Category: Physical Therapy

Retraining Balance After Bouts of Dizziness

Dizziness and unsteadiness aren’t minor annoyances, since they change how safely a person walks, drives, and gets through the day. Physical therapy can address some of the causes, and it starts with finding out what is going wrong in the balance system. Here is how we approach dizziness and balance problems at our Baltimore clinic.

Balance Problems Appear in More Than One Way

According to NIDCD, a balance disorder is a condition that makes a person feel unsteady or dizzy. The agency’s list of symptoms is broad, which is one reason a careful evaluation matters. Symptoms can come and go or last a long time, and they may bring fatigue or low mood along with them.

Listed symptoms include:

• • Dizziness or a spinning sensation

• A feeling of falling, or actual falls
• Staggering while walking
• Lightheadedness or a floating feeling
• Blurred vision

Falls Raise the Stakes for Older Adults

Data from the CDC show that more than one out of four older people falls each year, yet less than half tell their doctor. That gap can leave unsteadiness untreated until an injury forces the issue. The same CDC page names falls as the top cause of traumatic brain injuries in older adults, which is another reason not to wait on persistent unsteadiness.

Balance supports independence. Strength and mobility matter alongside it, and physical therapy for seniors works on all three.

A First Visit Focuses on Finding the Source

Dizziness can have more than one source, so a Baltimore physical therapist looks at how the inner ear, vision, and the body’s position sense work together. Each system sends the brain information about where the body is in space.

At the first physical therapy visit, the therapist asks when the dizziness happens, what position or movement sets it off, and whether there have been falls or near falls. Strength, gait, and balance testing follow, and the results shape the plan.

Testing can include standing with the eyes closed, walking while turning the head, and moving from sitting to standing. Each task shows how the body responds when one source of balance information is reduced.

Treatment Targets Dizziness, Gait, and Stability

Patients with dizziness, vertigo, or balance disorders can be treated through vestibular and balance rehabilitation, led by therapists trained in vestibular therapy. The aim is to reduce dizziness, restore balance, and improve stability.

When unsteady walking is part of the picture, gait rehabilitation in Baltimore adds work on how a person steps, shifts weight, and turns. Exercises are guided in the clinic and carried over to simple tasks at home.

The goal is steadier footing and fewer dizzy spells. Progress is gradual, so the program is adjusted as the body adapts.

Some Dizziness Does Not Fully Resolve

The same NIDCD source notes that some people with balance disorders cannot fully clear their dizziness and have to learn to cope with it. In those cases, a vestibular rehabilitation therapist can help set up an individualized plan.

Progress is judged against everyday tasks, such as turning the head while walking or getting out of bed without dizziness. Balance work is one part of the Baltimore physical therapy services we provide, alongside care for orthopedic, sports, work, and auto-accident injuries.

Simple Home Changes Support the Clinic Work

NIDCD also advises changes at home and work, such as adding handrails and wearing low-heeled or walking shoes outdoors. These steps can lower the chance of a fall while treatment is under way.

LeMoine Physical Therapy Has Served Baltimore Since 2007

At LeMoine Physical Therapy, we have treated Baltimore patients since 2007. Dr. Greg LeMoine, our founder, is a Doctor of Physical Therapy licensed in Maryland, with a doctorate from the University of Maryland School of Medicine and more than 17 years of clinical experience. He is a member of the American Physical Therapy Association.

A Single Evaluation Can Start the Process

An initial evaluation gives a patient a clear picture of what is driving the dizziness and what can be done about it. Anyone in Baltimore who has noticed unsteadiness can reach out to us to set one up.

Skip the Waiting Room and See a Therapist

A Law Most Patients Never Learn About

Many people assume physical therapy always requires a doctor’s referral before treatment can begin. Maryland law has actually allowed patients to skip that step for decades, and understanding how this works can meaningfully speed up recovery for anyone in Dundalk dealing with pain or a new injury.

This gap between what people assume and what Maryland law actually allows means many patients wait weeks longer than necessary before starting treatment, simply because they never realized a referral was optional in the first place.

What Direct Access Actually Means

Maryland’s direct access law allows a licensed physical therapist to evaluate and treat a patient without first requiring a physician’s referral. A Dundalk physical therapy clinic can confirm this means you can schedule an appointment and begin care as soon as you notice a problem, rather than waiting for a separate doctor’s visit just to obtain a referral first.

