By Rachel Miller, PT, DPT

Have you ever felt like a number in a waiting room? Or finally got into an appointment only to feel rushed- having 15 minutes with your PT who is juggling three other patients and just supervising the rest of your exercises from afar? You aren't imagining it. A massive shift is happening in our medical system. Behind the scenes, insurance companies have decreased reimbursements while increasing administrative burdens. This forces providers to see more people in less time, leading to less personalized patient care, reduced one-on-one time and clinician burnout.
This is why many specialists are moving toward a direct-care model. At The Pilates PT, we intentionally chose to be an out-of-network provider. This allows us to prioritize the patient-provider team over insurance requirements.

The Benefits of an Out-of-Network Approach
By stepping outside the traditional insurance "box," we are able to provide a level of care that is becoming rare in the modern medical landscape:

• 1:1 Attention: You spend nearly an hour with your Doctor of Physical Therapy every single time. No aides, no double-booking.
• Root-Cause Resolution: We treat the big picture and the "why" behind your pain, not just the symptoms insurance allows us to bill for.
• Fewer Visits, Better Results: In our model, we typically see patients once a week, tapering off as you improve. Because each session is high-impact, you often need fewer total visits to reach your goals.

Is "Out-of-Network" Actually More Expensive?
The truth might surprise you. When you factor in high deductibles, co-pays, and the sheer number of sessions required by traditional "high-volume" clinics, the cost difference is often negligible.
Most PPO plans offer out-of-network benefits, and we work with you to maximize those. Consider this: For less than the cost of a single MRI, you could complete an entire plan of care and actually feel better.

Our Three-Phase Path to Healing
Our PTs hold advanced training in manual therapy, orthopedics, pelvic floor health, and Pilates. We use this holistic toolkit to guide you through three vital stages:

1. The Manual Phase: Hands-on therapy to decrease pain and get the body moving optimally.
2. The Brain Work: Retraining inhibited muscles and identifying the movement patterns that caused the issue in the first place.
3. The Integration: Strengthening and returning to the activities you love, which can be supported by our specialized Pilates offerings to reinforce your progress.

Experience the Difference
If you’ve tried "traditional" PT and felt it wasn't the right fit, or if you didn't see the progress you expected, we are here to offer a different experience.
You don’t need a doctor’s referral to start your journey with us. Schedule a free virtual discovery session today, and let’s create a personalized plan to get you back on track—and keep you there.

As a Physical Therapist, one of the most common questions I get is, “Should I be wearing orthotics or supportive shoes?” And, in true PT fashion, the answer is—it depends! There’s no one-size-fits-all solution when it comes to our feet. But let’s break down the basics.
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At the heart of this question is whether we truly need external support—like arch supports or extra cushioning. There are absolutely times when additional support can be helpful, such as during an acute injury or pregnancy, when the body may benefit from temporary assistance.

My Experience with Orthotics

I’ll use myself as an example. When I was in elementary and middle school, I had custom orthotics that went into every pair of shoes I owned. I had been told I had “flat feet,” even though I didn’t have any pain or functional issues. So, I wore those orthotics for years.

Ironically, as a dancer, I never used orthotics in my dance shoes. But outside the studio, I became someone who sought out shoes with extra arch support. I used to look at people wearing flat sandals and wonder—how are they walking comfortably in those?

What Changed

Then came a major shift. I started Pilates and began strengthening not just my core, but also my feet. Around that time, minimalist and barefoot shoes started trending, and books by experts like Katy Bowman made me rethink my dependence on external support.

I slowly transitioned to flexible, minimally supportive shoes—and I felt amazing. My feet got stronger and more mobile. Before long, I became that person who could comfortably wear flat sandals all day. I also became a bit of a “shoe snob”—if the sole isn’t flexible, the toe box is narrow, the heel is too high, or the shoe isn’t securely attached to my foot, I’m not wearing it!

That said, if I know I’ll be walking all day, I might choose something with a bit more cushioning or support. But for most of my daily movement, I prefer my feet to be as mobile (and as free) as possible—often barefoot.

Building Internal Support

So, do some people need extra external support? Possibly. But it’s worth asking: do they have enough internal support to begin with? If not, that can often change with targeted strengthening.

In Pilates, for example, we typically recommend working barefoot to strengthen the intrinsic muscles of the feet. When clients ask if they can wear shoes on the reformer, I usually ask why—and, when appropriate, encourage them to try without.

Reformer work, like footwork in supine (essentially a lying-down squat), allows movement without the full load of body weight. It’s a safe and effective way to build strength and control from the inside out.

