727-459-0610 / [email protected]

FAQ

Payments

What are the payment options?

Payment is due at the time of the appointment. We accept cash, check and most major credit cards. We are also capable of taking Flex Spending Accounts (FSA) and Health Savings Accounts (HSA)

What are the fees for treatments?

Initial Consultation: FREE
New Patient Comprehensive Exam: $99.00
Follow-Up Treatment: $65.00

Do you accept my insurance?

At Peak Performance Sports Therapy we choose not to participate with insurance companies due to the restrictions and guidelines that are mandated for patient care. Insurance companies dictate the covered treatment therapies, how to treat and the number of visits. Currently, we don’t accept insurance, but this allows me the flexibility to treat the patient’s needs 100 percent, not just what the insurance company will cover. We desire for the patient to receive the best possible quality care and this can only occur if insurance companies are not involved.  If your insurance plan has out-of-network chiropractic coverage then we can provide you with a detailed receipt, which you can directly submit to your insurance company for possible reimbursement.

Appointments

Do I have to fill out paperwork before the visit?
Yes, you do. There are 4 very short forms that take less than 5 minutes to complete before your visit.
What happens on the first visit?
A comprehensive history of your injury will be taken. The examination includes a neurological evaluation, orthopedic evaluation, and functional movement procedures designed to find the cause of your pain. Upon conclusion of the exam, Dr. Maggio will explain his findings and render a diagnosis. He will also explain the treatment plan and options. At this point, you can discuss any questions or concerns you may have with him. On the initial visit and follow-up treatments, Dr. Maggio will focus on one area of complaint at a time to allow for the best outcomes.
How should I prepare for my first appointment?
1. Complete the intake forms that are available online (New Patient Application)
2. Bring in any applicable X-rays, MRI reports or films.
3. Plan on 45 minutes for initial exam and follow-up explanation.
4. Please wear loose fitting clothes (No skirts or jeans). If you have a neck or shoulder complaint, we prefer you wear a tank top. If you have a lower extremity complaint (hip, knee or foot) please wear shorts.
Do you treat on the first visit?
Treatment is never rendered on the first visit in order to allow us to focus on obtaining your correct diagnosis and mapping out your treatment plan.
How long is the first visit?
The first visit takes approximately 30 minutes. Please arrive 5 minutes prior to your appointment to in order to fill out the appropriate paperwork.
How long are the follow-up appointments?
These are approximately 10 minutes. Each follow-up appointment will begin with a retest from the previous appointment to serve as a baseline for the treatment and to keep up with the progress of the treatment. The findings from the beginning of the treatment will dictate which areas we treat. Throughout the process, as you continue to improve, the treatment locations will change. The ultimate goal is to have complete resolution of the pain. Once the patient reaches a resolution, he/she will be discharged with instructions, or we can address any other complaints.
What should I expect for follow-up appointments?
Each follow-up appointment will begin with a retest from the previous appointment to serve as a baseline for the treatment and to keep up with the progress of the treatment. The findings from the beginning of the treatment will dictate which areas we treat. Throughout the process, as you continue to improve, the treatment locations will change. The ultimate goal is to have complete resolution of the pain. Once the patient reaches a resolution, he/she will be discharged with instructions, or we can address any other complaints.

A typical visit can be viewed here: https://youtu.be/ieFPFZXsnlw

What should I wear for my visit?
If it is a neck/shoulder or upper extremity complaint please wear a tank top.If you have a low back or lower extremity complaint please wear loose fitting shorts so we can have access to your legs.

Treatments

What kinds of patients do you see?
Our Ideal Patient:
• Has recurring pain/injury
• Is interested in improving athletic performance
• Has poor or incomplete resolution from other options
• Was told, “You have to live with this.”
• Wishes to avoid surgery
• Would like to regain fitness but afraid of injury (including seniors)
• Desires lifestyle rehabilitation

If you’ve failed with physical therapy, your medical doctor doesn’t know what’s wrong with you, or your chiropractor hasn’t fixed you, contact us and let us help diagnose and properly your problem.

