Frequently asked questions
Do I need a referral for physical therapy?
Do I need to schedule a separate visit for Dry Needling?
What type of injuries do you treat?
What can I expect as a new patient?
Where did you do your training?
What got you interested in physical therapy?
Do you accept my insurance?
While Latitude Physiotherapy does not contract with any insurance companies, this is 100% to your benefit.
Let me explain. In an insurance-based physical therapy clinic, it is not uncommon for a single PT to be responsible for two to four patients per hour. This can be made possible with:
- the overuse of ultrasound, heat & cold packs, and e-stim—which have been shown to have low efficacy,
- the overuse of exercise equipment, which cannot re-educate natural movement, and
- the over-reliance on Physical Therapy Aides (sometimes called “Techs”) who don’t hold a degree in physical therapy.
In-network (insurance-based) physical therapy clinics also regularly bill insurance companies for upwards of $250 per session, knowing they will only get a fraction of that back in reimbursement from your insurance company. Unfortunately, the $250 is usually the patient’s responsibility until they meet their deductible. In 2020 the average deductible for individuals was $4,364 (1). Insurance companies have drastically decreased physical therapy reimbursement over the past 10–20 years. In that time, we’ve witnessed the reduction in one-on-one time with your Physical Therapist and the perpetuation of outdated practices.
At Latitude Physiotherapy, you will receive quality one-on-one care from a Doctor of Physical Therapy who is not influenced by insurance reimbursement and who is 100% focused on the patient in front of them. We typically see patients once, at most twice, per week because we can make a big impact during each of our sessions. In contrast, most insurance-based clinics want you to come in two to three times per week to see results.
Although Latitude Physiotherapy does not contract with any insurance companies, the payments you make may be partially reimbursable by your insurance company if your plan includes out-of-network physical therapy benefits. To use out-of network benefits, download the Insurance Benefits Worksheet and call your insurance company before initiating physical therapy—some insurance companies will deny your claims if you don’t follow their instructions carefully.
Do I need a referral for physical therapy?
Texas is a Direct Access state, meaning a referral for physical therapy is NOT required to start PT. However, we are required to get one to continue beyond two weeks from your evaluation session. This is a requirement of our state board, and it has nothing to do with insurance. A referral can come from a physician, physician assistant, nurse practitioner, podiatrist, dentist, or chiropractor. Often you may not need to go in for an office visit. However, every provider is different. Referrals can be sent to our fax (855-574-0792) or to our encrypted email inbox (info@latitudept.com).
How do I get started?
New to Latitude Physiotherapy, or have a new injury? Book a Discovery Session, enjoy a thorough evaluation, and discuss a tailored solution to your problem.
Do I need to schedule a separate visit for Dry Needling?
Dry Needling is included with normal physiotherapy sessions. However, additional Dry Needling sessions are also available alongside your normal physical therapy plan of care (i.e., 6, 9, or 14 sessions) to help speed recovery, or following the completion of a plan of care to facilitate continued progress.
What type of injuries do you treat?
