A PHYSIATRIST: Taking a Look at the Big Picture

Physical Medicine and Rehabilitation (PM&R) physicians known as physiatrists (fizz-EYE-ah-trist) are medical doctors who have graduated from medical school and have completed 4 years of residency training. The specialty is a very small one beginning with WWII when many military personnel returned home with various disabilities from the war. Over time the specialty has grown and now board certified physiatrists care for those with amputations, stroke, spinal cord injury, and traumatic brain injury, including concussions.

In addition to these conditions, physiatrists may also have sub-specialty certification in the management of sports medicine injuries. While they complement orthopedic surgeons in their care, they do not perform surgery, preferring to treat the injured athlete utilizing the most effective research-based non-surgical care. In addition physiatrists do not limit their care to only one area of the musculoskeletal system but instead focus on the interaction of how one link in the kinetic chain may affect the rest of the problem (i.e., “the shin bone’s connected to the knee bone” philosophy). For instance an overhead athlete such as a tennis player with recurrent shoulder pain may have inflexibility to their hamstrings or weakness of the hip muscles as the underlying issue. Similarly, a runner with knee pain may have difficulty with absorbing shock due to ankle and calf mobility issues.

While an athlete’s history and examination will often determine the cause of an athletes’ condition, a physiatrist will often utilize musculoskeletal ultrasound (US) to examine the injured area. Musculoskeletal US, much like that used to examine a pregnant woman, is able to use sound waves to determine if any ligaments, muscles, or tendons have been sprained or torn. Unlike MRI, claustrophobia is not a problem using US and the patient can actively move the injured tissue to give a dynamic picture to the physiatrist. This allows the physiatrist a glimpse as to what is happening at the tissue level. In this way they are better able to give an athlete a more accurate diagnosis as well as guide appropriate therapy.

360-ORTHOPEDICS believe in treating the whole person so you can get back on your feet, back to work, back in the game, and back to life. We have three convenient locations and are able to accommodate same/next day appointments.

Paul Lento, MD is a Fellowship Trained / Triple Board Certified PM&R physician with a subspecialty in sports medicine. He specializes in the non-surgical treatment of various musculoskeletal conditions to determine if the problem is mechanical, inflammatory, or degenerative.