FREQUENTLY
ASKED QUESTIONS

That is a great question with many answers. Essentially, breathing is the only motor task that all living humans share. Your body is naturally designed to breathe well, but it can also adopt bad habits for various reasons. Just like limping after a leg injury leads to problems elsewhere in the body, breathing with accessory muscles or maladaptive patterns uses valuable energy inefficiently and ineffectively, robbing us twice of optimal functional ability. The result is people with chronic pain, early fatigue, anxiety, decreased activity tolerance, reduced performance and endurance, incontinence, bowel dysfunction, poor sleep quality, stress and an overall decrease in quality of life. Breathing affects nearly everything our body does. If you can't control your breathing, what can you actually control?

By working with your therapist and nudging your breathing system every day. The brain is remarkably adaptive and will start making changes the moment that you start to understand how to breathe. As a part of Academy West, you'll work with your therapist to develop an individual program that fits into your life. These exercises often involve neural re-training intended to make you feel, see, and understand your breathing. We breathe between 17,000 and 30,000 times each day. How many breaths can you devote each day to change your life?

We get this question a lot, and the answer is in the details. Let's start with "breath work", which is an umbrella term used to describe a wide variety of practices, many of which are done with the goal of emotional healing. Practitioners do not require any certifications, degrees, or experience though many different trainings do exist. Literally anyone can provide these practices. It is unregulated and often performed laying down and while using an open mouth. Many of these practices are intended to bring about a seismic shift in how someone feels, but rarely if ever does breathwork involve any actually learning about how breathing works and what to do with it in your life. In short - breath work is like driving your breathing vehicle differently for an hour or so, which can be very exciting but ultimately confusing. Breathing performance is what we do at Academy West. We focus on clear language, research-backed concepts and provide meaningful tools to apply in your life as you do all your functional activities. We break down how to use your breathing for what matters most - when you exercise, clean your house, deal with the stress of relationships and work, sleep, stretch, lift weights, have sex, go running, dance at a party or pay attention when you need to. We show you how your breathing is tied into every emotion you experience, every bodily function and every goal you have in life. In short - breathing performance is like learning how to drive your breathing through every situation in your life, safely, efficiently, and with more skills and better results than you've ever imagined in your life. No matter where you're headed, your breathing performance will take you there.

Imagine your body's available energy like a bank account. Your breathing isn't supposed to cost you very much when working properly. Over time though, you can develop movement patterns that increase the cost of doing business of living your everyday life. When breathing is truly difficult, it takes all the energy you have just to make it through the day—just ask anybody with COPD. When you improve how you breathe, you drastically cut the cost of business, saving all that valuable energy for the rest of your muscles and systems to use for function. When operating optimally, incredible changes can be achieved in the human-powered machine that supports our respiration. As breathing improves, chronic problems begin to be more manageable and often abate completely. How much more could you be doing right now?

We understand chronic. Academy West helps to put the big picture together from a functional standpoint using a multi-system analysis. The perspective of a physical therapist is unique in the medical community, trained to understand how the different parts of the body work together. A multi-system body analysis helps to identify where things are working less efficiently and how that impacts you. More complicated conditions require various specialties, but understanding how those specialties tie in to one another is exactly what an ICU therapist is trained to do. Academy West is built on the principle that no breathing problem is too deep-rooted or far gone to gain improvement.

Because you are here to learn. A good physical therapist is an educator, and in order to improve your breathing you have to learn with both your brain and your body. We make sure that you understand your breathing system and why it may be working against you. Our hands-on approach teaches your body how to move, and we take the time to explain things so that you can build on that improvement when you leave. Being a part of Academy West means arming each person with knowledge about how your body works to meet your functional needs.

