Dr. Heather Cramer, DAT, ATC is an Athletic Trainer (AT) with El Dorado Physical Therapy clinic in Folsom, California. She works alongside other ATs, physical therapists (PT) and physical therapy assistants (PTA) in providing care to patients in an orthopedic outpatient physical therapy clinic.

Describe your setting:

Working in an outpatient physical therapy clinic, I treat patients from ages 3 to 99 who come to our clinic with a variety of orthopedic injuries, post-surgical, acute athletic injuries and chronic pain. I provide patient care in the form of manual therapy, neuromuscular re-education, strength and rehabilitation exercises, preventative exercises and biomechanical evaluation, along with recommendations for future strength and conditioning depending on what activities or work the patient is returning to.

How long have you worked in this setting?

I have practiced with this company for 14 ½ years and have practiced in the physical therapy setting for a total of 16 ½ years.

Describe your typical day:

On a typical day, I have a variety of patients and my job with each patient may vary. For the 8 hours I am scheduled in the clinic, we schedule patients every 15-30 minutes depending on the patient’s status and staff available. We thrive on a team approach when treating our patients, and we aim to keep clinical staff consistent for each patient.

Sometimes I have a patient for the first half of their treatment and other times I have them for the second half. Patients are assigned to me based on the plan of care laid out by the primary evaluating PT. I work in conjunction with 7 PTs in my office, determining what each patient may need and if my specialties are required or that of another colleague.

In one day, I may see anywhere between 12 and 30 patients. If I have a patient for their first half of treatment, I have 30 minutes to provide hands-on techniques such as Mulligan techniques, myokinesthetics, astym, neurodynamics, muscle energy techniques, joint mobilizations or soft tissue mobilization. Then, I may transfer the patient to another AT, PTA or physical therapy aide for their second half of treatment.

If I have a patient for the second half of their treatment, I may perform manual therapy if the PT believes more is necessary. Usually second half of a treatment involves instruction and supervision of rehabilitation exercises. Occasionally, I will be supervising 24 people in a 30-minute span.

What do you like about your position?

I like the variety of patients and injuries that I see on a daily basis. I like the challenge of thinking outside of the box because every patient is unique and presents differently. I also really like working with all of my colleagues because we each have different education and backgrounds so we can constantly bounce ideas off of each other, reach out to each other when we have hit plateaus with patients and get different perspectives. There are 2 ATs, 7 PTs, and 3 PTAs in my office so we have a lot of knowledge to share. Sometimes the PT is asking me for advice, and sometimes I am asking a PT or PTA.

What advice do you have about your practice setting for a young AT looking at this setting?

Every PT clinic is different in their main focus of practice, so my first recommendation is to get clinical rotations or internships in different ones. Some are mainly rehab and exercise/movement-based in their treatments. Others are very manual therapy-based with a lot of hands-on treatment. And some are a mix of both areas.

Secondly, I highly recommend continuing education courses across a broad spectrum of manual therapy techniques, movement analysis and the latest rehab exercises. I have learned from the 20 plus ATs and PTs I have worked with that it’s always good to have a broad toolbox of paradigms to choose from for treatments, even if you have 3 or 4 that are your typical go-to treatments. And lastly, NEVER STOP LEARNING!