limitations. This is sometimes a confusing revelation if you don’t know what your plan will and won’t cover. One thing that will be true? All plans are not created equal, and unless you take some time to know your benefits, it can be daunting and confusing experience. Here are a few words that you may encounter when you are learning more about your plan.

Deductibles: can range from $100.00 to as high as $10,000.00 annually. This amount needs to be satisfied before your insurance company will pay for any treatment. How it works? Each time you visit a doctor or specialist, you are chipping away at your annual deductible. Most plans will waive deductibles for preventive visits such as mammograms and annual physicals. Remember, each plan will vary as to how many visits will not be subject to deductibles, and how often.

Premiums: is the monthly amount that is paid to have an insurance plan, this is either paid by your employer or by an individual, or both. It often comes out of your paycheck directly and your employer pays to it to your insurance company on your behalf.

Co-insurance: is a percentage of the medical fees billed that will be due by the patient (you) each visit, usually about 10% to 20%. This amount comes due after your insurance company has paid their percentage to the medical provider, and after you have reached your deductible if applicable.

Co-pays: are a flat fee that you pay each time you see your practitioner. This fee can vary between doctor’s office visits and specialist.

Annual Maximum: is the maximum dollar amount or maximum of visits an insurance company will pay over the benefit of a year for all covered expenses. Usually this refers to a calendar year, but it can also be a plan year, so investigate which applies to your insurance plan.

Out of Pocket Maximum: is the total dollar amount a patient is required to pay for covered medical services during a specified period, usually one year. After this amount is met, ALL services will be paid at 100%. Some plans allow your copays to be included in this maximum, but usually it includes your deductible and or co-insurance payments only.

Number of visits: Some plans have a limit on the amount of visits a patient may obtain per year. After that limit has been reached, your insurance is likely not going to pay for your treatment you have received. This is often a limitation when you see a specialist, such as a physical therapist, and not your primary care provider.

HMO – means Health Maintenance Organizations: HMO usually means that you agree to use a specific team of health care professionals. In most cases you select one doctor, from a list of the members, who will serve as your Primary Care Physician. This physician now coordinates all of your health care, which means that he or she treats you directly and, when necessary, manages your referral to specialists.

PPO – means Preferred Provider Organization: 
With a PPO, you have the option of seeing a wider variety of providers, and you can usually refer yourself to a specialist in your network. 
When you choose to see a medical provider in your network your insurance, you will generally see a higher amount paid to your provider, which means less out of pocket to you. You may have out of network benefits, but check with your insurance company, not all PPO plans offer out of network benefits. Active Physical Therapy is a preferred provider for many health care plans offered in Washington State.

Our goal at Active Physical Therapy is to help educate you about your plan and advocate on your behalf. If you are not sure we have the correct insurance information, be sure to let us know if you think anything has changed with your coverage. Also, if you need help understanding your insurance, we are happy to break it down for you in understandable terms. 

Ultimately, you are in charge, and the more you know about your benefits, the more your insurance will work for you. 

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The Importance of Weight Bearing Exercise for Bone Health

What is “Bone Health”?
In simplest terms, bone health can be defined as bone density, which is a measure of the structural strength of a bone and its ability to resist external forces. A low density, unhealthy bone is much more likely to break down under normal loading (such as running) or when subjected to traumatic stresses, such as in a fall.

Basics of Bone Growth
Bones require two major things to be healthy. The first thing bones need is proper nutrition, which includes an adequate supply of calories and somewhere roughly between 1000mg and 1300mg of calcium (preferably with vitamin D) per day. The second thing bones need to be healthy is a reason to be healthy. Bones, like muscles, respond to the way they are treated; if you neglect them with too much inactivity, they grow weak. Challenge your bones and they will respond positively to the stress and will grow stronger.

Weight Bearing Activities
The best ways to challenge your bones are with weight-bearing activities, which can be as simple as going for a walk or a jog or a sprint, or more involved activities such as yoga, weight lifting, hiking, and racquet sports. Any activity that requires forceful muscular contractions will potentially cause bone growth. That having been said, not all weight bearing activities are created equal; the greater the demands placed on the skeletal system, the greater the response, and so then it is reasonable to think (and is supported by a vast body of research) that resistance training is better at strengthening bone than a walk in the park. It still stands, however, that some activity (any activity) is better than no activity.