• No physician referral required to begin physical therapy
• Maryland was the first state to pass this kind of law, in 1979
• Access applies without time or visit limits under current state law
• Some insurance plans may still require a referral for reimbursement

Why Maryland Was the First State to Allow This

Maryland passed its original direct access legislation back in 1979, making it the first state in the country to allow patients to see a physical therapist without a physician’s referral. Nearly every state has since adopted some version of direct access, though the specific limitations vary considerably from state to state.

Why Common Conditions Benefit Most From Direct Access

Musculoskeletal issues like lower back pain, shoulder impingement, sciatica, and sports-related injuries often respond well to prompt physical therapy without requiring diagnostic imaging or an outside referral first. These are exactly the kinds of conditions direct access was designed to address, letting patients get moving toward recovery without an unnecessary detour through a physician’s office.

Why Maryland’s Version Has No Time Limit

Unlike many states that only allow a limited period of treatment, often thirty days, before requiring a formal referral, Maryland currently operates under an unrestricted direct access model. This means a physical therapist can continue treating a patient for as long as treatment remains clinically appropriate, without needing to loop in a physician partway through the process.

Why Your Insurance Plan Still Matters

While Maryland law itself does not require a referral, some insurance plans have their own separate requirements for reimbursement purposes. A Dundalk physical therapy clinic can confirm that checking your specific plan’s requirements before your first visit helps avoid an unexpected bill, even though state law itself places no such requirement on the physical therapist.

When a Referral Still Becomes Necessary

If a physical therapist determines during an evaluation that a patient’s condition falls outside their scope of practice, or requires medical intervention such as imaging or medication, they are required to refer that patient to an appropriate physician right away. Direct access expands how quickly you can start treatment, but it does not replace medical care when a condition genuinely calls for it.

Why Starting Treatment Earlier Often Means a Faster Recovery

Research has consistently shown that starting physical therapy earlier after an injury or the onset of pain tends to produce better outcomes and reduce the likelihood of needing more invasive interventions like surgery or long-term medication use. A clinic evaluating a new patient can begin building a treatment plan immediately, rather than losing valuable time waiting on a referral appointment.

What to Expect at Your First Direct Access Visit

Your first visit typically includes a thorough evaluation of your specific condition, a discussion of your goals, and the beginning of a personalized treatment plan built around your actual needs. This evaluation helps the therapist determine whether your condition is appropriate for direct physical therapy or whether a physician referral genuinely makes sense first.

Getting Started With Care in Dundalk

LeMoine Physical Therapy welcomes new patients throughout the Dundalk area under Maryland’s direct access law, helping people begin treatment quickly rather than waiting on an unnecessary referral appointment that state law does not actually require.

You Do Not Need A Referral To Get Started

Waiting for a doctor’s appointment just to get a referral for physical therapy can delay recovery by weeks. Maryland law removed that requirement decades ago, giving patients direct access to a licensed physical therapist without a physician visit first.

Maryland’s Direct Access Law Explained

Maryland was the first state in the country to pass direct access legislation, and the Maryland Board of Physical Therapy Examiners confirms that licensed physical therapists in the state can evaluate and treat patients without a physician referral. Since 1979, this law has given Maryland patients the freedom to seek physical therapy care on their own timeline.

Why This Access Has No Built In Time Limit

Unlike many other states that limit direct access to a set number of visits or days before a referral becomes required, Maryland’s law places no such restriction on treatment duration. A physical therapist can continue evaluating and treating a patient for as long as clinically appropriate without needing a physician to sign off partway through.

Why A Referral Might Still Come Up

Even though state law does not require a referral, a physical therapist must refer a patient to an appropriate physician if a condition falls outside the physical therapist’s scope of practice or does not respond to treatment as expected. Some insurance plans also require a referral for reimbursement purposes, separate from what state law itself demands.

What Conditions Commonly Bring Patients In Without A Referral

Patients frequently come to physical therapy directly for issues like lower back pain, knee pain, shoulder stiffness, sports related injuries, and post surgical recovery once cleared by their surgeon. LeMoine Physical Therapy sees patients walk in directly for each of these conditions on a regular basis. Starting care quickly for these conditions often makes a real difference in how smoothly recovery goes.