What is your treatment process?
Our treatments are results driven. That means that every treatment will begin with a pre-test to establish a baseline. Then, a treatment will be rendered. Followed by a post-test to show positive change such as feeling looser, better movement and less pain.
How do your treatment techniques work?
Based on our exam and palpation, we can determine which structure are not moving properly and have adhesions. We then place the muscle into a shortened position, apply pressure and put the muscle through a full range of motion. The adhesion is then forced to slide through the tension we are placing on the muscle, causing it to break down.
What makes your treatments effective?
As the adhesion is manually broken down, normal blood flow is restored, bringing oxygen and nutrients back into the tissue – helping the muscle regain its normal function.
What does the treatment feel like?
You will feel a bit of pressure, but at no point should it be too much to tolerate. Many patients describe the feeling during treatment as “minor discomfort” followed by “immediate relief.”
How often should I be treated?
The typical protocol is to see patients twice a week for the first few weeks. Dr. Maggio recommends at least 36 to 48 hours between visits, as patients will experience some inflammation from each treatment.
How many visits will it take to fix my problem?
At Peak Performance Sports Therapy we don’t have an exact number of how long it takes to resolve your injury. Some cases are simple and clear out fast while others may take longer. However for most cases, Dr. Maggio asks that each patient commits to two visits per week for the first three weeks for the treatment to be fully effective.

Our goal is to fix your problem in the least amount of visits as possible so you can go back to functioning pain-free. We pride ourselves at Peak Performance Sports Therapy on building a trustworthy relationship with our patient by providing the best treatments possible, in the shortest period of time.

Can I continue activities while undergoing treatment?
While each case is different, ideally, for an efficient and effective treatment it is best to reduce some load to give the tissue a chance to heal properly.
What can I do for home care?
In early stages, it is best just to relax and let Dr. Maggio focus on clearing out the adhesions that have accumulated over time. Specific instructions will be given as needed on a case-by-case basis.
Why don’t you do chiropractic adjustments?
A chiropractic adjustment does not reduce scar tissue that has accumulated in a muscle or joint. Adjustments can temporarily reduce symptoms and give a short period of pain relief, but does not address the root of the problem. So, the symptoms will return until the muscle’s adhesion is addressed.
My original pain went away, but now I am experiencing new symptoms. Why?
As scar tissue is removed and one muscle begins to function normally, surrounding muscles that were compensating may begin to exhibit pain from accumulated scar tissue. This is a positive change as it indicates the effectiveness of the treatments.
Why do you only treat one region at a time?
This is done to allow full focus and attention to the primary region of concern – ensuring it is fully resolved before moving on to another problem. Working more than one area at a time reduces focus and can cause less effective treatments.
Do you perform spinal adjustments?
Our focus in the office is strictly on the diagnosis and treatment of adhesion. Spinal manipulation will not address the issue, so it is not performed in the office. Spinal manipulations can have a temporary reduction in pain, but they fail to fully address the root cause and dysfunction of the injury, so therefore we choose not to perform them.
What is adhesion?
It is a focal area of collagen fibers that form when there is damage to the muscle tissue. Adhesions are formed in two ways:
1. Direct injury to the muscle itself, via direct tear, trauma or accident.
2. As a result of being in a state of constant contraction, which deprives the area of oxygen and presents physical symptoms like those of a traumatic injury.
How do adhesions affect the muscle?
Having an adhesion is like pouring glue into the muscle. The muscles need to be able to slide and glide on one another and an adhesion makes it difficult to do so. With large adhesions, the muscle loses flexibility, gets weaker and will have increased inflammation at all times. It also causes the muscle to be poorly equipped to handle any force that is put into it. Thus, creating compensation in surrounding muscles.
How do you treat adhesions?
Scar tissue is highly reversible with the right treatment. Our treatments are the only way to effectively remove all adhesion. Dr. Maggio utilizes three types of techniques that are specific to targeting and breaking down adhesions that have accumulated in the muscle tissue:
1. Integrative Diagnosis
2. Manual Adhesion Release
3. Instrument Adhesion Release

Conditions

What causes headaches and migraines?
Have you ever had a sore scalp that is tender to touch and hurts when you raise your eyebrows or wiggle your ears? It can turn into pain at the back of the skull to the forehead, like a headache or tight feeling in the temples. These types of pain are usually caused by disorders of the nerves arising from the suboccipital triangle area of the skull and upper two cervical vertebrae.