The Long Haul
It is never too late to start strengthening your bones. Yes, bone density peaks in the third decade of life and from there it slowly declines, but research has shown that weight bearing activity can improve bone mineral density even in post-menopausal women and the elderly, segments of the U.S. population that are very vulnerable to osteoporotic changes. Which is to say that no matter how old you are or where you are in life, weight bearing activity is essential for your health.

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Adding in Exercise to your Daily Routine

Part of a healthy lifestyle includes being active. Regular exercise has many benefits such as improving sleep and mood, weight control, and combating health conditions. The American Heart Association recommends 30 minutes of moderate exercise a day five days a week as an optimal guideline. Increasing your daily activity can include participation in formal exercise such as joining a sports team or working out at the gym. It can also include taking the sedentary habits of your daily life and giving them a little flare.
Common activities that could use a little boost
Watching TV
TV just keeps getting better. This means that more of us are committing to at least an hour of daily sedentary time while watching the show. Add more activity to this sedentary act. Don’t fast forward through the commercials. Instead, pick an activity such as jumping jacks, push-ups, or lifting a small weight and see how many times you can do them before the commercial break is over. Next break, shoot for a personal record. Get more creative and set up a mini circuit training exercise list!
Brushing teeth
Hey, you’re just standing there staring at yourself in the mirror. Why not march in place to get the body moving and the blood flowing?
Talking on the phone
If possible, walk around the office or home when talking on the phone instead of sitting at a desk or table. This will keep your heart pumping and muscles active.
Food delivery
Why sit and wait? Power-walk your way to the restaurant and pick up your order instead of having it delivered to you. The added effort will help you work up an appetite.
Walking instead of driving when possible
Next time you need to make a quick trip down the street, try walking there instead of driving. It may be nice not dealing with parking or waiting for the bus. When you must drive, try parking as far away from the entrance as possible to get in some extra steps.
Go for a walk while listening to your pod casts
Enjoy a brisk walk while listening to your favorite pod cast, or audio book. If you would rather stay indoor, try walking on the treadmill or riding the stationary bike while you enjoy a good story.
Happy hour
Instead of happy hour at the local pub, try making a new happy hour and take the Frisbee for a toss or kick the soccer ball around with your friends.
Stuck sitting at the office too long?
Gather your favorite coworkers and take a brisk walk to blow off steam or just enjoy some air.

Make your activity choices fun and enjoyable for yourself. BE ACTIVE!!

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January 2013 Newletter: Ski Conditioning

Stay conditioned and healthy through the ski season
It’s easy to drop our other weekend warrior workouts once ski season starts, but it’s still important to cross train to prevent injury and even improve your performance through the season. Easy at home, no excuse exercises to do to keep balance and coordination in tip top shape:

Balance on one foot while brushing your teeth or try turning your head side to side all while keeping your hips and shoulders level with the horizon
Lunges with the top of your back foot placed on a chair, keep the shin of the front foot vertical (don’t allow your knee to go out over your toes), try to keep weight in the heel of your front foot & use your glutes as you rise up
Rotational planks: start in a push up position with feet wider than shoulder width, make sure to keep spine neutral (no sagging of low back or sticking of bottom up in the air), rotate your upper body so one arm comes off the floor and is then pointing to the ceiling, return to start position and repeat on the other side. Drive this movement from the hips and core, not by using momentum in the upper body.

Although skiing relies heavily on our lower body for success the power and strength in our legs comes from having a solid base to move from, so it is extremely important to keep our mid sections toned up and with plenty of endurance to get us through a day on the hill.

If you are want to make sure you are reaching your potential schedule an appointment for an assessment and we can outline a program to keep you strong all season long.

?Ask the Acupuncturist?
Can Acupuncture help me with my Physical Therapy?

Acupuncture works great in conjunction with physical therapy by stimulating the bodies’ natural ability to heal itself. Acupuncture promotes circulation, reduces swelling, and stimulates the release of endorphins which helps us to feel relaxed. Patients leave an acupuncture treatment feeling calm, rested, and rejuvenated. It’s a great way to jump start your physical therapy routine and get better faster, its covered by most insurance and its available right here!

Try acupuncture and find out for yourself how you can feel better now! Schedule an appointment with Tyler at your next visit to the clinic or give us a call and we would be glad to help get you started.

