Episode 16 | Evaluating Your ACL Rehab Options

What’s up guys, and welcome back for another episode on the ACL Athlete Podcast. I’m sitting here in my ACL athlete headquarters, aka my kitchen island. And today I’m ready to rock, I’m ready to talk about something that has come up that I’m really fired up about. I was going to be talking about the quadriceps to bring the quiet knee full circle. But I’m actually not going to. We’re going to talk about a message I got from an athlete today, that I’m working with. And I just want to read this to you. And it’s fueled the title of this, which is called “Evaluate Your Rehab Options.” So the message is, by the way, I went to one prehab PT visit (before I started working with you) to get an idea of exercises to start strengthening. And I just got the bill (crying emoji). They charged almost $900 and I owed $416 after insurance (sad face). That’s the message.

Today, this has fueled a lot, but let’s just kind of reflect on this for a second. She did one prehab visit, one PT visit, getting some exercises for her to be able to start strengthening and getting an idea of where she’s at. She got charged $900 from a physical therapy clinic, and she owed almost half of that. I even posted this to my Instagram because I think that this is something that needs more awareness and discussion. Again, the insurance and healthcare systems are falling short for us. As consumers of healthcare, it is very difficult for us to trust and really rely on it. Because if something happens, everyone fears, “Okay, I’m going to get slapped with this huge bill once this is all over with, especially if it’s nothing that is very major.”

We know insurance is valuable in a lot of things. I’m not trying to say that this is just taboo and terrible. But we just have to realize where it’s at in terms of, if there’s a major issue, then thank God that we have it. But if there’s something small, whether it’s a cold, whether it’s a cut or a broken foot, maybe you have to have some diagnostic tests. It’s all based on insurance, the deductible, and that is what’s going to ultimately dictate how much you have to pay. But the thing that’s hard is that most of the times when people are using their insurance, they’re going to have to pay for things. The way that insurance is built is that we in healthcare will (and I hate to say I’m a part of it but it is) but we will charge more to be able to get more reimbursement from the insurance. It’s the strategic game to get more money, which is the main fuel source of all of this. I’m going to end that rant there because I could keep going. Thank you, guys, for listening so far.  

It’s a big reason why I personally choose not to take insurance. And it’s something where premiums are getting more expensive. We pay more before we get any coverage. I just don’t like that. It can dictate how we treat, especially in the clinic can charge more, and how people get treated is very much affected by the cost and the units that they bill. Now, this is not every single clinic, but sadly, a lot of them. It’s the system that we are working against. I’m going to keep this super actionable because that’s where I’m going to stop with that stuff. But you need to do what’s best for you to set you up for the best success so you do not have a reinjury of your ACL. You do not want to have to do this all over again. Make sure that what you are doing is in the best interest of you and no one else. Because this is your knee you’re talking about, your functionality, your livelihood. You want to make sure that you don’t just do this sub-optimally. You want to make sure you do this the best that you can. And that might mean that you are not going to do something that is as convenient and is not the norm. And what I mean by that, just because there’s a PT clinic up the road or a clinic that might be convenient for you, that does not necessarily mean that that’s the best option. Let’s just kind of put that out there. Just because it’s convenient doesn’t mean it’s the best option. So that’s where PT and being able to evaluate your options for so many different things that we pick in life, you’re also going to evaluate the PT that you are paired with.

Now, if you don’t know as much about this, just know that if you have a prescription, you can go to any PT you want. You are not forced to go to that clinic. And in healthcare, at least in the state of Georgia, if you get a prescription for physical therapy, you do not have to go to the clinic that that doctor has recommended. You can go anywhere you want. This is just something to keep in mind if you’re planning to use your insurance because that convenience factor will play into it. If we’re talking about good care, that might not mean that the PT clinic up the road is the best option. As you guys know, there’s good and bad in everything in every profession, whether that’s healthcare as a medical doctor, a dietician, a physical therapist, or maybe it’s a teacher, maybe it’s a plumber. There’s good and bad in every profession that exists. So that’s where being able to filter through this and figure it out is important.

And maybe, you don’t know from the start of it because you don’t know the person as well, and it’s hard to even know what is right for the process. If you start to get this gut feeling of, this isn’t going in the right direction, or not feeling confident about the choice, that person should not be hurt by you trying to get a second opinion, or if you feel internally that needs to shift. We do this all the time in medicine where if we want a surgical consult, we’re not necessarily just going to settle unless resources are so slim that that’s the only option. But just know more often than not, there are always many different options than just that one. 

The person that you’re working with should know how to treat this injury. It shouldn’t just be this protocol on a sheet of paper that they’re following. They should have principles that guide them, and they should be able to explain to you, why you’re doing what you’re doing throughout your entire rehab process. If not, then that needs to be a question mark and you need to figure out, is this someone that I need to stick with? Again, reflecting back on your own care and what is going to be in the best interest long term for you. 

