So, but 99% of the time,
barring a tree falling on someone's house,
we rarely really edit stuff.
It really is supposed to be
a conversation.
Sounds great.
All right,
let me hit play and we'll do this thing.
Welcome to Orthostatic,
a product of the Academy of
Orthopedic Physical Therapy.
Welcoming our guest today,
an accomplished educator
and clinician making
strides in our profession
of physical therapy with
dual board certification in
orthopedic and sports physical therapy.
She is a recognized expert
in our profession.
Dr. Keri Rothschild, welcome to the show.
Thanks for having me.
Good morning.
All right, we're diving in in this,
a great overview or a macro,
a zoomed out episode for the show.
We wanted to create this
because we wanna start with the basics.
We harp on that all through
PT school and through our careers,
which is make sure you know
the fundamentals and the basics.
So I think there's no
question that's too simple
and we should avoid asking it.
So that's why my very first
question is gonna sound so simple.
I think we agree it's important to ask,
which is,
What is orthopedic physical therapy?
And maybe how does it differ
from other physical therapy specialties?
I remember when I was just a student,
I probably could name two
or three different types of
physical therapy.
And then I got exposed to a
whole lot more.
So how do you answer that
question in terms of how is
what is orthopedic physical
therapy and how does it
differ from other physical
therapy specialties?
Sure.
I think it's a great place
to start this conversation.
I think that for orthopedic
physical therapy,
when you think about orthopedic,
if you dissect the root word,
you're going to get some
information about Greek
word meaning deformity,
but ortho meaning deformity
and pedic meaning kind of
as the body grows.
But when we kind of zoom out
and look at what it is,
it's really dedicated
knowledge and expertise in
the musculoskeletal system.
So we're talking bones,
we're talking joints,
we're talking tendons,
we're talking fascia.
And of course,
the neurovascular structures
that accompany all of those body parts.
So really,
it's the physical therapist that
is dedicated to the
musculoskeletal system.
and improving the movement
and musculoskeletal health
of an individual.
And it's a little different
from some of the other specialties.
I think orthopedic physical
therapy is probably maybe
what the lay person might
know most about coming into
physical therapy school.
Maybe they've had some
physical therapy for a
sprain or a strain or
something like that.
But there are a vast number
of other specialties that
include neurological,
which focus on neurological injuries,
such as strokes, spinal cord injury,
And then we've got pediatrics,
which focus on younger people.
And we've got geriatrics,
which focuses on the
conditions of older individuals.
And then we've got some
unique specialties like
cardiovascular and
pulmonary and wound
management and oncology and
women's health.
So I think orthopedics
actually kind of falls in a
little bit of all of those because,
of course,
we have kids that have
orthopedic injuries and
we've got older adults that
have orthopedic injuries.
So
I think to start with that,
musculoskeletal expertise.
All right, well,
if we're jumping into that,
it feels like orthopedic
physical therapy covers a
lot of our profession,
what people might think of
physical therapy if they're
not in the profession.
So let's go with commonalities.
What are the most common
conditions treated by
specifically orthopedic
physical therapists?
Anything that has to do with a bone,
a joint, a tendon, a ligament, a muscle,
maybe nerve compression.
I think orthopedic physical
therapists see a lot of spine pain,
primarily lower back, neck pain.
I think we see different
conditions of tendons,
like tendinopathies, overuse conditions.
We also see lots of ligament sprains.
So you think about an ankle
sprain or an ACL sprain in
the knee or a tear.
And then we do a lot of work
with post-operative rehabilitation.
So once those structures are
injured and they have to be
repaired surgically,
we're looking at the back
end of that and protecting
those surgical repairs and
helping that individual get
back to the things they
like to do through a
strategic musculoskeletal
rehabilitation plan.
Let's talk about something
else that I don't know if I
was prepared for when I
went into PT school,
but it seemed to be everywhere,
and that's evidence-based practice.
Help us understand why
evidence-based practice in
orthopedic physical therapy
might be so important.
It's very important,
and I actually get a chance
to teach orthopedic
physical therapy in the DPT
program that I am a professor in,
and I think it's super important.
Evidence-based practice
includes the patient's preferences,
it includes the clinician's expertise,
as well as the best
evidence from research perspectives.
i think the field of our
orthopedic physical therapy
is constantly moving
forward we have new
evidence new research that
comes out on a regular
basis and so it's important
to make sure that
clinicians orthopedic
specialists specifically
are are looking at this
evidence and what does it
say what should we be doing
for a lateral elbow
tendinopathy for example and so
Some of the great work that
comes out of the Academy of
Orthopedic Physical Therapy,
along with some of the
sports physical therapy as well,
is the clinical practice guidelines.
And that's a nice summary of
all of the best evidence to
treat and manage different conditions.
