Setting:
Outpatient Orthopedics

Patient Population:
Primarily older adults with post-operative total joint replacements (TKA, THA), osteoarthritis, and general deconditioning. Occasional patients with balance deficits, chronic pain, or mobility limitations related to aging or inactivity.

Common Diagnoses:

• Total Knee Arthroplasty (TKA)
• Total Hip Arthroplasty (THA)
• Knee and hip osteoarthritis
• Generalized weakness and reduced endurance
• Postural instability/fall risk

Interventions & Responsibilities:

• Guided patients through therapeutic exercise progressions focused on strength, gait, and function
• Performed supervised manual therapy (joint mobilizations, soft tissue work) as indicated
• Led balance and proprioceptive training sessions
• Modified home exercise programs to match goals, ability level, and motivation
• Educated patients on joint protection strategies and long-term maintenance
• Managed caseload flow, took progress notes, and communicated effectively with patients and staff

CI:
Sean Reinertson, PT, DPT – a skilled and approachable clinical instructor who fostered a collaborative, hands-on learning environment.

Reflection:
My first clinical at C. Foster & Associates was the foundation of my confidence as a future physical therapist. I had the opportunity to take on the full responsibilities of a PT in an outpatient setting, managing patients with a wide range of orthopedic and age-related conditions. Working with post-op TKA and THA patients showed me how impactful early intervention and personalized care can be on recovery outcomes. I especially valued working with the geriatric population — helping them regain independence and confidence reminded me of why I chose this field. Sean, my CI, challenged me clinically but always had my back, and he encouraged me to think critically, treat compassionately, and lead with both knowledge and energy. This rotation helped solidify my commitment to orthopedics while deepening my appreciation for the slower, more thoughtful aspects of functional rehab.

Setting:
Outpatient Sports and Orthopedic Physical Therapy

Patient Population:
Primarily pediatric to early adult athletes, ranging from recreational to competitive levels. Populations included gymnasts, football players, endurance athletes (marathoners, cyclists), and other high-functioning individuals recovering from orthopedic injuries or overuse conditions.

Common Diagnoses:

• Post-operative ACL reconstructions
• Shoulder impingement and instability
• Lumbar and cervical strains
• Patellofemoral pain syndrome (PFPS)
• Ankle sprains, tendonitis, and other sport-specific injuries

Interventions & Responsibilities:

• Progressed patients through advanced therapeutic exercise, return-to-sport, and neuromuscular control drills
• Incorporated plyometrics, agility, and movement pattern corrections into rehab
• Led dynamic warm-ups, cooldowns, and functional testing sessions
• Developed injury prevention strategies tailored to specific sports
• Provided education on biomechanics, training volume, and recovery
• Practiced hands-on techniques like soft tissue mobilization and proprioceptive taping

CI:
Beth Riemersma, PT, DPT, FAAOMPT, SCS, ATC, LAT Clinical Director – a former athletic trainer and seasoned clinician with strong expertise in sports rehab. Her dual background provided a dynamic learning environment focused on bridging performance with evidence-based care.

Reflection:
This rotation was hands down my favorite clinical experience so far. Working with athletes from youth to early adulthood brought out the best in me as a student and future sports physical therapist. These patients were motivated, high-functioning, and eager to get back to their sport — and I was all in with them. I thrived in the faster-paced, performance-based environment and learned how to tailor programming to meet the unique demands of different sports and personalities. Beth, my CI, was phenomenal. Her background as both an athletic trainer and PT gave me a hybrid perspective on rehab, and she pushed me to refine my critical thinking, progressions, and patient engagement. This experience reinforced my desire to pursue my SCS and CSCS, and made me feel completely at home in the world of sports rehab.

Setting:
Inpatient Acute Rehabilitation

Patient Population:
Adults and older adults with complex medical conditions, often recovering from significant surgeries, trauma, or neurological events. Many patients presented with functional mobility limitations and required multi-disciplinary care for safe discharge.

