Frequently Asked Questions

Gate City Physio specializse in headaches, migraine, and complex facial pain. We understand the unique challenges these conditions present as head and facial pain carries much greater impact. This is because pleasures we take for granted – such as eating, laughing, and even just talking – can suddenly become dreaded tasks to be avoided.

You do not! However, patients may still ask for a referral from their primary care doctor, neurologist, or dentist, as it enables efficient communication between us and your team of providers. We often receive referrals from practitioners in the medical and dental fields, as well as other holistic health professionals.

An initial visit at Gate City Physio is designed to be a comprehensive, one-on-one session focused entirely on you and your unique health journey. Here's what you can expect:

1. A Deep Dive into Your Story (The "Why"): Dr. Hillman will spend significant time actively listening to your detailed health history, beyond just your primary symptoms. This includes discussing your lifestyle, daily routines, previous treatments you've tried, and how your pain impacts your work, social life, sleep, nutrition, and stress levels. He wants to understand your story and what your goals are for treatment.

2. Thorough Neuro-Orthopedic Evaluation: This isn't just a quick check. Your physical therapist will conduct a detailed, hands-on examination, assessing:

   • Structural tension: Especially in your neck, jaw, and cranial system, as these areas are highly relevant to headaches, migraines, and TMJ.

   • Nervous system reactivity: How your nervous system might be contributing to or amplifying your pain signals.

   • Movement and breath patterns: How you move your body and how you breathe can significantly influence your symptoms.

   • Eye-head coordination: Particularly important if you're experiencing vestibular symptoms.

   • Posture and overall body mechanics.

3. Initial Treatment to Start the Healing: You won't just leave with an assessment. During this first visit, Dr. Hillman will typically begin with gentle, calming treatment techniques to help ease your pain and start the process of resetting your nervous system. This could include manual therapy or early sensory retraining exercises.

4. Clarity, Plan, and Tools: Before you leave, you'll have a clear understanding of:

   • The "Why": What Dr. Hillman believes are the root causes of your symptoms based on his evaluation.

   • Your Personalized Plan: A customized treatment strategy outlining the recommended approach, including the types of therapies you'll receive and how often you'll need to come in.

   • Practical Take-Homes: You'll receive practical advice, initial therapeutic exercises, and educational resources you can start using immediately to support your recovery at home.

The entire initial visit is dedicated one-on-one with Dr. Hillman, ensuring you feel heard, understood, and leave with a concrete path forward towards lasting relief and a more resilient you.

Often 45-60 minutes, with longer initial evaluations, lasting up to 75-90 minutes.

We are committed to long term success and empowering you to take control of your care.

For more acute conditions, patients often will see us once a week for 3-4 weeks. For ongoing

We recommend new patients come in for 4-6 appointments to see effective and lasting change, though many report seeing a significant reduction in symptoms after the first few appointments.

Gate City Physio's "neuro-orthopedic approach" is a comprehensive and integrated method of physical therapy that recognizes the deep connection between the body's musculoskeletal system (bones, muscles, joints, ligaments) and its nervous system (brain, spinal cord, nerves).

Here's a breakdown of what it means:

• Beyond the Local Problem: Instead of just focusing on where you feel pain (e.g., your head for a headache, your jaw for TMJ), we look at how your entire system is functioning. This is crucial because chronic pain, headaches, migraine, and TMJ often involve changes in how the nervous system processes signals, not just a structural issue.

• Integrated Treatment: We combine techniques traditionally associated with both orthopedic physical therapy (like manual therapy for joints and muscles) and neurological rehabilitation (which addresses brain and nerve function). This includes:

  • Manual therapy: Hands-on techniques for the neck, jaw, and cranial system to release tension and improve mobility.

  • Somatosensory training: Helping your body and brain re-interpret sensory input (touch, movement, tension) to reduce hypersensitivity and promote a sense of calm.

  • Neural plasticity-based exercises: Exercises designed to "rewire" pain pathways in the brain and nervous system, leading to long-term changes in how your body experiences and responds to pain.

  • Brain-body integration: Strategies that help strengthen the communication and coordination between your brain and body, improving overall function and resilience.

  • Addressing overlapping conditions: We specifically acknowledge and treat conditions like POTS, dysautonomia, and vestibular symptoms, which are often intricately linked to nervous system dysfunction and can overlap with migraine and headache.

• Holistic and Patient-Centered: Our approach is holistic, considering factors like stress, movement patterns, breathing, and even emotional well-being, as these can all influence the nervous system and contribute to chronic symptoms. The goal isn't just to reduce symptoms, but to make your entire system more stable, confident, and calm, empowering you with tools for lasting self-management and a more resilient life.

Manual therapy, somatosensory training, neural plasticity-based exercises, visual-vestibular retraining, postural/breath retraining, brain-body integration techniques, gradual exposure tools.

We understand that navigating healthcare and insurance can be confusing, and you might be wondering why Gate City Physio chooses not to be in-network with insurance companies. Our decision is rooted in a commitment to providing you with the highest quality, most personalized care possible, especially for complex conditions like chronic migraines, TMJ, and dysautonomia.

Here's why our model benefits you:

• Your Care, Not Insurance Rules: Insurance companies often dictate the type of treatments covered, the number of sessions, and even how long each appointment can be. This can severely limit our ability to provide the comprehensive, holistic, and flexible care your unique situation demands. By operating outside of these restrictions, we're free to focus entirely on what gets you the best results, addressing the root cause of your pain without compromise.

• Dedicated One-on-One Attention: Unlike clinics that might juggle multiple patients at once due to insurance reimbursement rates, our model allows for extended, dedicated one-on-one sessions with Dr. Hillman This means more personalized assessment, hands-on treatment, and focused education, leading to faster, more complete progress.

• Focus on Lasting Solutions, Not Just Quick Fixes: Insurance coverage often stops once basic function is restored, even if more therapy could prevent recurrence or build greater resilience. Our goal is to empower you with long-term relief and self-management strategies. While the upfront cost might seem different, our intensive, personalized care often leads to fewer total visits and better, lasting outcomes, potentially saving you money and frustration in the long run.

We believe this model allows us to deliver truly transformative care in this specialized area.

Yes, we offer a free 15-minute consultation with Dr. Hillman before you book your initial appointment, to make sure we are a good fit for your needs. You can book that now through our contact page.

We understand life happens, however we strive to