To learn more about Tyler Martin and how Acupuncture works please visit his website at

Become a SoleMate
SoleMates is the adult charity running program for Girls on the Run. They are a team of female and male athletes who pursue individual fitness goals while raising money for Girls on the Run of Puget Sound.
Program Benefits Include: Coaching & training plans, scheduled group runs/walks, discounts at select area running stores & races, helpful clinics on funning gear-nutrition-and injury prevention, and a personalized fundraising website.
Join Us!!

Happy Birthday Etta!
Etta is quickly closing in on her first birthday and what a year it has been! We are all on a steep learning curve. She has brought us nothing but joys, smiles and sleep deprivation! The pace of life has changed for the good, Etta has made me take note of some of those things I had stopped being attentive too. I have been amazed to watch her mind work and physical development she has achieved. She has been teaching me to be a better person over the past year & I imagine will continue to do so.

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Raking and Shoveling

As the seasons change lots of us are probably finding ourselves in the yard with a need to do some raking and possibly, close to follow, some shoveling. I know you don’t even want to go there, but I think the actual shift of seasons has happened. To stay healthy and safe enjoying the upcoming seasons it’s best to use proper mechanics when both raking & shoveling. Here are some tips to follow:

• Bend you knees to lift any load heavy or light.
• Avoid bending and twisting together at your low back.
• Keep your reach as short as possible by moving your feet closer to leaves or snow you are moving, this will keep more upright & alleviate stress on your back from otherwise repeated bending.
• Drag loads vs. lifting whenever possible: this can be done by raking leaves onto a tarp (then pull to the curb for roadside pick up or if you live in a rural area dump deeper into the woods) vs. lifting lots of little loads into a garbage can.
• Ask for help if the load gets too heavy to move easily.
• Wear gloves to protect your hands from blisters and unexpected sharp sticks, biting insects and undisclosed objects.
• Alternate the side you rake or shovel on to spread out the work load among more muscles which will help prevent soreness later the same & next day.
• Stay hydrated by drinking plenty of water or other non-alcoholic & non-caffeinated fluids. Even though it’s cool out you are using energy and your muscles need fluid to prevent cramping.
• Stretch out your arms, upper and lower back & legs after you have finished for the day (check out our website for images
• Take a hot shower and relax

If you do find yourself having pain that goes beyond muscle soreness or you find you are having a hard time to straighten up in your spine after any of the above work, please let us know, so we can help get you moving well again. It is never a good idea to put back pain off. Back pain typically is worse with each episode, so learning how to avoid and manage it is essential to feeling good.

For more on staying healthy join us on Tuesday November 8, 2011 from 7-8 for a seminar on nutrition and healing. Light snacks & drinks will be served.

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Essentials for hiking and backpacking

Hiking is a great way to explore the beautiful geography around Seattle, and with a few tips and the correct gear, it’s a great way to stay active.

Hiking boots can enable you to have a successful and injury free hike if you have a pair that fits well and matches the rigor of your trek. For a day hike of a couple of miles you may be able to wear a light weight hiking boot which will give you a little extra foot and ankle support. If you are backpacking with a 40 pound pack, you are going to want a stiffer sole and a higher cut boot to help give you more stability and balance. Hiking boots that fit well can prevent blisters, foot fatigue, and toe injuries.

Trekking poles are a great tool for hikers to reduce the amount of force going through their knees by up to 28%. The lower forces through the hiker’s legs can help decrease your likeliness to have a knee or ankle injury when hiking, or allow you to go further without symptoms or pain.
A well packed and well fitting backpack can make any hike feel easier. Most of the weight of the pack should be carried on the hips through a properly adjusted hip belt and pack. Make sure heavy items are packed close to your body and centered up between the shoulder blades. Try to limit the amount of gear you attach to the outside of your pack. Gear lashed to your pack can affect your balance. When lifting a full pack, be sure to keep the weight close to your body. A friend or an appropriately sized rock or log can be used to hold the pack in a good position while you put it on. Always tighten your hip belt first. Then snug up the shoulder straps and the compression straps on your pack. Remember that the hip belt should be carrying the weight of the pack

Rest breaks and pacing are important while hiking. Keep a steady pace which allows you to maintain a conversation without becoming out of breath. Step over simple objects (instead of up and down) when possible to conserve energy. Take rest breaks and remove your pack or rest it on a rock, tree, or log when possible.