Finding Balance

Ultimately, my goal is to help people develop as much internal support as possible so they can gradually decrease their reliance on external supports. That might look like not needing to wear shoes around the house all the time, or being able to enjoy those cute sandals for a night out—without paying for it later.

As with most things in life, it’s about balance. External supports can be useful tools, but they shouldn’t replace strong, capable feet.

by Dr. Rachel Miller, PT, DPT
There’s been a lot of talk lately about whether Pilates falls under fitness or wellness. The truth? It can be both, but it will depend on the studio/environment.  There are many Pilates studios opening that are fitness focused which can still be beneficial, but are often missing the foundational piece especially in a group class environment.
Pilates is a journey. The more you learn about movement and the Pilates concepts, the more benefit you will gain from your practice which is what we focus on here at The Pilates PT.  Our bodies are designed to be efficient. When we move, the body naturally chooses the easiest path to get the job done, usually by recruiting the strongest and most accessible muscles. But what your body needs is often using the smaller, harder-to-find muscles.
Pilates is Brain Work
Pilates is just as much mental work as it is physical. The more you understand where your body is in space and which muscles are initiating movement, the more precise and effective your practice becomes. Subtle adjustments such as like changing your breathing pattern or alignment can completely transform an exercise.
Returning to foundational movements, experimenting with different verbal or tactile cues, and working with an experienced instructor can all help you connect more deeply to your body.
Getting the Most Out of Your Pilates Practice
So how can you make sure you’re getting the maximum benefit from Pilates?
1. Education
Knowledge is power—especially when it comes to movement. Understanding why and how your body moves builds awareness and control. Our Core Connections videos are designed exactly for this: educational exercise that helps you move smarter and more efficiently.
2. Personalized Attention
Private sessions are the best way to truly “wake up” the smaller stabilizing muscles and address your individual needs. Once you have a solid foundation, moving into a duet or small group classes can help you apply what you’ve learned while still receiving personal guidance.  
*Our Pilates intro package combines 2 private sessions with our Core Connections videos and is an amazing deal... 
3. Addressing Limitations
If you’re dealing with pain, tightness, or mobility restrictions, it may be helpful to start with physical therapy. Working with a Pilates-trained Physical Therapist can bridge the gap between rehab and movement, helping you transition to Pilates safely and confidently.
Pilates is more than just a workout, it’s a practice in awareness, precision, and connection. When you combine education, mindful movement and expert guidance, you create a foundation not only for strength and flexibility but for overall well-being.

By: Rachel Miller PT, DPT

Pilates is known for its incredible benefits in core strengthening—but is it possible to engage your core too much? The answer might surprise you.
The Core Should Be Functional, Not Just Strong
Our deep core system is designed to be reflexive, meaning it should automatically engage and relax as we move through life. For example, if someone bumps into you while you’re standing, your core should naturally activate to keep you balanced.
But what happens if your core muscles are already contracted all the time? They lose the ability to respond effectively. Just like any other muscle, the core needs to be able to both contract and relax to function optimally.
A Tight Muscle Is a Weak Muscle
Over the years, I’ve worked with many patients who habitually clench their glutes, suck in their stomach, or hold tension in their pelvic floor. While these patterns are common, they can actually lead to muscle weakness and dysfunction over time.
The causes vary:

• Glutes: Often tight due to posture—especially standing in a posterior pelvic tilt.
  
• Abdominals: Sometimes from a desire for a flatter stomach, but also as a subconscious reaction to pain or digestive discomfort.
  
• Pelvic floor: This one can be tricky since we can’t see it. Tightness here may result from pelvic or hip issues, past trauma, chronic stress, or the body’s attempt to stabilize when surrounding core muscles are weak.
  

How to Restore Balance
The first step toward a healthy, functional core is awareness.
Take a few moments throughout your day to check in with your body:

• Are you gripping your glutes or sucking in your stomach?
  
• Do you notice tension in your pelvic floor?
  
• If so, can you consciously let it go?
  

Try adjusting your posture or focusing on slow, deep breathing to encourage your muscles to relax.
Once you can release unnecessary tension, you can start rebuilding balanced strength. If you struggle to feel your glutes or deep abdominals engage during exercise, it might be because they’re already “on” all the time. Gentle release work or mindful breathing can help reset your system so your muscles can start firing appropriately again.
Contract and Relax
Here’s a simple example: If you flex your bicep right now and then try to contract it even more, you can’t. The muscle is already shortened. You would need to straighten your elbow first to relax it before you can contract it again.
The same principle applies to your core. For your muscles to activate effectively, they must first be able to let go.  As you move through your Pilates practice (and your day), remember this simple truth: A functional core isn’t one that’s always tight... it’s one that knows when to engage and when to release.