The suboccipital triangle consists of three deep muscles covered by dense fibro-fatty tissue and lying beneath the surface muscle called the semispinalis capitis. These muscles and deep membranes are connected to the base of the skull and the first two cervical vertebrae, the atlas (C1) and the axis (C-2). Exiting through a groove between the atlas and the skull is the first spinal nerve or the suboccipital nerve. This nerve controls the muscles around this suboccipital triangle. Arising between the atlas and the axis are the greater and lesser occipital nerves that supply the muscles of the skull at the top of the head, over the ears and the parotid glands. Disorders of this nerve are one of the causes of headaches. The cervicogencic headache arises at the back of the head and extends over the top of the head to the back of your eyes, referred to as occipital neuralgia.

Other conditions can occur related to these spinal nerves and the connection to other nerves including the cranial nerves. Dizziness, insomnia, high blood pressure, chronic tiredness, sinus trouble, crossed eyes, hearing problems and headaches can all be caused by impingement disorders of these nerves. Through accidents like whiplash, emotional trauma, stress and chronic tension, this suboccipital triangle, as well as other cervical paraspinal muscles, tighten and spasm. This tightness and spasm affect the vertebrae and related spinal nerves resulting in some of these conditions.

What causes rotator cuff injuries and shoulder pain?
Shoulder pain is one of the most common injuries we treat at Peak Performance Sports Therapy. Injuries to the rotator cuff are very common and usually come from some type of alteration in the axis of rotation. The rotator cuff is actually a group of four muscles whose primary roles are to stabilize the shoulder. When the axis of rotation is altered, it causes the load or forces to be distributed abnormally, which in turn causes the shoulder muscles to lose capacity and lay down scar tissue. When the shoulder isn’t functioning properly, it can lead to several other problems such as subacromial bursitis, impingement syndrome and a possible tear of the rotator cuff.
What causes neck pain and cervical disc herniations?
Some disc injury is usually to blame for neck pain. Disc injuries have a wide spectrum – from a small tear in the annulus fibers of the disc all the way to a herniation of the disc. A disc injury can be caused by trauma or some type of accident (such as whiplash).  In the majority of situations, the disc injury is actually caused by “wear and tear” over time. This comes from the disc having a diminished capacity due to excessive loads.

This can create many different symptoms, which can differ based on the location and severity of the disc. Symptoms of disc irritation can include local neck pain, pain that radiates down the neck into the arm/hand, and pain that travels into the back or between the shoulder blades. Our treatment focus is to unload the disc by addressing the surrounding muscles that are in protective tension. We also make sure the shoulder joints are functioning properly.

What causes hip pain?
Hip pain can be caused by a wide array of issues. In many situations, there is an altered axis of rotation of the hip (abnormal movement patterns). When the axis of rotation is altered, it can cause all of the tissues surrounding the hip joint to work harder to accomplish movement. As this occurs over an extended period of time, it can cause the muscles/ligaments/cartilage to break down and have a diminished capacity.

Other factors that can lead to hip pain are a herniated disc in the lumbar spine. To protect the disc from having additional force put into it the hip tries to pick up the slack. Over time, this can cause the hip to be overworked and start to break down as well. The key to finding out what is the root cause of the pain comes from the exam by the doctor. Based on movement screens and patterns, it is possible to determine what is the main pain generator in the biomechanics chain.

What causes knee pain?
Several different factors can cause knee pain. Unless there was some direct trauma to the knee, most knee pain comes from some other type of pain generator. Many vectors and forces go into the knee. Often one of the vectors is altered due to an abnormal axis of rotation. The treatment protocol is to focus on the surrounding muscles to help ease joint pain and the tissue that was damaged due to altered biomechanics.

We also treat the hip, low back and ankle as they all go together in the movement patterns. If the patient doesn’t get sustained relief with continued treatment, then a referral for an MRI may be needed. Based on the MRI results, the appropriate referral will be made to an orthopedic specialist if there is actual structural damage to the knee.

What causes elbow pain?
Elbow pain can have a wide array of causes. In many instances, the capacity of the muscle becomes slowly diminished over time from excessive load factors. This, in turn, causes the muscles to begin to degenerate (break down) in response to the load factors. This usually goes on for a long time before the patient notices the pain. There is a strong correlation between cortisone injections and degenerative tissues in the body, which can often lead to a more severe injury in the elbow. Instrument Adhesion Release is the best way to treat any issues in the elbow or forearm.

