A day in the life of a physical therapist

Jul 21, 2016, 08:33 AM by KirstiAnn Clifford
Nina Hernandez
Nina Hernandez 2
Nina Hernandez stands atop a fitness ball on one leg, demonstrating a stability exercise by slowly bending her knee while maintaining her balance.

“Let’s try 15 of these in a nice and slow, controlled movement,” she says to a patient, with an encouraging smile.

As a physical therapist at UTMB’s Sports Medicine and Rehabilitation clinic on the League City Campus, Hernandez brings indispensable energy and enthusiasm to her work helping those with injuries or disabilities manage pain, restore mobility and improve their overall quality of life.

When I join her at 7:30 a.m. on a Wednesday morning, she’s already working with her first patient of the day, who recently had knee surgery for an anterior cruciate ligament (ACL) injury. I’m immediately struck by the large, open gym area, complete with an indoor turf field and resistive and cardio equipment. (Hernandez and her colleagues moved from a smaller Brittany Bay location to LCC in June). Hernandez shifts her patient to a stationary bike, where she guides him through various movements as she tries to pinpoint the cause of his kneecap pain.

“Most patients I see have problems with their knees, back or shoulders,” says Hernandez, who is an orthopedic certified specialist and also works with sports injuries. “I’ll see between 10 and 15 patients a day, so it’s really busy. Here at our clinic, we get more moderate- to high-functioning individuals, so a lot of ‘weekend warriors,’ athletes, teenagers and active adults and seniors. We want to get them back to their sport or job quickly, but safely.”

Hernandez knows from personal experience how important physical therapy is to get back on your feet (literally) following an injury. Growing up, she saw her mother go through several hip surgeries and got a glimpse into the role of rehab and recovery. Then, as a high school student and competitive swimmer, Hernandez developed a huge tear in her rotator cuff.

“They wanted to do surgery and I said no, so I went through an intense six months of rehab,” she says. “That’s when it really intrigued me, and I knew I wanted to have a career in physical therapy. I’m really interested in what goes wrong when the body is injured—what do you do?”

Hernandez increases the incline on a treadmill for a patient who is undergoing rehab for a conditiont hat causes loewr back and leg pain.Hernandez puts her problem-solving skills to the test with each patient, carrying a laptop around the gym to document the exercises they complete, pain levels and treatment goals. She spends about 45 minutes for initial evaluations with new patients, looking at their medical history and providing objective testing and mobility measurements to help form a treatment plan.

She says goodbye to her first patient, who she says has come along way for being four months post-op. She hopes to give him the all-clear to head back to his physically demanding job soon, once he can perform all exercises with no pain.

“He is progressing nicely, but it took time to get there,” says Hernandez. “I respect the healing of tissue and stay within the ranges that the patient and their doctor is comfortable with. As the pain subsides, we do more complex exercises. After ACL surgery, it usually takes six to nine months to return to sports and four to six months to return to work, and I’ll see patients one or two times a week during that time.”

Frequently, she sends patients home with exercises to do on their own, as well. As she preps for her next appointment, she says how important it is for patients to be committed to putting in the hard work necessary to recover.

“Some of the most basic things we teach them can make the biggest differences in their lives,” said Hernandez. “But I can’t go home with them and tell them what to do—they have to be willing to put in the time and dedication to get better. I try to educate them as best as I can on why they are having pain and what they can do on their own to get back to feeling as normal as possible. In our clinic, evidence-based practice is very important and helps us provide high-quality patient care with quicker results. I include the patient every step of the way and make sure they understand why the treatment plan is so important—they have to be a ready and willing participant or it just won’t work.”

By 10 a.m. I’m ready and willing to rest on a stool and watch as Hernandez works upNina Hernandez 4 a sweat showing her third patient how to do squats without putting pressure on their lower back. She’s constantly on her feet, crouching, bending, repositioning patients’ limbs and laughing when one stability pose reminds her of “The Karate Kid.” It’s hard not to have a good time with Hernandez.

“There’s two rules in PT: no falling and no passing out,” laughs Hernandez, who stays active in her spare time and tries to set a good example for patients. “We don’t want to overdo it, but we also want to make sure patients stay challenged and keep progressing.”

One of her patients tells me Hernandez is the perfect mix of fun and down-to-business. “I like to joke with her and give her a hard time, but I need someone to give it to me straight. She’s honest with me, which I like, and she doesn’t let me cheat.”

Before heading back to Galveston, I see Hernandez work with a patient with degenerative arthritis. In the afternoon, her schedule is full of teenagers undergoing post-op rehab for sports injuries. She tries to get students through the most intensive part of rehab during the summer months, so they won’t miss much class once school starts back up.

Hernandez reflects on her own experience as a high school student with a sports injury, smiles, and gets ready to bring mobility, strength and hope to another thankful patient.