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Direct Access to Physical Therapy

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MADISON – For world-class triathletes like Madison's Jim Bruskewitz, the real opponent is time. And time's opposition presents itself in ways other than the seconds he tries to shave off his running, swimming and biking tallies while training for competition.

Bruskewitz, a lecturer in the kinesiology department at the University of Wisconsin and a performance trainer for endurance athletes, encountered a potentially devastating setback while training for the 2008 BG Triathlon World Championships, which were held in Vancouver this past June.

In May, Bruskewitz suffered a grade one hamstring strain. It was three weeks before the championships. Time was not on his side.

"People who injure themselves always feel like they're up against the wall. It's magnified if the race is close," he says. "The injury came at a horrible time. I needed to see someone quickly. "

Knowing he had to heal in a hurry, Bruskewitz contacted UW Health physical therapist Marc Sherry, who works in the Sports Rehabilitation Clinic at Research Park, through the Direct Access program.

Direct Access provides most patients with an option to access to physical-therapist services without a physician's referral. UW Health offers Direct Access physical therapy through its sports rehabilitation and spine physical therapy programs.

Bruskewitz called the Sports Rehabilitation Clinic and told them about his injury. Clinic staff referred him to Sherry, whom he e-mailed. Two hours later, Sherry returned Bruskewitz's e-mail.

"He said, 'You need to see me right away,'" Bruskewitz says.
 
Sherry met with Bruskewitz two days later. After diagnosing a hamstring strain, Sherry, who works to return both high-level and recreational athletes to training and competition, posed two questions to set the course for rehabilitation.

"What do we need to do to get the injured tissue to heal as quickly as possible?" Sherry says. "And what can we allow him to do to continue his training and not put the injured tissue at risk?"

The running component of Bruskewitz's training was the biggest challenge. Hoping to improve his acceleration and explosiveness, he was doing a lot of sprint work. Unfortunately, Sherry says, "hamstrings are most susceptible to injuries when sprinting, because of the stride length."

That meant the sprints were out, replaced by a series of drills that put less pressure on the hamstring.

"He could still do his distance work but we had to limit his speed work," Sherry says. "We changed a lot of his training to agility drills, things that were more side-to-side but still fast and explosive, so he wasn't extending his hamstring to its full length."

Bruskewitz engaged the new regimen with the intensity and dedication one might expect from someone who won the gold medal in his age bracket at the 1999 ITU World Triathlon Championship. But he was still fighting time, and the Vancouver competition was not a given.

"For a hamstring injury of that degree, return to sport is usually about 21 days," Sherry says.

"Obviously it wasn't the best situation," Bruskewitz adds. "We were right on the borderline."

In the end, Bruskewitz's success – he placed fourth in the 55-59 year-old bracket despite the cancellation of the swim, his strongest event, due to rough weather – can be attributed to the speedy diagnosis afforded by Direct Access and his superlative fitness.

"I ended up competing and ran without pain," Bruskewitz says, and adds that without Sherry's immediate response, "there's a good chance that it wouldn't have gone nearly as well as it did. No one wants to (have to wait for therapy) when you're hurt. If you're training and can't do anything, that's very difficult to deal with. Getting this help was great, because athletes want to focus their efforts and have confidence in what they're doing."

"He was different than most athletes in his preparation to that point, so a lot of the credit goes to him," Sherry says, but adds that the Direct Access process cuts down on a lot of the back and forth that too often burdens the therapy scheduling process. "There's a high level of frustration if people have to wait (for treatment). Our physical therapists are educated and skilled enough to evaluate if the patient needs physical therapy. If they do, you start the treatment right away."
 

Date Published: 07/25/2008

News tag(s):  ortho

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