Two of the most common causes of Forearm and elbow pain are:
1. Tennis elbow (lateral epicondylitis or lateral epicondylosis), or pain on the outside of the elbow.
2. Golfer’s elbow (medial epicondylitis or medial epicondylosis), or pain on the inside of the elbow.

What’s plantar fasciitis?
Plantar Fasciitis is usually caused by irritation to the fascia, located on the bottom of the foot.  The plantar fascia is a thick covering of tissue. The primary job of the plantar fascia is to support the arch of the foot. With overuse, it can become very painful. In many instances, the plantar fascia gets inflamed due to an abnormal gait pattern, which in turn can put increased load in the fascia.

This is most commonly seen in runners and long distance athletes, but can become a problem in anyone. Instrument Adhesion Release works very well on the plantar fascia. The goal of the treatment is to reduce local scar tissue, then address the muscle imbalances that may have led to the altered load patterns.

What causes carpal tunnel?
Carpal tunnel or carpal tunnel-like symptoms can be linked to irritation of the median nerve. Nerves need to glide and slide in between the muscles throughout the body. The nerve roots begin at the neck and start to form into the median nerve. The nerve travels down the entire arm and innervates the thumb and first two and a half fingers. The nerve can get caught up anywhere along its path.

In most cases, the patient will experience symptoms in the hand and wrist, but the problem usually arises from something higher up in the neck or arm. In many situations, people will have carpal tunnel surgeries/releases with only temporary or no relief at all. This means that the area experiencing pain isn’t the true root of the problem, but just the unfortunate area that feels the pain.

What about cortisone shots?
Cortisone shots have become a popular treatment for people with musculoskeletal injuries. The goal of the cortisone shot is to reduce inflammation, especially in the acute phase (24 to 96 hours). The problem with repeated cortisone shots is that they can cause a significant increase in muscle degeneration.

Pain is a signal to your brain to alert you that the capacity of the muscle has become diminished and that the activity you are doing is causing harm. Pain is not a bad thing; it serves as a “red light” to let us know that something is wrong. When you take a cortisone shot, pain pill or NSAID all it does is raise your symptom threshold so that you don’t notice the pain. The cortisone shot does nothing to fix any of the dysfunctions in the muscle; it causes you to break down even more and the “red light” of the pain isn’t there to stop you.

How can I benefit from sole supports?
Structural problems of the foot can lead to many problems including ankle, calf, shin, knee, hip and low back pain.  If the structural problems need assistance, then a custom orthotic may be considered. Sole Supports will make a custom orthotic based on the shape of your foot, the flexibility of your foot, and your weight. This will help support the foot and take pressure off of the plantar fascia and foot/calf muscles.  For more information visit solesupports.com.
What is Sciatica?
Sciatica is often characterized by one or more of the following symptoms:
• Constant pain in only one side of the buttock or leg (rarely can occur in both legs)
• Pain that is worse when sitting
• Burning or tingling down the leg (vs. a dull ache)
• Weakness, numbness or difficulty moving the leg or foot
• Constant pain on one side of the rear
• A sharp pain that may make it difficult to stand up or walk

Sciatic pain can vary from infrequent and irritating to constant and incapacitating. Specific sciatica symptoms also vary widely in type, location and severity, depending upon the condition causing sciatica (such as a lumbar herniated disc). In 80 percent of sciatica cases, the pain is caused by the sciatic nerve getting compressed in the deep external rotators of the hip. Our treatments specifically focus on this area to provide relief to the symptoms.

What Causes Low Back Pain / Lumbar Disc Herniations?
Axis of rotation is the key factor for the movement of any joint in the body and can lead to low back pain. In issues where there is an altered axis of rotation, it can eventually result in degenerative factors in the lumbar spine. Over time, if the axis of rotation continues to be altered, it can cause the capacity of the disc to become diminished, which in turn can lead to a disc injury. Low back pain can produce several different kinds of pain. Symptoms can include pain down the back of the leg (sciatica), local back pain, and pain in the gluteal region. During the initial exam, we can determine if the disc is the main generator of pain with our orthopedic exam. If any red flags come up during the exam, the appropriate referral will be made. We will also thoroughly exam the hips and mid-back as they can contribute significantly to the altered biomechanics of the lumbar spine.

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