FOOT & ANKLE
Achilles Tendinopathy (-itis), Ankle Fractures, Ankle Pain, Ankle Sprains, Chronic Ankle Instability (CAI), Foot Fractures, Foot Pain, Hallux Rigidus, Hallux Valgus / Bunions, Heel Pain, Metatarsalgia, Morton’s Neuroma, Plantar Fasciopathy (-itis), Posterior Tibialis Dysfunction, Medial Tibial Stress Syndrome (MTSS) / Shin Splints, Stress Fractures
KNEE
Knee Bursitis (i.e. Prepatellar, Infrapatellar), Iliotibial (IT) Band Syndrome, Knee Pain, Runner’s Knee, Ligamentous Injuries (MCL, PCL, LCL, and ACL), Meniscus Injuries, Patellar Tendinopathy (-itis), Patellofemoral Syndrome / Chondromalacia Patellae
HIP
Hip Bursitis (i.e. Trochanteric, Iliopsosas), Hip Osteoarthritis, Hip Pain, Labral Disorders, Piriformis Syndrome
ELBOW & HAND
Carpal Tunnel Syndrome, Cubital Tunnel Syndrome (Ulnar Nerve Entrapment), Elbow Pain, Hand Pain, Lateral Epicondylosis (-itis) (Tennis Elbow), Ligamentous Injuries, Medial Epicondylosis (-itis) (Golfer’s Elbow), de Quervain’s Tenosynovitis, Wrist Pain
SHOULDER
Acromioclavicular (AC) Joint Dysfunction, Adhesive Capsulitis (Frozen Shoulder), Shoulder Bursitis (i.e. Subacromial, Subscapular), Labral Tears, Rotator Cuff Tears & Tendinopathy, Scapular Dyskinesis, Shoulder Fractures, Shoulder Impingement Syndrome, Shoulder Instability, Shoulder Dislocations, Shoulder Pain, Sternoclavicular (SC) Joint Disorders
SPINE
Cervicogenic Headaches, Clinical Instability, Degenerative Disc Disease, Disc Herniations, Facet Joint Dysfunction, Foraminal Stenosis, Low Back Pain, Lower Crossed Syndrome, Lumbar and Cervical Radiculopathy, Migraines, Neck Pain, Osteoarthritis, SI Joint Dysfunction, Temporomandibular Joint Dysfunction (TMJ), Tension Headaches, Thoracic (Mid Back) Pain, Upper Crossed Syndrome, Whiplash
What can I expect as a new patient?
All sessions are one-on-one with a Doctor of Physical Therapy. We treat the individual based upon their unique needs, stage of recovery, and goals. A new client will first be interviewed for a thorough understanding of the circumstances of their injury or complaint. The following physical examination will help us determine the most pertinent impairments to your dysfunction. We will then address those impairments with hands-on techniques, and finally, re-educate the body using movement. Evaluations are 90-minute sessions and Follow-Ups are 60-minute sessions. Although every individual’s situation and goals are different, an average plan of care can vary from 6 to 10 visits, usually 1x per week, but sometimes more frequently due to urgent goals or a complex case. We utilize a biopsychosocial model at Latitude Physiotherapy because the research supports a multimodal approach. People who receive manual therapy (hands-on treatment), exercise, and pain science education have better outcomes than people who receive only manual therapy and exercise. Every patient receives pain science education as this is a cornerstone of your recovery.
Where did you do your training?
Dr. Gumbs graduated from Santa Clara University in 2008 with a B.S. in Combined Sciences and a Minor in Spanish Studies. For three years afterward, he worked for Olympic Physical Therapy in Seattle, WA learning from a group of expert Physical Therapists including fellows of Manual Therapy—the highest designation in the field of physical therapy. Since then, he has only built upon the concepts he learned there and continues to add to his unique perspective influenced by several schools of thought in physiotherapy, fitness, and athletics. These include NAIOMT (The North American Institute for Orthopedic Manual Therapy), The Postural Restoration Institute, The Running Clinic, and The Paris Method from the University of St. Augustine’s Manual Therapy Continuing Education Program.
In 2014, he graduated with Honors from the University of St. Augustine in Austin, TX as a Doctor of Physical Therapy. The program is strong in orthopedics and manual therapy, thus building on his passion for hands-on treatment. Since graduating, his experience has been mostly in orthopedics, and in 2016 he completed his certification in Dry Needling. Other techniques that he practices include IASTM (similar to Gua Sha and Graston), myofascial release, and cupping. Continuing education for runners has also helped him provide better treatment for this unique population.
What got you interested in physiotherapy?
For Dr. Gumbs, physiotherapy has been a journey towards a deeper self-understanding, and a desire to help others. As a collegiate cross-country and track athlete, injuries were a part of life. He struggled with severe anterior hip pain from the mid-point of his collegiate running career, and he also watched numerous teammates succumb to a variety of injuries. It sparked an interest and he had to know what was happening beneath the surface. A great course in anatomy was enough to get him started, but he didn’t have a good example of physical therapy until starting work with Olympic Physical Therapy in Kirkland, WA. It was there that his passion for rehab grew and his lifelong dysfunctions began to heal. The therapists he worked with were unlike other professionals he had come in contact with. They seemed to consider the whole body from head to toe. Inspired by this experience, he has made it his life’s passion to share physiotherapy with as many people as possible.
