My second clinical rotation brought me into a more familiar setting—outpatient orthopedics—working with patients who were highly motivated to return to peak performance, whether for recreational activities, active duty, or demanding jobs. Many of the cases I encountered involved common musculoskeletal conditions such as rotator cuff tears, tendinopathies, and various knee pathologies, including patellofemoral pain syndrome (PFPS), osteoarthritis, and patellar tendinopathy.
One case that particularly stood out involved a patient referred to physical therapy for bilateral knee osteoarthritis. They had already completed several rounds of physical therapy with minimal improvement. After a thorough evaluation and collaborative discussion with my clinical instructor, we discovered that one knee was also affected by patellar tendinopathy. This finding shifted our treatment plan significantly. We introduced isometric exercises and a progressive tendon loading protocol tailored for patellar tendinopathy. Within just four sessions, the patient reported less sharp pain when climbing stairs. This experience underscored the importance of a detailed assessment and differential diagnosis in clinical practice. While we often rely on clinical practice guidelines, applying them made a lasting impression on me.
Another unexpected takeaway from this rotation was the opportunity to integrate pain neuroscience education into treatment. During our final didactic semester, we completed a course in pain neuroscience that reshaped how I think about persistent pain. Initially, I assumed the athletic population at this clinic would have little need for such education. However, I quickly realized that many patients, regardless of their activity level, benefit from understanding the biopsychosocial model of pain. Incorporating these concepts, along with consistent positive reinforcement, helped build trust and enhance patient outcomes.
What I appreciated most about my time at OrthoSport was the dynamic learning environment. Shadowing multiple therapists with diverse treatment philosophies allowed me to see the many effective ways physical therapy can be delivered. This variety helped me begin to shape my approach to care. Moving forward, I plan to integrate my personal training background with evidence-based screening tools and clinical guidelines to deliver individualized, functional, and efficient care for my future patients.