Q: Many people think of rehab as something they do after an orthopaedic surgery. But you’re not just treating post-op patients at the Bone and Joint Institute of Tennessee. Is that right?
Dave: That’s right. Our mission here is to improve the lives of the community, which is very diverse. When people think about physical therapy, they often think about surgery and orthopaedic injuries. So much of what we offer treats issues in the community that people don’t think of that often: chronic pain, vestibular/balance issues, the concerns of a geriatric population and so on. We treat patients as young as six or seven years old, all the way up to patients in their 90s.
Q: Patients are now moving and walking quicker than ever before following surgery. How does that help the recovery process?
Dave: I’ve been a PT for about 18 years. The progress I’ve seen over the course of my career is unbelievable. It used to be that if we had a total knee patient come in, they would go through three or four months of rehab. Now, I’m seeing progress at six weeks that we used to try to attain after three months.
Because both surgery and anesthesia are getting better, we deal with less nausea, which allows us to get started with rehab earlier. We also work with our physicians to rehabilitate as fast as we can, while following protocol, in order to reach previous or higher levels of function.
Q: With Direct Access in Tennessee, do you find that many patients come to see the PT first for treatment, before going to their primary care provider?
Dave: People are starting to realize they can save time and effort and start the recovery process sooner by going directly to a physical therapist. At the Bone and Joint Institute of Tennessee, we do see direct access patients. Because we have such well-trained physicians, I feel very confident seeing those patients. Our therapists are highly trained in musculoskeletal care, but we’re also trained to see the red flags that may require physician evaluation. If needed, we can send rehab patients to physicians for consult. They’re literally right down the hallway.
Q: What are some of the physical therapy modalities that set the Bone and Joint Institute apart?
Dave: We offer a full range of modalities: heat and ice, ultrasound, iontophoresis (the use of steroids to treat inflammation), as well as specialty therapies like kinesio taping to decrease swelling or facilitate proper movement action. We have therapists trained in IASTM and ASTYM which are treatment techniques that deal with the mobilization of soft tissues. In addition, we have a vestibular rehab specialist, and several of us have gone through training and extensive education to help people with inner ear disorders or balance issues. Sometimes those issues can come along with a knee injury, for example. While we’re treating the knee, we can also focus on getting them back to a safer, functional life and decrease their risk of fall after surgery.
We also offer dry needling to treat soft tissue lesions or areas of pain or muscle restriction, known as trigger points. In short, what sets our practice apart is that we not only have the experience to competently treat a wide variety of patients, but we have the tools and the training to address almost every orthopedic need. Additionally, a lot of what we do is education. We truly listen to patients and the patient is always actively involved in their care.
Q: Tell us about the Occupational Therapy services offered.
Dave: In addition to our seven physical therapists and three PT assistants, we have three occupational therapists (OT) who treat everything from the shoulder to the fingertips. Two of our OTs are Certified Hand Therapists (CHT). Only about 50% of people who take the CHT exam even pass, so we are very fortunate to have them. Our third OT will sit for this exam later this year.
CHTs do a lot of specialized orthosis/splint making for tendon repairs, fractures, and post-operative hand surgery recovery. They add something to not only our staff but the community as a whole. It’s really rare to have the skill that our department has been blessed with through these OTs. It’s wonderful for our patients that we can provide on-site splinting.
Between the total staff of Physical and Occupational therapists, we have 146 years of experience in our two locations. The ability to collaborate not only with our physicians and nurses in-house, but to collaborate within our own department makes the Bone and Joint Institute of Tennessee a destination site for any physical therapy need.
Q: Thanks, Dave, for taking the time to chat. It sounds like you all are doing some rewarding work at the Bone and Joint Institute of Tennessee!
Dave: Absolutely. It’s never boring. We are always working to improve the patient experience and thinking about what we can do as individuals and collectively to improve our care. It’s challenging, but this is a really rewarding profession to be in and the reason why I’ve been able to do it for so long and still look forward to coming into work every day.
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