PTCAS Personal Statement Prompt 2021-2022

If you're applying for a Doctor of Physical Therapy (DPT) Program for the 2021-2022 cycle, you're in the right place.

This year's prompt matches last year's prompt which is:

Every person has a story that has led them to a career. Since there are a variety of health professions that “help” others, please go beyond your initial interaction or experience with physical therapy, and share the deeper story that has confirmed your decision to specifically pursue physical therapy as your career.

This is an elaborate way of asking... Why physical therapy? Why PT above all other health professions?

If your answer is simply, "because I want to help people," I'm going to be the one to tell you that you're going to need to dig a lot deeper than that. The prompt literally asks for a deeper story.

You don't have to have been a patient in PT to want to apply to PT school. I hadn't been a patient myself before I applied to school. Through observation hours and more, I found my calling in PT. I share my "PT why" in my personal statement for the 2013-2014 cycle here.

If you're finding yourself scrambled on how to write your essay or even how to start, a coaching call may be the best option for you. I've helped several pre-PT, pre-OT, pre-PA, and pre-med, students with their personal statements, and they've successfully been accepted. I specialize in finding the deeper WHY and making sure the writer is showing, not telling. 

If you've already have what you think is a close-to-final draft, I also provide consults to go over the essay with an unbiased view and help you bring in an emotional touch to your story to captivate the reader. I had a less than ideal application and I believe my personal statement helped me stand out. Read more about my less-than-ideal application here.

Good luck to all of those applying! And follow @clinicalsprinkles on Instagram for more application tips and learning about the life of an outpatient ortho PT.

Pros and Cons of a Percussion Massager

If you're wondering whether you should get a percussion massager, you're in the right place. This blog post will answer your questions.

If you prefer to learn via video, here's a link to my YouTube video where I give an in-depth, honest review.

What is it?

A percussive therapy tool is used to improve mobility and blood flow to the applied body region by sending repetitive taps to the region applied to, like a jack-hammer. This can be used to reduce recovery time or reduce pain. As a physical therapist, I would apply this as a supplement to my normal treatment methods. But this would definitely save my hands in terms of soft tissue work for patients. Soft tissue including tendon, muscle, capsules, and fascia. I can use my hands more for joint mobilizations that the percussion tool isn't able to perform.

Who is it used for? 

People with muscle aches or pains. It can be used for athletes including runners, weight lifters, cyclists, basketball, baseball, you name it. It can be used for office workers looking for relief in between the shoulder blades or in the pec region. It should not be used for patients with chronic pain disorders that are hypersensitive to stimulus.

Pros

  • Saves hands from doing soft tissue work
  • Reduces time in treatment spent on manual therapy so it can be spent on therapeutic exercises or functional training
  • Easy to use
  • Increasing mobility and range of motion
  • Reducing aches/pain
  • Stimulates an increase in blood flow to the region being targeted

Cons

  • Hard to access areas like the upper back and around neck/lower back when performing on self
  • Cost, not covered by insurance
  • User error, if you don't know how to apply it, its effect may not be great

What it does NOT do

  • Evaluate or diagnose musculoskeletal conditions
  • Joint mobilizations
  • Treat pain in isolate
  • Eliminate the need for a proper warm-up

Which one to buy?

I've tried a couple of different types and one of my biggest factors is the sound.

Some percussion devices are LOUD and the one that I've liked is relatively quiet which is the Back Hammer (BH$50 saves you $50 from the sale price).

This device has speed settings from 1-20 and can tolerate being pressed pretty hard on the muscles by the person handling the device. It also has 6 different attachments that vary based on the target tissue.

Questions?

Send me a message on my page here with the subject line "Percussion Device" so I can help.

Orthopedic Residency Q&A for Physical Therapists

These were some questions/answers I had put together with the help of my peeps from my Instagram story 11/10/2020 regarding my experience with an orthopedic residency. So thank you to those who contributed questions.

 

How long did it take?

Two years.

 

How much time out of work did it take?

It is hard to put a true number to this! However, there were several weekend courses that were spread over the course of two years. There were 6 600-level NAIOMT courses and three additional lectures, pharmacology (in-person), imaging, and research (online). Plus studying for the CMPT (certified manual physical therapist) certification and OCS (orthopedic certified specialist) exams. But this was manageable with working 40-hours per week.

 

What was the most valuable part?

MENTORSHIP. I had an amazing key mentor that followed me from the beginning to the end of the residency and he helped me grow as a clinician. The first year was recognizing and performing manual techniques and special tests. The second year was about putting the puzzle pieces together and building clinical patterns. I valued my key mentor immensely and included experience with other PTs as well.

