How does remote PT even work?
Let’s take a look at a case study with a patient I worked with last year…
We’ll call this person Paul for confidentiality purposes.
Paul struggled with achilles pain for years
Before I met him, Paul had been to numerous physical therapists. He tried various massage techniques, calf raises on the stairs, and even plenty of new shoes. The result? He continued to have pain with any race beyond a half-marathon.
It was clear he needed a different solution.
Paul contacted me per the recommendation of another former client. It was clear that I was Paul’s final hope for this problem. After the first meeting, two things were clear: he had competent and caring providers, but scheduling was a mess. He has two young kids and a demanding job, which left little overlap between his schedule and the PT’s.
One of the unique features of the phyziologic way is pricing based on a completed plan of care
With this in mind, I created this estimate for his plan.
Total Cost: $1050 paid in monthly installments
Estimated time to completed plan of care was six months
Unlimited text or email access
A specific and weekly activity plan
Up to six video visits
Outcome to be achieved for total cost:
Return to running 10 miles per week and resume working with his coach.
Desipte receiving good care when his schedule allowed, I found out no provider had educated Paul on what to expect. Achilles pain can persist for months and years and Paul was stuck in the cycle of rest, return to run, and pain. It was clear he would benefit from more clarity on his condition.
With expectations aligned, we proceeded with plans like this…
Week 1
Monday: 2x/day 20 minute walks for more gentle achilles loading; and 5x30 sec calf raise holds
Tuesday: 90 min cycling for improved aerobic fitness
Wednesday: 2x/day 20 minute walks for more gentle achilles loading; full-body weight training for 30 min
Thursday: 90 min cycling for improved aerobic fitness
Friday: Off
Saturday: 2x/day 20 minute walks for more gentle achilles loading; Full-body weight training for 30 min
Sunday: 90 min cycling for improved aerobic fitness
Week 12
Monday: 2x/day 20 minute runs for achilles load tolerance; full-body weight training for 30 min; and 5x30 sec calf raise holds
Tuesday: 90 min cycling for improved aerobic fitness
Wednesday: 2x/day 20 minute runs for achilles load tolerance; full-body weight training for 30 min; and 5x30 sec calf raise holds
Thursday: 90 min cycling for improved aerobic fitness
Friday: 2x/day 20 minute runs for achilles load tolerance; full-body weight training for 30 min; and 5x30 sec calf raise holds
Saturday: 180 min cycling for improved aerobic fitness
Sunday: Off
Week 21
Weekly Objectives (schedule based soreness levels)
2x/week full-body weight training with at least 3-4 sets of heavy, fatiguing calf raises
4x/week low intensity, 30 minute runs
1x/week plyometric/jumping program
2x/week 90 min cycling workouts to continue aerobic fitness increases
With the first week, we prioritized consistency and predictable workouts that didn’t cause flare-ups. As week 12 approached, we had begun our return to run program and ramped up cycling training to keep his aerobic engine strong for his scheduled half marathon in the Fall. Week 21 finished with a priority on maintaining his strength training and increasing the volume and frequency of his runs. Additionally, we continued to progress jumping activities to build tolerance to a variety of activities. This stuff isn’t rocket science and from my perspective, we kept it simple and focused on the details of HOW he performed his plan. He previously thought that all pain during tendon rehab was bad… constantly causing panic whenever pain flared. With new expectations and quick, simple encouragement when the process became rocky, Paul began to trust his body more and more. He eventually told me the consistent access to my guidance proved to be a key ingredient to his success.