With that said, in terms of pricing, there are other options. Sometimes you can even ask the PT clinic, “Hey, can I do cash only?” And they might actually have a cheaper cash option. Now with this said, you just have to figure out, “Okay, how many visits am I going to need with the ACL rehab we have talked?” We know that there are going to be a lot of visits that you will need if you decide this is going to be an in-person thing. You make sure you figure out what the cash price is, and that might be a cheaper option for you than getting billed 900 and being responsible for half of that. So this athlete said that she didn’t really get much out of it. It’s hard to rationalize spending that much money for one visit when there are other options out there that are available. So think through this. 

Another point that I wanted to bring up was spreading out your visits. I know that this isn’t necessarily focused on the cost. But if you’re limited on the visits – I did an episode on episodes three and nine about how to spread those out, to be able to maximize the return on those. And that way you don’t just get rid of all of those within the first month. 

Another option to think about that goes with this is to find out if there is an out-of-network clinic close to you. Now, this might cost a bit more for each session. But the money that you spend for that compared to potentially the insurance-based clinic, it might even out, it might be a little less. But you got to factor in the quality of care you’re getting; you have to. This is the risk/reward of this. And to me, the reward is so high of getting really good care but there might be a little bit of an investment early on. So that’s where you got to compare this. Sit down, look at your budget. This would be the thing that I would advise. Look at the budget, see what is available, whether you are working with your parents, or whether you’re doing this on your own, or whatever the income source is. I want you to sit down and look at what that number is, and then see how many insurance visits you have. 

Have you met your deductible? And then use all of those different components to be able to figure out, “Okay, this is what my game plan is.” And if there’s an out-of-network clinic and you prefer to be in-person, then that is something that I would suggest pursuing and looking to see, “Okay, can this work compared to the insurance model?” Again, I’m not saying all insurance models are terrible. I just get a lot of athletes who are fed up with it. Most of the time, people are seeing multiple people at the same time. And it is just hard to get more personalized care, which is what is needed in ACL rehab. 

Another option is to get far enough out in this process where you can start working with a strength coach. I’m a strength coach, I’m a physical therapist, I believe that most of this continuum should be strength and conditioning. Maybe the initial phases are rehab, and you’re dealing more with the pain and trying to get everything to calm down. But then it’s really looking at strength and conditioning. How can we do this in a progressive way? And making sure that we’re loading you in the ways that you need to be and challenging you. And I think a good strength and conditioning coach can really help get you there. That is really a solid option. I also think that it is more affordable because the price per session is decreased. And sometimes you can even get into a group setting, which can be helpful as well.

Lastly is remote coaching. Technology is super cool, it is really cool. The ability to work with people has been really cool. I just haven’t been able to see in person. There are people that I’m working with that I have not met in person, and we are making strides in the ACL rehab. And with that said, and with Covid that has opened the door for a lot of opportunities to utilize the technology that we have, to be able to not have to focus and rely on what is convenient to us in our location and in our city when we can do this across the globe, if we really want to, right? Don’t let your location and honestly laziness limit you with this. Sometimes you have to experience the bad to figure out what is actually good. And technology has really changed that, for me, to be able to work with athletes. The other things that you can reference, I mean, think about it, we can do school from home now, we can work from home. You can do doctor’s visits from home. Why would rehab really be any different, especially if there’s not really any hands-on care. We have video, we have access to talking to each other. This is something else that I would ask you to consider to try and reach good care. 

And again, at the center of all this is what you deserve best with your ACL rehab. So that’s where remote coaching and having access to coaches who are able to do this. I’m not the only one out there that does this. But there are some really solid people who do this. I want to make sure that you know that’s an option. Your location does not have to limit the care that you can get. And because I’m so fired up today, I’m opening up three athlete slots on the ACL athlete team. And I don’t do this all the time, but it is something that is important to me. And I think people deserve really good care. If you’re listening to this and you are needing help, you’re frustrated, you got a message or mail from your doctor or your PT, that is an absurd amount of money, and you are looking for a reasonable option, then please reach out to our team. Go to my website theaclathlete.com. It’s also down in the show notes. But send me an email, let’s talk. If anything, we can just hop on a call and make sure you have some questions answered and you know the next steps. This process is very confusing. I’ve done it myself twice. I have helped other people navigate this process as well, and they’re fully back to sports. 

And look, there are so many other options that you can stick to. I just want you to find something that is going to work for you and make sure that you don’t look at this in three years, in five years, and in 10 years of being like, “Man, I wish I would’ve done something different.”  This is your call to action, you the ACL athlete, for doing something else if you are frustrated. Don’t settle and know there are different options and there’s a different way.

That’s it guys, I’m done with this one. I appreciate all of you for listening. This is something that I’m very passionate about. I think that people need other options. Thank you all so freaking much. We hit 2,000 downloads, which is insane. Thank you guys. It’s been awesome. It’s been fueled for me. And the messages that I continue to get are just unbelievable. You guys are awesome. All right, that’s a wrap. As always, thank you all so much for listening to the ACL Athlete Podcast. This is your host, Ravi Patel, signing off.