Legendary PTs shadowed me working with patients and vice versa. Each experience, I walked out with something new.

 

Which residency did you do?

The one I completed was offered through my employer, Therapeutic Associates Inc. It was an orthopedic residency with a focus on manual therapy with a structured curriculum surrounding NAIOMT (North American Institute of Manual Therapy).

 

How much did it cost?

The cost was dependent on how much course work I already had completed. Over the course of two years, I had my paycheck deducted ~$142 every two weeks which ends up being $14,768 over the course of two years.

 

Was it worth it considering the financial strain?

Yes, 100%. Although it cost, $14k, the mentorship and method of accelerating my clinical skills and pattern recognition are priceless. I strive to be the best physical therapist I can be for patients and starting early in my career was invaluable. The plan was for my company to pay it back to me over two years of working with the company post-completion however, I was laid off from COVID-19 and didn’t return. I don’t regret the investment in my career.

 

Are residency programs standardized/accredited?

Yes. Residency programs are held up to a standard by the APTA and become accredited. There are minimum requirements for the curriculum and are dependent on the type of residency (ie. sports, manual, neuro, etc.).

 

Do you have to do a residency in order to sit for the OCS?

No. There are two options: (1) complete an APTA-accredited residency within the last 10 years or (2) “Applicants must submit evidence of 2,000 hours of direct patient care as a licensed United States physical therapist (temporary license excluded) in the specialty area within the last ten (10) years, 25% (500) of which must have occurred within the last three (3) years.” per the American Board of Physical Therapy Specialists website.

 

When should I apply?

When you are ready and when you plan to start. Depending on the program, there are different start dates throughout the year. I personally liked working for 1-year before applying to develop my own style and gain experience. There were many peers that were in my cohort that just graduated PT school less than 6 months before the start of the residency program. In my opinion, if you were to start one, I’d recommend starting within the first three years of working as a PT.

 

Did your work offer an in-house residency?

Yes! They did which made obtaining hours and collaborating with colleagues within the company/residency very easy. 

 

Residency or certification?

You can get certifications without a residency. For example, I earned the Certified Manual Physical Therapist (CMPT) within the residency but that certification is not exclusive to residents. I performed an orthopedic residency so I can’t speak much towards a sports residency. 

 

Are you able to be as thorough as you were in residency as you are in your daily practice?

Yes, 100%. If anything, more thorough. On days of mentorship, we filled out clinical reasoning forms for each patient to lay out subjective, objective measures, interventions tried so far, and our assessment of how the patient has progressed (expected or not expected). This practice is helpful and carries over to my daily practice and makes me more efficient and effective as a PT!

 

I hope you found these answers helpful in weighing the decision of whether to pursue a residency program. I highly recommend it. If you have more questions, feel free to send me a question on the Contact page or DM me on Instagram!

Differences between a PT and PTA

I have been a physical therapist (PT) for 4 years so far and honestly, I didn’t know about physical therapist assistants (PTA) until I started my observation hours and I had already decided to pursue a career in PT.

Now that I’ve worked closely with PTAs and can compare our jobs, I created a list of the differences between a PT and PTA in the table listed below.

*The numbers are a generalization as it varies greatly between schools and regions. This is more of a representation of the difference between the two options.

Although I would love to have WAY FEWER student loans, I am too curious to not be a PT because it provides me a set of tools and knowledge to assess and diagnose conditions. Also being able to dictate a plan of care for patients and problem solve through differences in individuals or changes in POC feeds my mind. 

I am happy with my decision to be a PT and I wouldn’t change it if I were to go back. I’d just tell myself to be a little smarter with spending, saving, and taking out less in loans.

Inspirations for Clinical Sprinkles

I started my Instagram page over a year ago and was sharing my experiences with learning within the orthopedic residency and it was a mix of PT and fitness.

Not until the Coronavirus did I really buckle down and create a business out of this page to change my IG handle to @clinicalsprinkles.

The page has grown into a platform where I help pre-PTs, student PTs, and current DPTs to develop professionally and clinically.

As a pre-PT, I had a less than ideal application with a relatively low GPA and average GRE scores. My application was enhanced by my extracurriculars and personal statement. Hear my personal statement here. I have helped many others with their essays before creating this page and they have locked in their placement into their dream schools. I realized I have a talent for building an emotional connection with a reader and want to share this with others. Find out more about how I help with this here.

For student PTs, I have created resources to help prepare for clinical and what to look for in a job. I share my tips on my YouTube page and also on my website.