Why Starting Treatment Sooner Tends To Improve Outcomes

Delaying physical therapy while waiting on a physician referral can allow a treatable condition to worsen or become more chronic. Beginning evaluation and treatment promptly gives a physical therapist the chance to address a problem while it is still relatively straightforward to treat.

What To Bring To A First Direct Access Visit

Because a physical therapist will need a clear picture of a patient’s history and current symptoms, having the following ready helps the first visit go smoothly:

• A description of when the pain or limitation started and how it has changed over time
• A list of any prior injuries, surgeries, or relevant medical conditions
• Insurance information, since some plans have their own referral requirements
• Any relevant imaging or prior treatment records, if available

Getting Started At A Dundalk Physical Therapy Clinic

Because Maryland law allows patients to begin treatment without waiting on a physician referral, scheduling an evaluation can happen as soon as pain or limited mobility becomes a concern. A Dundalk physical therapy clinic can evaluate a new patient directly and begin building a treatment plan right away.

What If Your Insurance Still Requests A Referral

Even where Maryland law does not require one, some insurance plans still ask for a physician referral before covering physical therapy visits. A Dundalk physical therapy clinic can help clarify what a specific insurance plan actually requires before treatment begins.

Maryland’s direct access law exists specifically to remove unnecessary delays between the onset of pain and the start of effective treatment. If you are dealing with pain or limited mobility in Dundalk, reach out to our office to schedule an evaluation and get started.

What to Expect at Your First Physical Therapy Visit

Many people arrive at their first physical therapy appointment expecting to start exercises immediately. In reality, the first visit is almost entirely an evaluation. Before any treatment can begin, the physical therapist needs to understand what is wrong, how it is affecting daily function, and what the goals of treatment should be. That process takes time and forms the foundation for everything that follows.

The evaluation begins with a detailed conversation about your medical history, the condition you are seeking treatment for, when symptoms started, and what makes them better or worse. You will likely be asked about your daily activities, work demands, sleep patterns, and what functional goals matter most to you. A therapist who understands the full context of your life can develop a plan that addresses not just the physical findings but the practical realities of your recovery.

What the Physical Examination Involves

After the initial conversation, the therapist will conduct a hands-on physical examination. The specific components depend on the condition being treated, but an evaluation for most musculoskeletal conditions will include:

• Range of motion testing to measure how far joints can move in each direction and identify restrictions
• Strength testing of the muscles surrounding the affected area to identify weakness or imbalance
• Neurological screening when pain, numbness, or tingling suggests possible nerve involvement
• Postural and movement assessments to identify biomechanical patterns that may contribute to symptoms
• Palpation of soft tissues and joints to locate areas of tenderness, muscle tension, or joint restriction

A Dundalk physical therapy evaluation gives the therapist the baseline data needed to track your progress over time and adjust the treatment plan as your condition changes. Treatment that starts without this foundation is less precise and typically produces slower results.

How Your Treatment Plan Is Developed

Based on the evaluation findings, the physical therapist develops a treatment plan that outlines the goals of care, the specific interventions to be used, and the expected frequency and duration of visits. You will review this plan together before treatment begins, so you understand what to expect at each stage and what your role is between sessions.

Home exercise programs are almost always part of the plan. What you do outside the clinic between appointments significantly affects how quickly you progress. Therapists design these programs to build on what is done in the clinic and to maintain gains between sessions.

LeMoine Physical Therapy provides physical therapy services in Dundalk and tailors each initial evaluation and treatment plan to the specific condition and functional goals of each individual patient.

What to Bring and How to Prepare

Coming prepared to your first appointment makes the evaluation more productive. A few practical steps help:

• Bring any relevant medical records, imaging results such as X-rays or MRI reports, and surgical notes if applicable
• Bring a list of current medications, including supplements, since some affect healing and pain perception
• Wear or bring clothing that allows the therapist access to the area being treated
• Note any activities, positions, or movements that consistently aggravate or relieve symptoms before your appointment
• Arrive a few minutes early if there is new patient paperwork to complete

Be as specific as possible when describing your symptoms, including when they started, how they have changed over time, and what you are hoping to accomplish through treatment. The more clearly you can communicate your experience, the more precisely the therapist can direct the evaluation.

Your first visit sets the direction for the weeks ahead. If you are ready to begin, scheduling a Dundalk physical therapy appointment is the first step toward a recovery plan built around your specific needs and goals.