Common Diagnoses:

• Post-Cerebrovascular Accident (CVA/Stroke)
• Coronary Artery Bypass Graft (CABG) recovery
• Gunshot wounds (GSW) and polytrauma
• Sepsis-related debilitation
• Post-amputation care (TTAs, TFAs, UE amputees)

Interventions & Responsibilities:

• Assisted patients with bed mobility, transfers, ambulation, and ADL retraining
• Monitored vitals and exertion responses during therapeutic activities
• Participated in interdisciplinary care planning and patient/family education
• Performed neuromuscular re-education and gait training with assistive devices
• Documented progress using functional outcome measures (FIM, 10MWT, etc.)
• Practiced safe guarding techniques and built rapport with medically complex patients

CI:
David Avelar, PT – an experienced inpatient therapist who served as both a knowledgeable clinical instructor and an encouraging mentor. His guidance made the hospital environment feel welcoming and manageable.

Reflection:
Coming into this rotation, I was nervous. I had never worked in a hospital before and wasn’t sure inpatient rehab was for me. But working at PAM Health changed that. Under the mentorship of David Avelar, I gained the confidence and skills to function effectively in an inpatient setting. He didn’t just teach me how to be a PT in this environment — he helped me appreciate the emotional strength and critical thinking that inpatient care requires. I worked with patients recovering from strokes, amputations, and serious surgical procedures, and witnessed how powerful PT can be in restoring hope and independence. By the end of the rotation, I found myself no longer resisting the idea of working in inpatient care — in fact, I found value in it. This experience expanded my clinical comfort zone and reminded me that growth often begins where comfort ends.

Setting:
Outpatient Orthopedic and Pelvic Health

Patient Population:
Broad range of patients including athletes, orthopedic post-surgical cases, vestibular conditions, pelvic floor dysfunction, and chronic or acute musculoskeletal disorders. Patient age ranges from adolescence to older adulthood, with varied levels of functional demand.

Common Diagnoses:

• Status post ORIF (ankle, clavicle, wrist, etc.)
• Bankart lesion repairs and other shoulder instability conditions
• Total Knee Arthroplasty (TKA)
• Vestibular dysfunction (BPPV, post-concussion, gaze instability)
• Pelvic floor dysfunction and core instability
• Extra-articular pain syndromes and movement system impairments

Interventions & Responsibilities:

• Managed a full patient caseload with autonomy in treatment planning and progression
• Performed evaluations, progress notes, and discharge summaries using Raintree EMR
• Applied evidence-based practice daily under CI guidance and reflection
• Led interventions including return-to-sport training, functional strength programs, and movement retraining
• Integrated manual therapy, therapeutic exercise, neuromuscular re-ed, and education
• Collaborated with CI on complex patient presentations, including vestibular and pelvic health cases

CI:
Dr. Xiomara Doster, PT, DPT, OCS – a highly experienced clinician in orthopedics and pelvic health with a teaching style grounded in clinical reasoning and evidence-based care. Dr. Doster has played a significant mentorship role in my development and has made a lasting impact on my growth as a future sports and orthopedic therapist.

Reflection:
This final clinical rotation has been the most meaningful and influential of my DPT journey. Under the mentorship of Dr. Doster, I’ve not only advanced my clinical skills but gained full autonomy and confidence as a future practicing clinician. Her approach to teaching is exceptional — blending compassion, evidence-based guidance, and a constant push to critically think and apply new knowledge.

A unique aspect of this rotation has been her intentional decision to assign me a high volume of athletes, knowing my aspirations to obtain the SCS, CSCS, and OCS. I’ve treated patients post-ORIF, Bankart lesion repairs, and other sport-related injuries, allowing me to begin carving out my future specialty while still a student. Every day has felt like a preview of the career I’m working toward — and I’m showing up ready.

This experience has confirmed my passion for outpatient orthopedics and sports rehab and has helped me begin to embody the doctor of physical therapy I’ll officially be on August 23, 2025.