So I think we give the best
care to patients from an
orthopedic perspective when we
Yes,
we utilize our own expertise as a
clinician,
and we also take into account
the patient's preferences,
but then we really back
that up with some good
research that is going to
help improve the outcomes
of the patient in the most
efficient manner.
Well said.
Let's move on to maybe the
first contact that a
patient might have with a
physical therapist,
and that's the initial assessment.
What assessments are critical,
and why is the initial
assessment so important in
orthopedic physical therapy?
As part of that initial assessment,
first thing that a
therapist needs to do is
rule out any red flags.
Those might be some things
that are alarming to an
orthopedic physical
therapist that might
warrant a referral to a
different healthcare provider,
kind of outside the scope
of what we could be able to treat.
Another thing we want to
pick up as an orthopedic
specialist is some of those yellow flags,
which are some of the
psychosocial factors that
influence the patient's condition.
But ultimately,
we want to get to the point
of doing a good physical examination,
and that includes doing
some range of motion,
some strength testing, some special tests,
because the best we can do
is finding the root cause
from a pathological standpoint.
We want to know what
structures are involved,
but we want to take into
account all these other
things as we look at the
individual as a whole.
We definitely want to make
sure that we're doing
the tests and measures that
are appropriate for that body part,
as well as given the
timeframe post-injury.
Now, you mentioned evidence-based practice,
and that is terribly
important in the research,
but how might orthopedic
physical therapists stay
current with the latest treatments,
the technologies, things change rapidly?
How do people stay up to
date in the profession?
You know,
we are bombarded with information.
I think one thing we do have
is a plethora of resources.
We've got lots of journals.
We've got the Journal of
Orthopedic and Sports Physical Therapy,
which presents a lot of
great content for
orthopedic physical therapists.
as well as the physical
therapy journal also has an
orthopedic section typically every month.
I think we've got lots of
information coming at us
from different podcasts, for example,
from different YouTube sites,
for example.
We've got webinars,
we've got constant ability
to take continuing
education now in a virtual format.
I love getting emails that
give me some new information.
Oh,
this new clinical practice guideline
came out.
I'm a podcast junkie,
so I love listening to
podcasts on my drive into work.
I think those are really
some great informational sources,
as well as our professional
organization and the
Academy of Orthopedic
Physical Therapy has got a
lot of good resources on
their website as well.
Good to hear that you listen to podcasts,
being that you're on one.
Yeah.
Finally,
since this is a product of the
Academy of Orthopedic Physical Therapy,
again, as a PT student,
I was exposed to the APTA
as a student and started to
figure out and learn all
the different places around
that one association that I
could learn from.
So specifically for AOPT or
the Academy of Orthopedic
Physical Therapy,
what do you think are some
of the benefits
specifically for a new grad
physical therapist for
joining something like the
Academy of Orthopedic Physical Therapy?
You know,
I've been a member of the Academy
of Orthopedical Physical
Therapy for 25 years since I graduated.
I do believe that the
Academy's website is continually updated.
I think you've got access to
people so you can meet and
contact different people
that might be in a
in a community that is
aligned with something that
you're interested in, like pain,
for example.
There's lots of resources.
You've got access to the journal,
access to clinical practice guidelines,
access to the special groups,
the communities as well.
If you're interested in volunteering,
there's ability to do that.
You can find that through the academy.
And also,
you can do some service and
volunteer in some different
areas that might be
within that skill set you
have or something that
you're learning and growing.
Yeah.
It sounds like to summarize people,
information, people, and opportunities.
Absolutely.
All right.
We didn't prepare you for this,
but I'm always confident
that this never catches an
educator off guard because
you always seem to have
some words of wisdom.
So the last thing we do on
the show is called words of wisdom.
What would you want to leave?
What's one thought or
sentiment you'd want to
leave with the audience
today as we wrap up?
So if you're interested in
orthopedic physical therapy,
I would definitely advise
finding a mentor.
I think the mentors are
invaluable in whatever
specialty practice you end up doing.
But I think having a go-to
person that can answer questions,
help provide some guidance,
and also give some good feedback,
whether we want it or not,
I think mentorship is huge.
And so I would definitely
put that as a little nugget
to take forward.
Yeah,
I'd like to give a nod to my mentor
who was my former professor.
And now she hates when I
call her my former professor.
She says,
you should just call me your
friend because we're still friends.
But having that person who's
maybe seen some things or
just maybe walked a little
bit ahead of you in a
career to be able to suggest,
because again,
she won't give me any answers.
She's a great educator.
She won't give me any answers,
but she keeps asking me
questions to keep me on track.
Carrie Rostrad,
we appreciate you coming by
Orthostatic and sharing with us today.
Absolutely.
Thank you.
All right.