Remember to keep up your overall fitness for hiking. Aerobic fitness can enable you to hike longer and farther. Lower body and core exercises are important to keep you strong and ready to tackle any hike safely.

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Lifting Mechanics

How to Lift

Throughout our everyday lives we are carrying grocery bags, lifting children, laundry baskets and garbage cans. Lifting correctly with these simple tasks and when packing heavy bags for our summer vacations can help prevent neck, shoulder and back pain, and possibly even more serious injuries. Learning the proper way to lift will help you minimize the risk of pain and injury.
Before lifting, test the weight of an object or multiple objects before lifting. If it seems too heavy, ask for help or make multiple trips. Plan ahead before lifting heavy objects and make sure you have a clear path. This will help you avoid any awkward or sudden movements that can strain your muscles.
Lift with your legs, not with your back. Stand close to the object, bend your knees and keep your back straight, then lift. Don’t lean over an object to lift it. Instead, bend your knees to get down to the level of the object and bring it close to you. Face the object you intend to lift and avoid twisting. When lifting contract your stomach muscles, but be sure not to hold your breath.
Keep feet shoulder-width apart and maintain your balance by distributing the weight equally on both sides of your body. Hold heavy items with both hands, distribute the weight of multiple items between your hands, and alternate the side you carry your purse or child to avoid over working the same muscles all the time.
If an injury does occur, seek help. What starts as a minor back injury can progress to a chronic condition without early intervention.
If you have any questions on how to lift or aches and pains that are not subsiding let us know. We would be happy to assess the troubled area for you at Active Physical Therapy.

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How to Maintain Healthy Knees for Running

Healthy Knees for Running

For many runners knee pain is a familiar problem. However, knee pain is not inevitable. You can take some simple steps before, during, and after your run to help prevent knee pain.

The warm-up is one of the most important parts of any run. 10-15 minutes should be an adequate length to comfortably raise your heart rate and bring increased blood flow to your muscles. In addition to preventing injury, warming-up can help decrease your recovery time and improve muscle function while you are exercising.

While you are running the surface you choose can make a huge difference. Softer surfaces can cushion impact on your joints. Try running on a track, trail, grass or even asphalt (it’s softer than concrete) Keep in mind that some streets or trails have a ‘cross-slope’ to allow for rainwater drainage and can have an effect on your stride and alignment. Try to make sure the same leg isn’t always on the ‘downhill side’.

Cool down for 10 minutes following your workout to allow your heart rate and muscles time to adjust. Like warming-up, cooling down helps prevent injury and reduce recovery time.

Stretching after a run can be a great way to keep your body supple and help you maintain your flexibility. Try some of the stretches below. Each should be held for 30 seconds and performed twice on both sides.

• Calf (both with a straight & bent knee) Place the leg to be stretched behind you with your heel down and knee bent or straight. Rest your hands on a wall, tree or car, and lean forward until you feel a gentle stretch at the back of your calf
• Hamstrings (back of thigh) Place the leg to be stretched out in front of you or up on a step or bench. Bend at the hips keeping your back straight until you feel a stretch at the back of your thigh
• Quadriceps (front of thigh) Standing, bend the knee of the leg to be stretched and gently pull foot & ankle towards the buttocks feeling a stretch in the front of the thigh.
• Hip flexors (front of hip) Kneel on one knee with the other leg in front in a lunge position. Tuck your hips under and lean forward to feel a stretch at the front of your hip.
• Gluteals (back of hip) While sitting hug your knee toward your opposite shoulder to feel a stretch at the back of your hip.

Before, during, and after a run hydration and nutrition are key to keep your body running optimally. Be sure to drink plenty of water!

Cross training is a great way to train other muscles, give your body a break from impact, and keep you healthy and strong.

Give your legs a day off at least twice a week if you are running frequently.

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Holiday Health Tip #5

While traveling pack snacks to keep your energy and metabolism high.

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Holiday Health Tip #4

Stay rested. Try to maintain a normal sleep schedule through the holidays. Lack of sleep can lead to overeating and generally not feeling your best. Enjoy the party but give yourself some time to bounce back.

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