Throughout my 4 years of practicing as an outpatient PT,

I found myself saying, “wow, I wish I would have known about this sooner”

multiple times. So I’m sharing “clinical sprinkles” with you to help you stumble less and make progress with your patients sooner. Also, become a better communicator and listener. Both of which are essential skills for this job.

My inspirations come from my experience and my passion for helping others. I want to help others grow within this amazing profession and help build each other up.

Imposter Syndrome as a Physical Therapist

I lacked confidence for the first year out of school and had a lot of anxious feelings the first six months after graduating. Was I helping my patients? Will they get better? Would they be better off with another PT?

These are struggles I dealt with as a new grad PT and with more experience, I’ve learned to become more confident. I was able to trial and error, observe and learn patterns, and receive feedback from PTs I looked up to.

I’ve created a list of things that helped me create a mindset for success for those struggling with Imposter Syndrome:

Be over-prepared. I spent time after work studying and getting ready for my next day of patients. And I super-extra prepared for the patients that normally weren’t on my schedule and was very nervous to treat my boss’ patients. The more prepared you are, the fewer curveballs, right? Wrong. Make sure you don’t spend too much time after work because it is still healthy to have time to decompress. So set a certain amount of time aside and try to stick to that (for example less than 45 minutes).

Play out different scenarios in your head. Before you bring patients back, think about how you’d expect them to feel after their last session and also a scene where they’re flared up. Be mindful not to put blame on your own treatment/intervention. Sometimes the patient will reveal that they did something out of your control like a household chore non-stop for 3 hours.

Tone of voice. The way you present the information carries a lot in how the patient will receive it. If you say a lot of “ums” or soft-spoken, it may come off as you’re unsure. Be mindful of how you’re saying things. Or words you emphasize on like “abnormal” or “degenerated” may generate fear. 

Use more confident phrases. For example, “you have” instead of “I think you have” or “you will get better” vs “I think you’ll get better” can be perceived very differently. The patient will have more trust in you if you carry more confidence in your voice and how you say things.

Don’t act surprised when an intervention works. I’ve had it where a patient is surprised after treatment that they feel better immediately. Don’t act surprised with them (even if you are). Tell them that you expected that. 

Give your patients expectations. Be clear in your communication with the patient of what you expect after an intervention. Should they expect to be sore afterward? Should they feel better? After doing a new exercise, do they know what delayed onset muscle soreness is? Giving a patient of what you’d expect, especially if it can be misinterpreted as a regression, can also build confidence with the patient in you because you predicted it was going to happen. So that way when they’re sore a couple of days later, they’ll think, “it’s okay because Pauline told me I might be sore.”

The common theme throughout confidence is clear and direct communication. We went through a lot of schooling (7 years to be exact) to earn our Doctorates in Physical Therapy. We know a lot. It’s okay to not know everything but as long as we keep reaching for resources to learn, things will be more than okay. If you’re having struggles with a patient case or want to talk more, join me for a Virtual Office Hour.

6 Tips to Increase Home Exercise Adherence

Patients need to be active players in their recovery as well. We know this as PTs, but we need to teach our patients this concept.

Here are some tips to try

  • Understand why they’re doing an exercise⁣
  • When best to use an exercise⁣
  • A short yet concise list (3-5 exercises)⁣
  • It is convenient – minimal equipment and positions they already spend most of their time in
  • They know that some exercises can be broken up throughout the day instead of all at once⁣
  • Keep them accountable – ask them if they’ve been doing it⁣

Ask yourself if you’re implementing these strategies when creating a home exercise program.

Another method I’ve tried is asking the patient how much time would they be willing to give for exercises each day. Is it 10 minutes? 15 minutes? Great. Keep this time frame in mind when creating the program but even make it shorter. For instance, I give them 5 exercises for home but point out my top 3 out of the 5. If they do the 3, that makes me happy. If they do all 5, that makes me elated.

And then give positive reinforcement when they tell you that they’ve been doing their exercises. They want to be appreciated and acknowledged when they gave their time outside of their session to do the exercises. 

I hope these tips are helpful to you and your patients!

School Supply List for Physical Therapy Students

First off, congratulations on making it into a Doctorate of Physical Therapy program! This is a huge accomplishment and you should be very proud of yourself. The programs across the country are incredibly competitive. Huge high five!

Now for your school supplies and essential for PT school… These are items required for the lab portion of PT school, the best part, am I right?

So I’ve taken the time out of shopping around and picking the best-valued items from Amazon to make it easy for you to shop. Some of the links have different color options. 

