SportsMedicine – Page 2 – CA Work Experience Program

Day 3

In the morning, I continued shadowing a few different physical therapists; each has different methods and insights to offer. The patients had injuries of the glutes, back, neck, shoulder, and wrist. In the past couple days, I haven’t been able to do very much because much of the work done here needs certification such as touching patients, teaching exercises, and giving information. The other manual work such as cleaning, washing and folding towels, taking over exercises, and putting together heat and ice packs is usually done by the other interns, known as “technicians”, who are physical therapists in training. However, today I was able to learn how to make a heat pack: place a hot pack from the steamer in a wrap, then place a towel on it for an extra layer of protection. I talked to a few of the patients and watched more dry needling. Although I’ve had dry needling done on me before, I had always been scared of needles and wasn’t able to watch it. However, after extensive viewing of patients having needles stuck into their various muscles, I have gained an understanding of some of the science behind it, and therefore have become less scared of watching it being done on other people. Continue reading Day 3

Day 2

My second day was with Dr. Tyler Cope again, and I also did one session with Dr. Kristina Wulff when Dr. Cope’s patient cancelled. I was surprised after seeing over the past two days how many people cancel their appointments the day of or just don’t show up. I got to see how more of the machines were used, and how different weights are utilized. Dr. Cope also had me do some exercises with the patient so I could feel what muscles it was working.

Today the patients were a bit more engaging, and it was nice to talk to them and hear about their journey whether they were 2 or 12 weeks out. One patient in particular was a very successful scientist turned business manager, so he had some very interesting life advice to share with the college intern and me. The patient I saw with Dr. Wulff was older, and very reluctant to do the exercises, but got through them all with a little complaining. He told me he hated doing the exercises but it all paid off in the end. Overall, I learned that one of the most important things to do as a PT is to create a safe trusting environment for your patient and to communicate effectively.

Day 2

For my second day of shadowing at Breakthrough, Kenny had his shift from 6 am until 12:30 pm. He didn’t want to make me come in that early, so I did my regular 8:30-5. I watched while various physical therapists treated patients with back, rotator cuff, hip flexor, back, and piriformis injuries. Many of these were treated with dry needling, which is a faster alternative to long periods of massage in order to relax and loosen certain muscles. Usually, when a patient comes in for their appointment, the physical therapist will begin with discussion and updates of the condition, then move to treatment and massage, and finish off with exercises follow by heat or ice. One piece of insight that I found interesting today was from one of the PTs, which was that many people tend to come in for treatment immediately after an incident that causes them pain, but what they should do is wait about a week to see if the pain subsides or if the minor injury heals itself. If not, then they should come back in to seek help. Many of the physical therapists at Breakthrough have developed personal relationships with their longtime/recurring patients, asking about updates on their personal lives. I really enjoy it when the PTs explain the reasoning behind what they are doing to the patient and why it helps them. Another interesting observation I had is that oftentimes, many of the stretches are done as a sort of cross-training. For example, one woman who had back issues had her hamstrings stretched. This may seem ineffective, but many muscles in the body are connected in a way that stretching and strengthening of one muscle can benefit other nearby or distanced muscles. The PTs have back to back appointments, which can be very exhausting. However, long breaks aren’t really desired, as it is probably better for their work schedule to leave earlier than later–many of them are in from 8am-7pm, which is the length of almost 3 shifts. Prior to lunch break, I watched a client who performed exercises in the pool, as well as someone with a knee injury. Afterwards, I observed treatments on people with knee injuries, wrist tendonitis, and scoliosis.

Day 1

Front view of Breakthrough Physical Therapy building

Today was my first day interning at Breakthrough Physical Therapy under Mr. Kenneth Biggs. Breakthrough PT has multiple locations: Raleigh, Apex, and Cary (the one I am at). It has its own building located at the intersection of High House and Cary Parkway. I began at 8:30 AM and was given a tour of the entire facility, which I was fairly familiar with considering I had previously been a patient here. The facilities include a pediatric space, gym, pool, multiple offices, and the general physical therapy room. I then met the team of 6 therapists/trainers as well as the administrators. I was able to observe multiple different patients who received treatment. Their injuries were wide-ranging, and all over the body–it is clear that these physical therapists are very knowledgeable about all parts of the body. Kenny’s first patient came in at 9:30 with knee pain and back spasms, which he treated through dry needling and massage, which resulted in an overall improvement in her flexibility and pain levels. Next, he treated patients with injuries in their ankle, knee cap, feet, shin, calf, back, and hips. After a lunch break I was able to observe the work of Melissa (my former PT) and she treated patients with injuries in the rotator cuff, feet, and back. At the end of the day, I was able to observe her working with a patient in the pool, which was very interesting and different from the rest of the treatment that goes on at Breakthrough. For some of their clients, the regular activity and exercise they do on land is too intense or harsh on the muscles of people with a certain degree of injury or sensitivity. Therefore, they are given the opportunity to do some of their exercises in the pool which has more resistance, but less exertion and impact on the muscles.

Day 1

Due to unforseen circumstances, my schedule for the day actually changed just last night. The doctor I was originally working with is out for a few days, so I got to shadow Dr. Tyler Cope and Dr. Kristina Wulff today. I went in at 10:00am instead of the previously scheduled 7:30am and met up with Dr. Jaime Blanton to complete orientation and fill out some paperwork saying I’d abide by Duke’s rules and HIPPA. I then met Dr. Tyler Cope to tour the facility, which I had actually seen before since I used to go to the clinic for my own physical therapy. Aside from the physical therapy area upstairs, the Duke Physical Therapy Sports Medicine Clinic also contains a gym downstairs, indoor pool, outdoor track, and is adjacent to a more traditional doctor’s office. At the end of the tour and before Dr. Cope’s first appointment, I learned how the station carts are organized and how each station is set up. Each cart contains everything needed to reset the tables between appointments and some basic tools needed during sessions.

The top drawer of each cart contains gloves, scissors, gauze, tape, lotion, a goniometer, and other basic essentials.

The upstairs clinic area is split into 4 main sections: The waiting room, exam rooms, the open gym area, and staff desks. Dr. Cope stayed in the open gym area and used the tables there to assess his patients, but the doctors can also use one of the separated exam rooms. In the open area, there is a cart between every few tables, and there is also a cart in every exam room. Of the exam rooms, some are like the first one pictured below, with curtains separating them between each other and the open gym area. There are also more closed off rooms like the ones in a standard doctor’s office.

Standard Exam Rooms:

At the end of the day, I worked with Dr. Kristina Wulff who was working with patients in the pool. She explained how utilizing the pool allows patients to work more comfortably since the pool takes off some body weight pressure, which is especially useful for post-op patients. Water to hip height takes off 50%, mid chest height takes off 75%, and up to the neck takes off 90%. The water resistance also forces patients to utilize different muscles.

I’m excited to go back in tomorrow and work with Dr. Cope again to see some more patients!