PMR Clinic OP Rotation

PMR Clinic OP Rotation

PM&R Residency Program Manual
PM&R Resident Rotation Descriptions

PM&R Outpatient Clinic: Spine & Sports Care Rotation  – Dr. Robert Wilder
During this rotation PM&R residents will learn appropriate assessment and management strategies in outpatient rehabilitation medicine with an emphasis on musculoskeletal disorders of the spine and extremities, including sports medicine. Time is spent evaluating and treating general outpatient rehabilitation patients, plus residents will develop and sharpen skills necessary for the management of the injured athlete. Residents will perform history and physical examinations of patients with musculoskeletal disorders of the spine and extremities, and order and interpret ancillary testing when appropriate (x-rays, advanced imaging including MIRJ, CT, CT Myelogram, nuclear studies, ultrasound, laboratory testing). They will generate differential diagnoses of patients with musculoskeletal pain complaints, and describe appropriate rehabilitation treatments and, when appropriate, recommend needed consultations. Time is also scheduled in the Rheumatology Clinic, and the P&O Clinic.

This rotation also involves some mandatory sports medicine event coverage of such items as track events (Charlottesville Marathon, 10K, Women’s Four-Miler), football games, football clinics, and various other sporting events. The resident who is on this rotation during football season will cover each of the Monticello High School Friday night games, and each Saturday morning football clinic.

Goals and Objectives:

  • Understand the importance of a specific diagnosis for spine-related disorders, with specific treatment based on this diagnosis.
  • Understand the anatomy, biomechanics and pathophysiology of spine-related disorders.
  • Assist and learn how to assess patients with acute, sub acute, and chronic spine-related disorders. 
  • Learn when and when not to use specific diagnostic tools for spine-related disorders, such as x-ray, CT, myelography, MRI, and EMG.
  • Participate in care of EMG’s and understand how the exam benefits the patient and his/her spine treatment. 
  • Understand and observe the specific use of lumbar epidural, selective epidural, facet joint and sacroiliac joint injections as an important adjunct in therapeutic management when properly indicated.  Also, understand the risks of these procedures as well.
  • Understand and implement acute, sub acute, and chronic spine rehabilitation and its importance, with the goal of returning the patient to as high a functioning level as possible. 
  • Understand the importance of a specific diagnosis for musculoskeletal/sports injuries, with specific treatment based on this diagnosis.
  • Learn the anatomy, biomechanics and pathophysiology of musculoskeletal/sports injuries.
  • Learn how to assess patients with micro traumatic, and to a lesser extent, macro traumatic musculoskeletal/sports injuries.
  • Understand musculoskeletal/sports injuries due to overload in relation to the site of injury, the associated biomechanical deficits and functional adaptations. 
  • Understand musculoskeletal/sports rehabilitation and its importance, with the goal of returning the patient to as high a functioning level as possible. 
  • Participate in sports-specific EMG/s and understand how the exam benefits the patient and his/her injury treatment.
  • Learn when an when not use specific diagnostic tools for musculoskeletal/sports injuries, such as x-ray, CT, arthrography, MRI, and EMG.
  • For each patient you evaluate, an attending physician will also evaluate the patient.  After evaluating the patient, you will discuss and implement a plan of care with the attending.