Mock PT Telehealth Session Transcription

Michael: “Hey, Erin?”

Erin: “Yes.”

Michael: “Hi. Nice to meet you. I’m Michael.”

Erin: “Hi, Michael!”

Michael: “I’m going to be your virtual physical therapist.”

Erin: “Sounds good. I’ve never done this before. So…”

Michael: “It’s understandable. A lot of us really haven’t done this before, but I guess, right now, this is the thing that is the easiest for everyone. So, following the link wasn’t too hard to find?”

Erin: “Nope. I got the email, clicked on the link, just put my name in. and then here we are, so it was pretty easy.”

Michael: “Perfect. Ya and I got the forms that you filled out, um, from the front desk.”

Erin: “Okay.”

Michael: “So, those all look pretty good, but I understand you’re here for some right knee pain.” 

Erin: “Ya, ya. It’s been going on for about a month, and I decided to kind of just, well, come in, but now virtually. Get a PT appointment and see if there’s anything I can do to kind of help it.”

Michael: “Ok, what happened? How did it all start?”

Erin: “I was doing a lot of hiking--”

Michael: “Okay.”

Erin: “And, you know, kind of going up and down a lot of hills, and then I started getting some pain and discomfort. So right now, I think the things that are bothering me the most are probably stairs and going down more so than going up.”

Michael: “Okay.”

Erin: “And then, kind of uneven surfaces and going down hill.”

Michael: “Okay. Where is the pain? Can you actually like show me or point to it?”

Erin: “You see my knee okay?”

Michael: “I can see it. Ya!”

Erin: “I’ve got my slippers on. Haha!”

Michael: “No worries!”

Erin: “I’m kind of having pain right in here.”

Michael: “Like on the inside or kind of like around your knee cap?”

Erin: “Ya, kind of just around.”

Michael: “If you actually poke around your knee cap, are there any spots that are really tender?” 

Erin: “Right here is a little bit tender.”

Michael: “Okay, and then on top of the knee cap?”

Erin:  “A little bit, but not as -- not too much.”

Michael: “Ya, actually on top -- on top.”

Erin: “Oh! Top, top.”

Michael: “Ya, does that hurt a little bit?”

Erin: “A little bit, ya.” 

Michael: “Okay. Okay. Since -- since -- since the hiking and the knee pain, have you continued to be able to do any of those things or is that been really tough?”

Erin: “I’ve honestly kind of avoided doing them for now just because it started to get a little bit too painful. So, I’ve just been doing some -- some walking, but keeping it pretty level and not doing a lot of up and downs, and hiking and stuff.”

Michael: “Got ya. So, what I'd like to do today is kind of see how you move to see what’s the best way to address that knee pain. So, I might have you do a couple of things if you don't mind moving the camera around a little bit to help me out.”

Erin: “Okay.”

Michael: “That would be awesome.So, we’ll be a little bit creative with how we look at things.” 

Erin: “Okay, sounds good.”

Michael: “The first thing I’d like to look at is how you do a squat.”

Erin: “Okay.”

Michael: “So, just basically like getting up out of a chair.”

Erin: “Do you want me to just show you that motion or --?”

Michael: “Ya, if you can move the chair out of the way. Can I see you do it front view, and then can I see a side view of you?”

Erin: “Yup. Okay. Let me see if -- is that -- does that work there?”

Michael: “Ya, that looks good.”

Erin: “Okay. Okay.” 

Michael: “Can you do it one more time? Okay. Does that hurt when you go down like that, the same way as stairs or going down a hill?”

Erin: “Ya. Ya. Similarly, ya.” 

Michael: “Okay. Can I see a side view of you?”

Erin: “Okay. Can you see okay there?”

Michael: “Ya. I can see. Okay. One more time, please. Okay. Awesome. Does it -- it doesn't get worse as you’re doing it right?”

Erin: “No, it just feels it doesn’t-- the pain isn’t worse every time, but it just feels the same.”

Michael: “Okay. That's an awesome set up actually. Do you mind -- can you get on the floor? We can move the foam roller out of the way.”

Erin: “Ya!”

Michael: “There's just one other thing I want to check out.”

Erin: “Yes. Okay.”

Michael: “And, if you lay on your back so I can get a side view of you, that would be awesome.”

Erin: “Okay.” 

Michael: “Alright.”

Erin: “Does that work?”

Michael: “Ya. That looks good. Can you straighten out the right knee for me, as far as you can straighten it out? Okay. And then, can you bend it as far as you can bend it, and can your foot flat on the ground? Okay. Any pain going either of those two directions?”

Erin: “No. That actually feels okay for the most part.” 

Michael: “Okay, so basically the pain happened when your foot was on the ground, when you’re weight bearing.”

Erin: “Ya.”

Michael: “Okay. Can I see the left side really quickly?”

Erin: “Yup!”

