Rehabilitation
What physical therapy actually involves.
Most people arrive having already tried something that didn't hold. What changes here is the order of operations: a physical therapist works out what is actually driving the problem before anything is prescribed, and the program is then built around that answer rather than around a protocol.
How it works
Four things that make it physical therapy.
Not a class with a therapist in the room. The difference is who decides what you do, and what that decision is based on.
- It starts with an assessment, not an exerciseYour history, how you actually move, and what is driving the pain or the limit all get worked out before anything is prescribed. Often that turns out to be somewhere other than where it hurts, which is the usual reason a problem keeps coming back.
- The program is built, not chosenNothing is standardised. Which exercises, which equipment, how much load and in what order all follow from your diagnosis and your goals, and they change session to session as your body does.
- Pilates is the tool, not the destinationSpring resistance lets load be dialled to what the tissue can take today, and the equipment supports the parts that need supporting so you can work the part that needs working. That is why the method is here: it makes precise, graded loading possible earlier than floor exercises would.
- It gets written downSession notes and mobility markers carry forward from visit to visit, so progress is something you can be shown rather than asked to take on trust. True of every session here, where all care is one-to-one and physical-therapist-led.
Who ends up here
Usually, the case that didn’t resolve.
A large share of the San Rafael practice arrives by referral from physical therapists, chiropractors, osteopaths and doctors, who send the cases they haven't been able to resolve elsewhere. That is worth saying plainly, because it describes the work: a lot of it is second opinions on problems that already have a history.
You do not need a referral to come. If you are not sure whether this is the right thing at all, the honest first step is a free fifteen-minute conversation rather than a booking. Most San Rafael clients start there, and sometimes the answer is that you want something else.
The evidence: asystematic review in the Journal of Orthopaedic & Sports Physical Therapy found Pilates-based exercise produced clinically significant reductions in pain and disability in chronic low back pain, and asecond review in PLOS ONE found improved outcomes across a range of musculoskeletal conditions.
Ways in
Three ways to be seen.
Laura works in the San Rafael studio; Zeina works remotely, which is what makes the second and third of these possible from anywhere.
- In-studio, San RafaelOne-to-one with Laura Winner, DPT, at the California studio. In high demand, and typically booked two to three months ahead.
- Live over ZoomThe whole session remotely, with Zeina Asfour-Grifoni guiding you through it from wherever you are. This is not a compromise version. It is a large and growing part of the practice.
- HybridIn the studio with a Pilates instructor beside you, while Zeina leads the session live over Zoom. The hands-on cueing of an in-person session with the therapist who knows your case.
Looking for your condition specifically? The conditions we see most often each have a guide of their own. Find yours here. And if you want the method rather than the profession, that iswhat Pilates actually does.
Paying for it
How reimbursement works.
Worth understanding before you book rather than after.
You pay at the time of the visit and we submit to Medicare and to your secondary insurer. Medicare covers 80% of the approved amount and secondary insurance covers most of the remaining 20%. In practice 90–100% comes back, and most often it is 100%. You are reimbursed directly, within three to four weeks. If you have private insurance rather than Medicare, we can provide a superbill on request to submit yourself.
In Ascona it works differently. Rehabilitation there is paid out of pocket and is not billed through Swiss basic insurance, though complementary policies often reimburse part.See the Ascona studio page for how that works.
Ready to start
Start with the conversation, not the booking.
Fifteen minutes, free, with no obligation to book anything afterwards. Enough to tell you whether we are the right people for what you are dealing with, and which of the three ways in fits.