Goniometer: https://amzn.to/3f7Y0kR (12” for neck, shoulder, elbow, forearm, knee), https://amzn.to/3eVKz7n (6” ankle, wrist)

Stethoscope: https://amzn.to/38ocfzp

Blood pressure cuff: https://amzn.to/2NMTFr0 

Reflex hammer:  https://amzn.to/2VHHHU2

Gait belt: https://amzn.to/2C2FlrE

Pen light: https://amzn.to/3grSn17

Clipboard with PT cheat sheet: https://amzn.to/3eY2biT 

Pulse oximeter: https://amzn.to/2OzeKFZ

Other things that I would recommend but didn’t link because are too many good ones to choose from and should be personalized:

  • Planner
  • Set of colored pens
  • External hard drive
  • Water bottle

These items are linked through Amazon’s Affiliate program and I will receive a commission if you purchase through these links.

Is Therapeutic Ultrasound Still Being Used?

I took a poll on my IG story last week and the results surprised me.

The majority voted no but, I’m still surprised that 36% of people said that they do. 

I started a new job recently in another outpatient orthopedic clinic and they use ultrasound here… a lot.

I’ve used more ultrasound in the past three weeks than I have in the last 3.5 years of practice!

I tried to do the “let’s try a session without it and see how you do” explaining how the treatment effects are short term and the benefits of an active warm-up instead. But the patients requested ultrasound to be brought back in more than 75% of the time in the following session.

So I’ve collected information and will be doing a clinic in-service on ultrasound in a couple of weeks for the clinic staff. If we’re going to be using it, let’s be sure we’re using it appropriately. 

Keeping in mind, best absorption of ultrasound energy is in the tendon, ligament, fascia, joint capsule, and scar tissue.

Table 1. Indications, contraindications, and precautions for therapeutic ultrasound.

Table 2. Parameters for Use of Ultrasound

Table 3. Comparing the difference between thermal vs non-thermal effects.

Most of these notes were gathered from my PT school notes (graduated 2016).

There’s a concept called “triangulation” we learned in PT school which connects evidence-based practice, provider experience, and patient choice. There technically is evidence that supports the efficacy of ultrasound. And if the patient strongly wants the treatment intervention, they’re likely going to feel better as a result of receiving the treatment, to an extent.

If the patient lacks progress, I’ll pull the intervention and be able to use this as a reason to discontinue the service in replace of another one. But for now, I’m doing it for some patients and it’s a very different practice than where I came from.

Check out this blog post about more differences I’ve found between my last job to the one I’m at now. 

Outpatient Ortho vs. Outpatient Ortho

I practice physical therapy in an outpatient orthopedics clinic. It’s been almost two weeks working at a new one and I’ve found many differences. Differences that make me feel like I have to change the way I practice. Here are some of the differences and what/how I’ve changed.

Working with a chiropractor. Patients are being treated by a chiropractor within the same session of me treating them. Thrusting through the spine multiple times may be overtreating and will not be beneficial for the patient. I am a manual therapist and have trained with thrust manipulations (grade V’s). But not all of the patients see a chiropractor so, I can still use them for patients that don’t see the chiropractor. But when we do share patients, I need to be clear in my communication when speaking with her to let her know the areas I worked on and what my target is for my treatment intervention.

Modalities. This clinic is heavy on the use of ultrasound which I used to use 1x or less in a month at the clinic I worked at before. In DPT school, we did learn that ultrasound has its place for tissue remodeling (pulsed setting) and deep tissue heating (continuous). However, I prefer to use active methods to warm tissues. Coming into an already existing patient load, I’ve dabbled with taking ultrasound away but some patients request for it to be brought back in. Part of my style of treatment is shared decision making which is including the patient in their treatment plan. So for those who still want ultrasound, I add it back in.

Manual Therapy. I am a Certified Manual Physical Therapist (CMPT) and have earned this certification through the North American Institute of Manual Therapy (NAIOMT). I consider myself a skilled manual therapist but this clinic uses a ton of STM (pettrisage and effleurage). My hands and fingers were dead tired after doing this for one patient!! So I’ve also dabbled with changing the amount of this treatment with some patients and have shown them other methods or self-mobilization techniques so that they become less reliant on passive treatment with studies that show only temporary relief.

Wellness visits. After a patient has completed functional goals and pain is resolved, the patients are encouraged to keep up with “wellness visits” and come monthly for check-ins. I used to discharge patients and have them come back if something is wrong but the model here is that patients may not come back until the pain has progressed and it’s harder to turn around. In theory, having monthly check-ins will reduce this from happening. Being there for only two weeks, I haven’t encountered this discussion yet.

It has been challenging to change my style and method of how I want to treat patients but, after a lot of reflection… I realize I need to change my mindset to also look at the similarities between both. I have realized the end goal is still the same. Help the patients out of their pain, get them moving better, and guide them to achieve their goals.