Michael: “Straighten it out. Oh, ya. That’d be awesome. Thank you. And then, go ahead and bend it when you’re ready. Okay perfect! Okay. So, from watching you move and just seeing a couple of things that it seems like the pain is really just limited based on when your feet are on the ground. You’re weight bearing, which is when your pain comes on normally. And, to me, that seems like it's a strength problem. And, part of the way that you're moving right now, it seems like you use some muscles a little bit more than other muscles.”

Erin: “Okay.”

Michael: “What I'd like to try to do is give you one exercise to try to get you to use some other muscles to go down slopes and stairs.” 

Erin: “Okay.”

Michael: “I’d also like to -- do you have a rolling pin available?”

Erin: “I do. Ya.”

Michael: “Okay. I’d like to try to give you something to massage out some of your muscles that might be getting used too much.”

Erin: “Okay.”

Michael: “If you want to go grab that first.”

Erin: “Yup.”

Michael: “And then we can go over both of those things.”

Erin: “Okay. Okay.”

Michael: “Alright. So, the first thing we can do -- let's actually use the rolling pin. And so, I don’t -- I want you to try to roll out. Let's see if you can see me now. Roll out the front of your thigh. I wouldn't go all the way down to the points that are bony.” 

Erin: “Okay.”

Michael: “Stay on the parts that are like a lot of meat.”

Erin: “Okay. Do I do it sitting or standing like you were?”

Michael: “So, you can do it sitting. Why don’t you try that out first.”

Erin: “Okay.”

Michael: “The second place that might work better is if you’re sitting in a chair with your knee bent a little bit.”

Erin: “Okay.”

Michael: “ The goal of it is to just get those muscles to relax.”

Erin: “Okay. So, you said staying kind of up and not getting down into the lower part.”

Michael: “Ya, and not too far down.”

Erin: “Okay. Oh, ya. That’s a little tender!”

Michael: “Okay. So, if you focus on some of those tender spots and just get them to relax, that might help out with a little bit of your knee pain.” 

Erin: “Okay, cool. Ya, I’ve been noticing that it’s been feeling pretty tight up here, so…”

Michael: “Okay. Awesome. Awesome. Well, this is the first way to address it.”

Erin: “Okay.”

Michael: “The second thing I’d like to try out is an exercise called ‘a clam.’ Can I have you lay on your side?”

Erin: “Sure. Which side?”

Michael: “Doesn’t matter. We’ll just try out both of them.”

Erin: “Okay.” 

Michael: “And so, with your knee and ankles together, can you just bend your knees a little bit? Alright. The goal of this exercise is to get you to use your glutes a little bit more. And so --”

Erin: “Okay.”

Michael: “Exercise is, keeping your ankles together, can you just separate your knees using your butt?

Erin: “Okay.”

Michael: “Why don’t you try out ten?”

Erin: “Okay.”

Michael: “Hold on one second. It seems like you’re rolling backwards a little bit when you're doing that. Do you feel like your butt is getting a workout there?”

Erin: “Not yet.”

Michael: “Okay.”

Erin: “Was I rolling back a little bit?”

Michael: “A little bit. If you keep your hips rolled down--. Why don’t you finish up and do maybe about five more? And, just let me know if it feels more like you're using your butt.”

Erin: “Okay. Ya. I can feel that more.”

Michael: “Okay. Awesome. No pain, right?”

Erin: “Nope. No pain there.”

Michael: “Okay. Why don’t you just roll over and we’ll try the other side.”

Erin: “Okay. So, I was going to ask, do the knees need to be up higher or were they okay where they were?”

Michael: “They look okay where they are. And, the main thing is if you feel it in your glutes, then you’re doing great.”

Erin: “Okay. Okay.”

Michael: “Remember to keep the hip forward.”

Erin: “Okay. It feels more challenging on this side.”

Michael: “It seems like it might be. And, those are the muscles that I think you’re not using quite enough when you go down stairs or slopes.”

Erin: “Okay. Okay.”

Michael: “Alright. So --”

Erin: “How many repetitions and sets do you want me to start out with?”

Michael: “So, I’d like you to start off with three sets of ten. And, what I’m going to do is I’m going to write up a little home exercise program with pictures.”

Erin: “Okay.”

Michael: “And then, I’m going to email those to you right after we hang up this call. Okay?”

Erin: “Okay. That sounds good.”

Michael: “Do you have any other questions for me today?”

Erin: “No. I don’t think so. I think this is going to be really helpful. I can definitely tell that it was a lot more challenging to do that on the right side, so...”

Michael: “Okay. Awesome. Well, I'm going to -- going to hang up the call and I’ll print off and actually email you those exercises right now.”

Erin: “Okay. That sounds good.”

Michael: “Alright. And, I’m going to have the front desk call you to set up some -- some more appointments. Okay?” 

Erin: “Okay. Great!”

Michael: “Alright. Take it easy.”

Erin: “Thank you!”

Michael: “Bye.”

Erin: “Bye.”