3/20/2017 1:30-4:30
This was my first day observing in the clinic, and I followed Caitlin around. Caitlin is an LACT in an out-patient PT setting. I did not realize that athletic trainers could work in a PT clinic. The first time she introduced herself, I thought she was an AT who went to school to become an PT. What I found more interesting is that she can do just about everything all of the physical therapist can do too. The only thing she can’t do is work with patients who are covered by Medicare.
I saw three patients this day. The first was a hip replacement “pre-hab.” I came in near the end of this rehab, but basically they Caitlin was just trying to strengthen her muscle so that there is a better chance of a good surgery. They did a machine exercise called nustep. This looked like a reclined bike mixed with an elliptical, but it does steps instead of running. I thought it was an interesting machine. Then they did some hamstring stretching. After, they did a ball exercise where her feet were on the ball and she had to bridge up. Then she was done and they gave her ice.
The next patient I saw was a woman with an unknown injury, but a lot of symptoms. The PT though she may have had a mini stroke which paralyzed her on one side, but the MRI didn’t prove that. I thought it might have been some nerve root compression issue. Either way, her goal is to walk, and that is all she did for her rehab. She would stand up, walk 3 feet, then sit back down in her wheel chair, and she continued this until she made it to the exit door, then she would leave.
The last patient I saw that day was a total knee replacement rehab. She had a visionary knee replacement which is a newer method where the surgeons measure the bones to make a custom fit for the patient. I don’t remember the exact amount of time since her surgery, but if I had to guess it would probably be 6 weeks out. She did some nustep, then she walked up some real stairs. She worked on vestibular balance by closing her eye and turning her head while standing on a foam pad. Then she walked on the treadmill and was done. During this patient’s exercises I asked Caitlin what the surgeons do with the ACL and PCL since in the model she was showing me, it didn’t have the ligaments. Apparently the structure the surgeons put into the knee is secure enough that there is no anterior or posterior gliding and shifting.
3/22/2017 1:30-4:30
The second day, I saw 4 patients and a followed Matt for the day. The first one was a shoulder surgery rehab. This one was interesting because it was actually a reverse repair, meaning instead of having a socket on the scapula and a ball joint on the humerus, it was reversed. Matt said that these typically do better than the traditional repair, but he didn’t know exactly why. She was primarily doing ROM exercises like assisted cane, and window wipers. Then Matt took her into a room and did a flexion stretch which I got to help with.
Then we saw the patients with the unknown paralysis injury, and we walked again. Although she was faster this day, she didn’t go as far as she did the day before.
Next I saw a patient with 2 total knee repairs done at different times. He did the nustep machine, then we practiced sitting to standing and then worked on some of his joint stiffness with a joint mobe and stretching.
The last patient I just briefly observed was a ACL repair on a football player. I came when he was working on leg extension, and in between reps when he was just standing there I could see the obvious lack of ROM and he had a lot of joint effusion. After he did the extension exercise, he moved onto stairs and he walked up and down them a couple of times. After that they went to do some manual stretching and then iced him.
3/24/2017 1:30-3:30
The last day I has at the clinic it was super slow and I only saw 2 patients. Again, I was with Caitlin. The first one I observed was a middle aged man with degenerative disk disease. He had a lot of pain and decreased ROM. He did some sitting to standing exercise, then he did some window washers. After that he got some stim done on his lower back and was done. This is when I learned about the modalities, and process of how PT’s are allowed to treat their patients. Previously I thought the doctor was the end all be all. They would refer to a PT and maybe if they thought the patient needed it they could approve a modality. What really happens is the patient is referred to the PT and the PT will do an evaluation do determine a plan of care which includes length of rehab and modalities if the PT thinks It would be useful. Then they send it back to the doctor and they have to get a signature before anything can happen. I thought this was a crazy process, because I am so used to athletic trainers in a college setting being able to make all of these decisions and if there was something out of our scope, then the AT would refer. It was good for me that Caitlin explained that, because previously, I didn’t know how it worked at all.
The second patient I saw was the football player with the ACL repair. He was really tired, and there were no significant changes.
I thought going to the PT clinic was very interesting. This was probably my favorite observation I have done so far. Now that I know athletic trainers can work in a PT clinic, this opens up more possibilities that I didn’t know were available previously. My preferred setting would be with performing arts, or a collegiate athletic level. However, this is not an opportunity I would disregard. I think it would be good experience right out of college, but I really want to travel which is why I would prefer the other two positions over a clinical setting.