What types of patients have you worked with?
Dr. Gumbs has worked with a wide variety of individuals from elite athletes to older adults who suffer from any number of musculoskeletal conditions such as jaw and neck pain, headaches, tennis elbow, rotator cuff tears, hand and wrist injuries, knee pain, ACL rehab, labral tears, ITB syndrome, ankle sprains, meniscus repairs, low back pain, disc herniations, plantar fasciitis, and more.
Dr. Gumbs loves to work with active people who are trying to get back to what they love because he believes that ultimately movement is the only thing that will truly set the body free.
So what’s the big picture?
I became a physiotherapist to make a difference, but the utilization of physical therapy in the United States is poor. About 50% of people over the age of 18 and 75% over the age of 65 in the United States have chronic musculoskeletal pain, but less than 10% of them go to physical therapy (2,3). This is extremely disappointing considering physical therapy is the best choice for musculoskeletal concerns when compared to surgeries, injections, and medications that many times do more harm than good. Doubly concerning when we realize that nearly 50% of people in the United States have one or more preventable chronic diseases that could be treated by diet and exercise (4). Physiotherapy has the potential to make a massive impact on getting people moving again.
The problem is that the United States spends the majority of its annual $3 trillion in healthcare costs on treating chronic diseases instead of trying to prevent them (5). Physiotherapy should play a bigger part in keeping Americans moving pain-free and empowering them to lead a healthy lifestyle. Unfortunately, the U.S. does not invest much in preventative measures like physiotherapy. Moreover, the numbers show physicians rarely refer to physical therapy (only 7% of the time for complaints of low back pain) (6), and until recently, patients in Texas had to acquire a prescription before starting physical therapy.
The healthcare system as it exists simply does not make preventative measures a priority, nor does it make them easily accessible. In this environment, it’s no wonder why most people put off physical therapy as long as they can and then try to stay for as little as possible. In fact, only about 35% of people complete their plan of care for the number of visits recommended by their physical therapist (7). Latitude Physiotherapy strives to provide a solution for musculoskeletal pain that is effective, holistic, and transparent in its pricing. This way, more people will choose physiotherapy first, lowering the overall cost of healthcare and improving the quality of life in our communities.
Chris Gumbs, PT, DPT, ICDN
Physiotherapist & Running Specialist
References
- Insurance E. How much does individual health insurance cost? – eHealth insurance. Ehealthinsurance.com. Published June 27, 2019. Accessed January 16, 2021. https://www.ehealthinsurance.com/resources/individual-and-family/how-much-does-individual-health-insurance-cost
- American Academy of Orthopaedic Surgeons. One in two Americans have a musculoskeletal condition: New report outlines the prevalence, scope, cost and projected growth of musculoskeletal disorders in the U.S. Science Daily. Published online March 1, 2016. Accessed January 17, 2021. https://www.sciencedaily.com/releases/2016/03/160301114116.htm
- 7 facts about physical therapy you can’t ignore. Webpt.com. Published February 19, 2018. Accessed January 17, 2021. https://www.webpt.com/blog/7-thought-provoking-facts-about-physical-therapy-you-cant-ignore/
- Chronic diseases in America. Cdc.gov. Published January 12, 2021. Accessed January 17, 2021. https://www.cdc.gov/chronicdisease/resources/infographic/chronic-diseases.htm
- Auerbach J, Warraich HJ, Ho P, et al. Why aren’t we investing in prevention efforts for chronic conditions? Statnews.com. Published April 19, 2017. Accessed January 17, 2021. https://www.statnews.com/2017/04/19/prevention-chronic-illness-investing/
- Fritz JM, Childs JD, Wainner RS, Flynn TW. Primary care referral of patients with low back pain to physical therapy: Impact on future health care utilization and costs. Spine (Phila Pa 1976). 2012;37(25):2114-2121.
- Sluijs EM, Kok GJ, van der Zee J. Correlates of exercise compliance in physical therapy. Phys Ther. 1993;73(11):771-782; discussion 783-6.