You will be in a private treatment space, one-on-one with your physical therapist, though a family member is also welcome and encouraged to attend. We perform a thorough review of your history including a discussion of medical and surgical history, sleep, stress, pain, and activity levels. We discuss your goals and answer any questions you have. After all that talking, we will use mirrors and video to assess your current breathing mechanics. We then move back and forth between teaching and re-examining your breathing to understand where you are having problems. You and your therapist will work together to develop a treatment plan that works for your life. Evaluations are extremely thorough and may take longer when the nature of your pathology is multifactorial and or chronic, or if you are curious and ask lots of questions, which is always welcome. How good is your understanding of how you actually breathe?

There are many factors at play regarding your health, and so much depends on the individual. Commitment to self-care, primary cause of dysfunction, and how long compensations have occurred over time all play a role. Many patients can improve their breathing immediately by nudging their system. However, in order to see significant improvement, it is pertinent that they have follow-ups with their PT as well as diligent but manageable home programs. Typically, patients will leave with a daily home exercise routine that takes 15 minutes or less. As a patient begins to incorporate breathing strategies into their lives, the brain actually changes and begins to work differently. Essentially, the more one thinks about breathing the faster and more profoundly it changes. Some patients are better in two visits, while other patients require a long-term approach. We would be able to better asses your needs, once seeing you for the evaluation appointment. Most follow-up sessions are spaced out 2 weeks apart. The goal is to teach you and your body how to function and eventually cut you loose to breathe on your own. However, some patients find that regular "check-ins" help keep them functioning at the level they desire. How much time has it taken for you to develop bad habits?

The initial evaluation will last about 2 hours. This is to really take the time to get to know you as an individual and teach you about breathing. Please come with your forms completed online in our program (Pt Everywhere). If you'd rather fill them out in person, please arrive 10-15 minutes in advance to fill them out. Follow up appointments are 60 minutes long and will build on what was prescribed prior.

Academy West offers office visits and telehealth visits on Mondays, Tuesdays, Thursdays and Fridays from 9am - 5:30pm. We offer patient self-scheduling directly from the website, which allows you to easily pick a time and date from the comfort of your computer. What works best for you?

No, but it may help if you want your insurance to reimburse you for out of network physical therapy. Oregon is an unrestricted Direct Access state for physical therapy, which means patients are allowed to seek evaluation and treatment from any licensed physical therapist without a prescription or referral from a physician. However, if you plan on seeking insurance reimbursement, your provider may require a physician's referral, which you are more than welcome to obtain. You can complete this insurance benefits checklist to find out if your insurance requires a prescription or referral and choose to obtain one prior to your first visit. Has your doctor ever actually looked at how you breathe?

Academy West is a cash-based physical therapy practice or "out-of-network" provider. This means payment is collected at the time of service, and you are provided a receipt or "super bill" that you can submit to your insurance company for out-of-network coverage. Depending on your out0of-network plan benefits, the insurance provider may reimburse you directly. If you want to understand more about what your insurance company will and will not reimburse, give them a call and have this insurance checklist ready. It is important for each person to understand exactly what their insurance covers. If you have questions or need guidance with this, please don't hesitate to give us a call.

Academy West does not have a relationship with Medicare, which means patients who wish to submit to Medicare for treatment reimbursement that Medicare normally covers may not be treated at Academy West. Additionally, physical therapy for breathing performance is not really on Medicare's radar, and their definition of "pulmonary rehab" is extremely narrow. Medicare is exceedingly complicated and if you are denied reimbursement, that is a risk you take. Failure to comply with Medicare rules in every case, even with best intent, could result in federal investigation, fines, or other legal action. The Medicare Benefit Policy Manual is available in full as a series of downloads at CMS.gov; outpatient physical therapy benefits are discussed in Chapter 15, which is currently 289 pages. Under current Medicare regulations, it is illegal for a physical therapist to accept cash pay from Medicare patients for services that may be covered under Medicare, even if the services provided meet all treatment, documentation, and HIPAA requirements and have been prescribed by their physician. In some cases, a Medicare beneficiary may pay cash for services that are no longer considered medically necessary, for example a "maintenance" or "wellness" program. Confused? So are we...give us a call and we can talk it through.