There is no single correct frequency, but there is a standard one. At Solas PT most courses run weekly for four to seven weeks, structured in three stages of rehabilitation. Some conditions need more than that, and Dr. Cisneros will tell you if yours is one of them. What carries the time between visits is the home program — and that is where most of the change actually happens.
The reason a course of care runs four to seven weeks is not a billing block. It is that rehabilitation moves through three phases, and each one has to hold before the next is worth starting.
Restoring mobility, and building enough strength and stability to load the area safely. This is where manual therapy and dry needling do most of their work, where they are indicated at all. You cannot progressively load a joint that will not move or a muscle that will not fire.
Once the foundation holds, load goes up deliberately. This is the stage that actually changes tissue capacity — and it is the one most often cut short, because people start feeling better partway through it.
Taking that capacity back into the thing you needed it for — lifting, running, a return to sport, a shift at work. Skipping this stage is why people finish therapy feeling fine and re-injure two months later.
Each stage needs time to take effect between sessions. A weekly visit is where the plan is checked and progressed; the work that produces the change happens on the days you are not here. That is also why the length of a course is set by how the stages progress rather than by a number chosen in advance.
Some presentations need two or three sessions a week. If yours is one of them, you will be told that at the evaluation — spacing visits is a clinical judgement, not a price.
Not a consolation prize. The reason is arithmetic: the home program is performed far more often than any clinic visit, and frequency is what produces adaptation. A visit is a correction and a progression. The program between visits is the work.
You will not remember the exercises, form will have drifted, and your tolerance for increased activity will not have moved. Those three together are unmistakable by the second or third visit — and they change the plan.
Understanding why each exercise is there. A program you understand is a program you do. That is the reason a full hour goes into a session rather than fifteen minutes and a printout.
Take a mild rotator cuff strain with some weakness and instability. A tailored mobility and strength program performed two to three times a week independently can produce meaningful functional gains in about four weeks.
The two-to-three times a week did not go away. It moved from a clinic schedule to a home program — where it costs nothing, fits around work, and happens whether or not you can get across El Paso on a Tuesday afternoon.
Patients arrive here having been turned away elsewhere — not because their condition was wrong for physical therapy, but because they could not commit to a 2–3x/week schedule for months. Sometimes it is cost, sometimes work, sometimes childcare, sometimes a drive that only works on a Saturday.
They were not told physical therapy would not help them. They knew it would. They were blocked by access to care.
The scheduling is not misconduct. Insurance reimbursement per visit is low, plans authorise care in visit blocks, and a clinic working inside those constraints needs visit volume to stay open. That is arithmetic, not indifference. But it is the clinic’s constraint, and it is heard by the patient as a clinical requirement. A cash-based practice has no visit block to fill, which makes it possible to build the plan around what a person can actually do — and to say so plainly when what they can do is not enough.
For some patients the right plan is a session, a reassessment weeks later, and a check-in when something changes.
This is not offered to everyone, and it is not a cheaper tier. It suits a specific patient: highly motivated, demonstrably compliant with the program, willing to do the work, and presenting with mild impairments rather than severe ones. If any of those are not true, the honest recommendation is a standard weekly course — and you will be told that.
There is no single correct frequency, but there is a standard one. At Solas PT most courses run weekly for four to seven weeks, structured in three stages of rehabilitation. Some conditions need more than weekly — particularly early after surgery, after a manipulation under anaesthesia, and where a joint is actively losing range. What carries the time between visits is the home exercise program, and that is where most of the change actually happens.
Stage one builds a foundation: restoring mobility and enough strength and stability to load the area safely, with manual therapy and dry needling where indicated. Stage two is progressive strengthening, where load goes up deliberately and tissue capacity actually changes. Stage three is functional and sport-specific loading — taking that capacity back into lifting, running, return to sport or a shift at work. The schedule follows the stages rather than the other way round, because each stage needs time to take effect between sessions.
Not always, and it depends on your condition rather than on how a clinic bills. Two to three visits a week is a common scheduling default, and for some presentations it is clinically correct — early post-operative care, a joint losing range, or a course where faster gains are the priority. For many others a weekly visit through a staged course is sufficient, provided the home program is genuinely being done.
For many conditions, yes. Weekly is the standard course at Solas PT, not a reduced version of one. The visit is where the plan is corrected and progressed; the home program between visits is where the adaptation happens, because it is performed far more often. Where weekly is not enough, Dr. Cisneros will tell you at the evaluation.
Early after surgery, where hands-on manual therapy is needed at a frequency a weekly visit cannot deliver. After a manipulation under anaesthesia, which needs stretching more often than a weekly schedule allows. Where a joint is actively losing range and mobilisation frequency follows the significance of that loss. Where a condition needs closer supervision, or where faster gains are the clinical priority. And where a patient is fear-avoidant under load — guarding against loading an area calls for more supervision while that load is introduced, not less.
It is common, and it is usually the clinic's constraint rather than a statement about your condition. Insurance reimbursement per visit is low and plans authorise care in visit blocks, so a clinic working inside those constraints needs visit volume. That is arithmetic, not indifference, and the clinic is not doing anything improper. But 'we cannot fit your schedule' and 'physical therapy will not help you' are different sentences, and they are often heard as the same one. A cash-based practice has no visit block to fill, so the plan can be built around what you can actually do.
Most courses at Solas PT run four to seven weeks on a weekly schedule. That is an average rather than a promise. Some presentations need more: post-operative patients in early phases needing manual therapy, patients after a manipulation under anaesthesia, and patients who are fear-avoidant under load and need more supervision while it is introduced.
The course slows down, and it shows. By the second or third visit you will not remember the exercises, form will have drifted, and your tolerance for increased activity will not have moved. When that happens the correct response is to increase supervision to weekly or more, to rebuild compliance and tolerance — not to space visits further apart.
A spot check or pop-in is a session, then a reassessment weeks later, then a check-in when something changes. It is appropriate for a specific patient: highly motivated, demonstrably compliant with the home program, willing to do the work, and presenting with mild impairments rather than severe ones. It is not a cheaper tier and it is not offered to everyone. If those conditions are not met, the honest recommendation is a standard weekly course, and you will be told so.
You should see gradual improvement in motion, in strength, and in how much activity you tolerate — and you should be able to handle increased loading as the course progresses. If those are not moving by the second or third visit, the plan changes.
Not to start. Texas direct access allows a qualifying physical therapist to evaluate and treat you for up to 30 consecutive calendar days without a physician referral. A referral is required to continue past that window.
You will get a specific recommendation at the evaluation — including if the answer is that you need to come in more often than you were hoping.