Ask how to receive 25% discount on all visits.
Ask how to receive 25% discount on all visits.
Before anything is treated, we must know the source. Like chest pain, your doctor must figure out if it is a heart attack, acid reflux or something else before treating it.
Musculoskeletal pain is no different.
Therefore the first objective is to identify the source of the pain. (Is it a muscle, tendon, joint? Is overuse, bone on bone, inflamed, torn?)
Nope, we don't need imaging to do this. In fact imaging is notorious for showing false positives and false negatives. It is a misconception to believe imaging shows a crisp high definition picture with an arrow pointing to the pain source. In reality, it is a grainy low-grade image, showing lots of possible pain sources or none at all. Imaging is really good for showing the big stuff: tumors, massive disc herniations or large soft tissue tears, etc.
So how do to figure out what is causing the pain?
FIRST: We talk:
Tissue talks. By asking you specific questions regarding your pain, we can narrow down the most likely source and what tissue is involved. When you hurt, when you feel better, and how the pain behaves gives excellent clues.
SECOND: A physical exam:
The body doesn't lie. We rule in or out the likely source by taking your painful region through a specific and systematic movement exam.
All need to see how your joint moves and hear you tell me how the pain reacts.
Most diagnostic tests can be performed by you, on occasion and second pair of hands is helpful, at which point friends or family members get involved. We give very clear step-by-step instructions.
THIRD: We coach treatment:
What about modalities like electrical stimulations (TENS unit), ultrasound, dry needling, etc? Treatment under the guidance of Mechanical Diagnosis and Therapy® typically allows us to forgo the need of any aforementioned modalities, often with superior outcomes.
Yes, delivering MDT® care through telehealth is shown to be as effective as in-person care. (source)
What is Mechanical Diagnosis and Therapy®?
Sometimes referred to as the McKenzie Method, MDT® is a unique cause/effect exam and treatment Classification System. It is globally recognized as a leading treatment for back, neck and extremity disorders and is supported by robust scientific evidence (source).
Most pain is "mechanical". That means it is not due to a serious pathology like cancer or infection but due to abnormal forces to tissues or joints. Therefore, positions, movements or activities caused the pain in the first place. And that means we can simply use pain responses to positions, movements and activities to identify the source & most often reverse the painful condition.
The MDT® exam and treatment process hinges on systematically moving the painful joint or body part repetitively into specific directions to understand the pain behavior and subsequently the mechanical source. It then involves classifying the painful condition into one of three outcome categories:
Based on the exam, the condition is matched with the most appropriate treatment.
And each classification and mechanical diagnosis have predictable outcomes.
Therefore, at every follow up visit, the response-to-treatment is assessed. Based on the response, adjustments or alterations to the treatment are implemented. Following this Response-Based Treatment algorithm takes the guess work out of treatment and optimizes recovery times and outcomes.
As mentioned above, most outcomes are rapid. Which is because many painful conditions have Directional Preference.
What is Directional Preference?
Since mechanical forces are usually the cause of the painful issue, mechanical forces are often the solution.
This simply means that moving into one direction may provoke and worsen the pain while moving into the opposite direction can eliminate the pain and restore function.
This is known as Directional Preference, one of the most scientifically validated phenomena in the musculoskeletal literature (source).
When Directional Preference exists, it takes 1-2 movements repetitively in a specific direction. This can rapidly reduce pain and restore normal function within days to weeks. When the joint is functioning properly, resolution to surrounding tissue like weakness, tightness or spasms easily and quickly follows suit.
The exciting part? Studies show that around 75% of people with painful conditions have Directional Preference (source). Find out the likelihood your pain does by taking the DIRECTIONAL PREFERENCE QUESTIONNAIRE.
Take the questionnaire to find out the likelihood your pain has Directional Preference and get better in a matter of days to just a few weeks.
YOUR body leads us to the most appropriate treatment. As opposed to other PT & chiropractic approaches which involves trial and error of multiple treatments of what some OTHER people have responded to.
Improvement by Movement, PLC was started by me, Kristina Wimer. Like the majority of healthcare professionals my drive is to simply help people live healthy and happy lives. Specifically, there was not much more rewarding than helping people in pain. Bla, bla, bla, yes you’ve heard that before, nothing new for a physical therapist to say. While that is truly the core of my mission, that is not what led me to start this company.
The process of addressing pain needs to be refined.
Traditional medical models are designed with a hidden incentive to keep you returning for more tests and interventions. But what if clinicians were given an incentive to optimize their outcomes? What if the results from their evaluation and treatments were being tracked and, in a way, being graded? They would have an intrinsic motive to give the best possible care. Which just means to deliver accurate diagnoses & proper solutions in an efficient amount of time. It is a pay-per-performance model.
Well I found this model exists with Outcomes Accountable™ Care. Using tens of thousands of patient outcomes data, this company has been able to establish a highly reliable system for 1) identifying the source of pain, 2) providing the appropriate treatment or referral and 3) holding the clinician accountable for their outcomes. To this day, they continue to collect data and refine the process so patients receive the best possible care. That’s quality assurance which ultimately saves people money, time and unnecessary suffering.
Outcomes Accountable™ delivers care utilizing the Mechanical Diagnosis and Therapy® Method (MDT®), or more commonly known the McKenzie Method. The system is backed by extensive literature. And if you ask any cert. MDT clinician, it is a game changer for patient outcomes.
I have been a cert. MDT clinician since 2018 and have experienced the value of this system since before I completed PT school in 2014. I’m proud to say I have taken the next step to join the network of Outcomes Accountable™ Care clinicians (OAC™). If outcomes are not met, weekly sessions with experts are in place to guide me on any challenging cases, again, ensuring the patient is receiving the best possible care. The learning never stops. This comes with a lot of work, but that is the kind of care I would like myself and my loved ones to receive and believe my patients deserve the same.
The neat part? The method is perfectly suited for virtual physical therapy. In fact, most of the time I see patients in person, there is no need to do any hands-on work to get them better and it could be done through video calls. OAC™ has been a pioneer and leader in the telehealth platform since 2017 (prior to the pandemic’s telehealth push!). And their data analysis continues to prove great success through the mode of video calls. So while telehealth is relatively new, especially for physical therapy, you will not find a more successful or established version for evaluating and treating pain.
In summary, I was only confident in starting this business because I know the quality I can deliver in a convenient way so I can help change people’s lives for the better.
Goals for Patients: To obtain a complete understanding of a patient’s mechanical condition, reach a resolution of the problem or advise a proper referral, reduce fear of pain, fully return patients to desired activities, educate in prevention & guide lifetime self-management.
Mission Statement: To optimize quality of life by treating musculoskeletal disorders using a highly standardized model built on research and best practices with the unmatched accessibility and convenience of telehealth while being held accountable for the quality and outcomes of patient's care.
I am a James Madison University graduate receiving bachelors and masters degrees in biology. I then graduated from Shenandoah University with my doctorate in Physical Therapy in 2014 and began work in outpatient private practice. In 2018 I received my certification in the Mechanical Diagnosis and Therapy™. From 2019 to 2021, I worked in a hospital delivering care in the outpatient, in-patient and acute care settings. I completed further mechanical training called Outcomes Accountable™ care in 2021.
I enjoy outdoor activities, running, traveling, boating, snow skiing and water skiing. I loves enjoying breweries and wineries. And sometimes I prefers to just relax on the couch with my husband Derek and two cats, Lily and Rocky.
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