This was my first day observing in the clinic, and I followed Caitlin around. Caitlin is an LACT in an out-patient PT setting. I did not realize that athletic trainers could work in a PT clinic. The first time she introduced herself, I thought she was an AT who went to school to become an PT. What I found more interesting is that she can do just about everything all of the physical therapist can do too. The only thing she can’t do is work with patients who are covered by Medicare.
I saw three patients this day. The first was a hip replacement “pre-hab.” I came in near the end of this rehab, but basically they Caitlin was just trying to strengthen her muscle so that there is a better chance of a good surgery. They did a machine exercise called nustep. This looked like a reclined bike mixed with an elliptical, but it does steps instead of running. I thought it was an interesting machine. Then they did some hamstring stretching. After, they did a ball exercise where her feet were on the ball and she had to bridge up. Then she was done and they gave her ice.
The next patient I saw was a woman with an unknown injury, but a lot of symptoms. The PT though she may have had a mini stroke which paralyzed her on one side, but the MRI didn’t prove that. I thought it might have been some nerve root compression issue. Either way, her goal is to walk, and that is all she did for her rehab. She would stand up, walk 3 feet, then sit back down in her wheel chair, and she continued this until she made it to the exit door, then she would leave.
The last patient I saw that day was a total knee replacement rehab. She had a visionary knee replacement which is a newer method where the surgeons measure the bones to make a custom fit for the patient. I don’t remember the exact amount of time since her surgery, but if I had to guess it would probably be 6 weeks out. She did some nustep, then she walked up some real stairs. She worked on vestibular balance by closing her eye and turning her head while standing on a foam pad. Then she walked on the treadmill and was done. During this patient’s exercises I asked Caitlin what the surgeons do with the ACL and PCL since in the model she was showing me, it didn’t have the ligaments. Apparently the structure the surgeons put into the knee is secure enough that there is no anterior or posterior gliding and shifting.
3/22/2017 1:30-4:30
The second day, I saw 4 patients and a followed Matt for the day. The first one was a shoulder surgery rehab. This one was interesting because it was actually a reverse repair, meaning instead of having a socket on the scapula and a ball joint on the humerus, it was reversed. Matt said that these typically do better than the traditional repair, but he didn’t know exactly why. She was primarily doing ROM exercises like assisted cane, and window wipers. Then Matt took her into a room and did a flexion stretch which I got to help with.
Then we saw the patients with the unknown paralysis injury, and we walked again. Although she was faster this day, she didn’t go as far as she did the day before.
Next I saw a patient with 2 total knee repairs done at different times. He did the nustep machine, then we practiced sitting to standing and then worked on some of his joint stiffness with a joint mobe and stretching.
The last patient I just briefly observed was a ACL repair on a football player. I came when he was working on leg extension, and in between reps when he was just standing there I could see the obvious lack of ROM and he had a lot of joint effusion. After he did the extension exercise, he moved onto stairs and he walked up and down them a couple of times. After that they went to do some manual stretching and then iced him.
3/24/2017 1:30-3:30
The last day I has at the clinic it was super slow and I only saw 2 patients. Again, I was with Caitlin. The first one I observed was a middle aged man with degenerative disk disease. He had a lot of pain and decreased ROM. He did some sitting to standing exercise, then he did some window washers. After that he got some stim done on his lower back and was done. This is when I learned about the modalities, and process of how PT’s are allowed to treat their patients. Previously I thought the doctor was the end all be all. They would refer to a PT and maybe if they thought the patient needed it they could approve a modality. What really happens is the patient is referred to the PT and the PT will do an evaluation do determine a plan of care which includes length of rehab and modalities if the PT thinks It would be useful. Then they send it back to the doctor and they have to get a signature before anything can happen. I thought this was a crazy process, because I am so used to athletic trainers in a college setting being able to make all of these decisions and if there was something out of our scope, then the AT would refer. It was good for me that Caitlin explained that, because previously, I didn’t know how it worked at all.
The second patient I saw was the football player with the ACL repair. He was really tired, and there were no significant changes.
I thought going to the PT clinic was very interesting. This was probably my favorite observation I have done so far. Now that I know athletic trainers can work in a PT clinic, this opens up more possibilities that I didn’t know were available previously. My preferred setting would be with performing arts, or a collegiate athletic level. However, this is not an opportunity I would disregard. I think it would be good experience right out of college, but I really want to travel which is why I would prefer the other two positions over a clinical setting.