Welcome to OrthopaedicProtocols.com
There are two objectives in the successful management of musculoskeletal (MSK) injuries;
- The restoration of anatomy (often referred to as ‘healing’; achieved through a period of ‘protection’)
- The restoration of physiology (often referred to as ‘rehabilitation; achieved through progressive ‘exercise’)
Protocols exist in healthcare to help patients achieve the best possible outcome.
- Protocols help healthcare professionals in making informed decisions and recommendations to patients based on their clinical presentation at any given point in time.
- In the event that surgery is required to restore anatomy, these patients will typically receive a post-surgical rehabilitation protocol provided by their surgeon.
- In the event surgery is not required, these patients will typically require a non-surgical treatment plan and rehabilitation protocol provided by an orthopaedic physiotherapist (often in collaboration with a family physician, sportsmedicine physician or orthopaedic surgeon).
- Protocols are not a ‘universal recipe’ for every patient with the same condition, but rather a framework that outlines a safe, appropriate and progressive pathway that is individualized by a physiotherapist and / or surgeon based on the patient’s clinical presentation.
Inherit to the process of writing a protocol is;
- Knowledge of the injury, condition or procedure and biological healing timelines.
- The awareness of risk factors that could have a negative impact on the final outcome (i.e. inadequate rest, premature activity, delayed activity)
- The inclusion of language to minimize the occurrence and impact of these risk factors. (i.e. short term goals, timelines, etc).
In my professional opinion, it’s the responsibility of every healthcare professional to;
- Conduct a thorough MSK assessment consisting of a history, a detailed description of the patient’s subjective complaints and thorough physical examination.
- Use a differential diagnosis approach to arrive at a valid and reliable “clinical” diagnosis.(i.e.anatomical tissue(s), severity of injury).
- Educate the patient on their diagnosis, prognosis, biological healing timelines and an evidence-based treatment plan for their condition (i.e. set realistic expectations, responsibilities, timelines)
- Develop and educate the patient on a safe, appropriate and progressive non-surgical treatment plan and rehabilitative protocol (protection to facilitate tissue healing and rehabilitation pathway)
- Monitor the trajectory of the patient’s subjective complaints and rehabilitation and – in the event the patient is not progressing on schedule – be open to getting a second opinion or revising the clinical diagnosis, current treatment or rehabilitation plan.
- In the event of surgery, adherence to the post-surgical protocol provided by the surgeon.
- Educate the patient on their role and responsibilities in executing their treatment plan and rehabilitation program as prescribed as well as the consequences of non-compliance and/or delayed action.
Written Protocols help co-ordinate collaborative care to prevent clinical problems and consequently help compliant and engaged patients to achieve the best possible outcome.
The views expressed here are my own alone and not those of any provincial, national or international orthopaedic or physiotherapy body/ organization. If you’re a healthcare professional and interested in more information on post-surgical or non-surgical protocols, I invite you to email me at firstname.lastname@example.org .
Terry Kane Registered Physiotherapist
Founder / Owner OrthopaedicsCanada.com Network
Rural Canadians can now connect with one of Canada’s most experienced orthopaedic and sports physiotherapists without leaving home.
ABOUT TERRY KANE
Since 1985, Terry has worked with some of the top Orthopaedic Surgeons, Sports Medicine Physicians and Chronic Pain Specialists in Canada as well as treated over 500 Olympic and professional athletes.
A graduate of the University of Toronto, Terry has served as Team Physiotherapist with Canadian Olympic Hockey Team and Calgary Flames, as well as a physiotherapist with The University of Calgary Sport Medicine Centre, Calgary Chronic Pain Centre and Calgary West Central Primary Care Network.
In addition to his clinical practice, Terry has spoken at conferences such as the American College of Sports Medicine, the University of Calgary Department of Orthopaedics (Glen Edwards Day), University of Calgary Department of Continuing Medical Education’s Calgary Chronic Pain Conference, consulted to the National Hockey League Injury Analysis Panel as well as served as an editorial reviewer with The Physician and Sports Medicine and the Clinical Journal of Sports Medicine.
Terry has also served as a volunteer with the Alberta Health’s Bone and Joint Strategic Clinical Network, a contributing developer of a MAINPRO-C Course on Chronic Pain Management For Family Physicians and a contributing author to Foundations of Professional Personal Training textbook published by Human Kinetics.
Terry currently works for a group of Primary Care Physicians in Calgary, as well as sees patients in-person and online. For more information on seeing Terry in-person, please visit www.terrykane.ca
THE FUTURE OF ORTHOPAEDIC CARE IN CANADA.
There are Canadians with muscle and joint pain who get better at home everyday without requiring hands-on treatment.
Online consults with experienced orthopaedic physiotherapists like Terry Kane, allow rural Canadians to get answers to their questions as well as treatment advice without leaving home.
Should I see a physician? What should I do to get better? What shouldn’t I do?
Rather than travelling long distances to see a physiotherapist, Terry Kane is now able to connect with patients on their computer, tablet or mobile phone to assess, educate, provide home based treatment recommendations and rehab exercise programs as indicated (videos).
Terry Kane ‘coaches‘ patients online with orthopaedic conditions in the following ways;
⇒ Conducting online assessments to ensure patient safety and to form a working diagnosis.
⇒ Ensuring patients are on the right clinical pathway for their condition .
⇒ Providing patient education on their condition
⇒ Providing education on strategies to reduce flare ups of pain and how to self-manage pain flare ups.
⇒ Designing safe, appropriate and progressive rehab exercise programs.
⇒ Helping post-surgical patients with following their rehabilitation protocols.
⇒ Monitoring patients to ensure their making progress as expected or according surgical protocols.
⇒ Communicating with other healthcare professionals as indicated (physicians, surgeons)
YOUR SAFETY IS OUR TOP PRIORITY EVERYDAY.
If Terry Kane has any health or safety concerns about you at any time, he will discuss them with you and offer to contact the most appropriate healthcare professional with his recommendations.
To further ensure patient safety, Terry uses a computer application known as Physitrack, that allows patients to contact him by confidential and secure text messaging. This allows you to contact Terry quickly so he can stay on top of your questions and status at any time.
YOUR PRIVACY IS PROTECTED EVERYDAY
As a registered physiotherapist, Terry is required to maintain the privacy of any and all communications with patients. All electronic communications and online appointments are conducted via a HIPAA certified secured video platform (Physitrack) and all clinical patient records are saved in a HIPAA certified secured electronic medical record system (Cliniko).
A key part of Apple’s Mobility Partner Program since 2015. Physitrack is already used by 20,000+ healthcare professionals including MD’s, surgical specialists, physical therapists and chiropractors from around the world.