Q: What is your background and what led you to a career in physical therapy (PT)?

Dave: I grew up in western Montana and kind of always was drawn to the sciences. I thought I wanted to be a physical therapist. Then I was a college athlete and I saw guys go through some pretty devastating injuries. A really good friend of mine tore his ACL, so I watched him rehab that and he came back the next year, a better athlete. That’s when I really started getting hooked. Not only just because he came back, but because he came back better than he was before and actually was a better athlete. That was inspiring to me. I then went through undergrad, went off and got a chance to play football after college for a while, and then came back to the University of Montana and finished up. I knew that was the right choice for me from the start.

Courtney: I was a multi-sport athlete growing up, in and out of different injuries, but not any season-ending injuries – I dealt with doctors and PTs along the way. I always knew I wanted to be in the health care field, so when I was at the University of Alabama, I shadowed a few different physicians and then PT’s. I saw what kind of impact PT’s could have, as well as the one-on-one time you get with patients. I ended up choosing that route, went to the University of Southern California, and started my PT career there, and just have loved it ever since.

Q: Can you give an overview of Rehabilitation Services here at Bone and Joint?

Dave: We’ve been open as a Bone and Joint Rehab Services for about a year and a half. We have the location in Franklin, and we also have a location in the Tollgate Medical Plaza down in Thompson’s Station. Right now we employ seven PTs, three PTAs (Physical Therapy Assistants). We also have three Occupational Therapists. Two of those Occupational Therapists are certified hand therapists, which is an additional certification they obtain through extensive training. Only about 50 percent of people pass that exam, and it’s basically a specialization for hand therapy. On top of that, we have a great receptionist staff that we couldn’t manage our days without. They are a huge part of who we are as well. The services that we provide are head-to-toe physical therapy – we treat everything from neck and back injuries to post-operative and sports injuries. The Occupational Therapists provide rehab services from the shoulder to the fingertip, and also do a lot of specialized splinting and making orthoses and things like that.

Q: What populations do you treat?

We’re here for the community. The main thing that we want to do is help out people who live here. The only thing we really wouldn’t see is infants. But we treat kids very young – as young as six or eight years old, all the way up to our geriatric populations. I think it lends itself to being a pretty neat setting for us because we see all kinds of people from the community. You get a wide mix of people. It’s great to see the interplay of the ages. Sometimes some of your hardest workers could be your eighty-five year old, and it’s funny because you’ll see them motivate young kids. But then you’ll see an athlete working out in there, too, and they’re inspiring to somebody else. Then somebody will come in with similar injuries and they might have just had a total knee replacement, for example. They can look across and be like, “well, what did that guy have done?” Then a patient may share, “that was me four weeks ago.” And they’re like, “no way, I could be doing what you’re doing in four weeks.” So it’s neat to see the interplay between all the different populations in the clinic. And I think it makes it a pretty high energy fun place to be.

Q: We know that sports medicine is a huge part of Bone and Joint Institute. We are involved in the local sports community. What are some of the most common sports injuries that you see here? And how do you address their injuries and get them back in the game?

Courtney: I would say one of the most common ones we see, especially right now, is ACL injuries. Some we see before or after surgery, some we see that aren’t having surgery. What I think we pride ourselves most on here is our individualized care. Every athlete’s journey is totally different. Most of us were athletes in the past, so we know what kind of journey they’re going through and how they need to be treated as individuals. So one of the things we do, we collaborate with the physicians right out of the gate. We know the exact surgery they had, what they’re going through, and collaborate with them throughout their continuum of care, which is really, really important. We also don’t really go by timelines. We’re really looking at these athletes in a functional way, testing them as they go just to make sure that they are ready to return to sport. We look at evidence-based practice, so testing batteries of different things so we can make sure each individual is ready to return to play. We have something called the DorsaVi, which is a sensor-based system that gives us objective data to give to the doctor, but also be able to collaborate with the patient and their parents and be able to show them – are they ready or do we need to extend the plan of care? I think the most important thing is that every patient is different, every athlete is different, and we can individualize their care appropriately.

Q: Tell us about the sports medicine, rehab, and the relationships we have here in the community.

Dave: We talked about the continuum of care and the cooperation between the doctors and our team, but there’s such a psychological issue that happens when you have a bad injury. There’s that, “gosh, am I going to do it again?” My team does a great job of providing that psychological component and being encouraging from the get-go. A big part of that is just education and saying, listen, this week’s going to be really hard, next week is going to be a little bit better. These are your goals and this is what we expect to see – but realize, this is the timeline for your injury, so what you need to do is let’s focus on the here and the now, but always remember that there’s a tomorrow. I think that helps a lot, and it helps the parents as well to understand what the goal is, because I know as a father, that’s what I would want. And so I think that’s a big part of what we do – the educational component and building the confidence in moving forward. Obviously, we try to provide the best care we can, which is why we’re big into evidence-based practice and making sure that we’re not only just going for the goals that we know that they need to hit to get through the protocol, but also the goals of functionally what they want to get to. And that’s different. That’s why being good listeners and making sure that you’re incorporating the patient’s goals into the sports medicine rehab program is really important. Another thing that we really pride ourselves on is getting people to their highest level, and that means being better than you were before. That’s important to us – making sure that that you see us not just doing the minimum for you. I want them to be confident and feel just like my friend did that got me into PT, watching him go back to sporting better than he was before. The other thing that we have that’s just an absolute blessing is our partnership with Williamson Medical Center, we provide athletic training to a lot of the high schools around here. We also have athletic trainers that we communicate with, so if a high school athlete gets injured and start transitioning away from us, we have someone who has been involved in their care, who knows them, and can take over where we left off. 

Q: How does Rehab Services make us a destination for orthopaedic care and provide comprehensiveness to our practice?

Courtney: Talking to athletic trainers, and everybody outside of the walls of our building, is so important. It takes away from just the medical side of things and helps us treat everyone like an individual, which we pride ourselves on. One of the things I love, and I’ve worked in a few other clinics before coming here, everyone is so experienced – I am the least experienced person on staff, and I have six years of experience. We have people with 15, 20 years of experience. We’re able to learn from each other and we draw from and challenge each other. We’re also able to collaborate right there with the physicians. I can’t tell you how many times we’re down the hallway talking with the physicians about who we’re seeing and giving them updates – it’s just such a team approach. We’re able to see everyone’s x-ray images, whether they’re going into surgery or coming out, which is huge because it gives us a bit of a better picture of what’s going on with the patient and why some people might be progressing quicker or slower than others. It’s not just me treating a patient, from the second you walk in, even our front desk staff, all collaborate together to create the best possible experience for the patient.

Dave: This is a group of physicians that comes to us and wants our opinions. We have roundtable discussions with them and we go around the table and say, “where are we missing something?” We can work with each other to collaborate and provide information and expertise. It’s really easy for doctors to get busy with patient care and their lives, but the fact that they sit down and take the time to go through things with us is huge to me. The Bone and Joint Institute is also able to assist with most any bracing needs patients require through the use of our in-house Durable Medical Equipment (DME) team. They are very helpful to Rehab Services as they ensure that any braces used after injury or surgery are not only well-fitting but maintain the patient’s safety as their mobility and function improve during their time with us. Not only are we working on trying to be good, but we’re working on being the best and doing things we’ve never done. We want to take rehab to a level that no one else does – that is the ultimate goal.

For more information about our Rehabilitation Services Department, visit Rehabilitation Services, or call 615-791-2640.