When you play music for a living, your art becomes an extension of who you are. The soundtrack of your life changes with your mood – you play when you’re feeling happy, you play when you’re feeling stressed, and even when you’re feeling pain, the beat goes on. As physical therapists we often see two kinds of trauma in musicians – that caused by repetitive use and unrelated pain due to an injury. Either way, pain in your shoulders, elbows, neck, hands, etc. can make it very difficult to keep the music alive.
Alexis Del Palazzo spent many years as a professional musician until she suffered a playing-related injury that brought her passion to a halt. To treat her pain, she was introduced to physical therapy. The outcome was something she wasn’t quite expecting.
The start of a new career
“Throughout my treatment I began to see physical therapy as a way to meld my interests in movement, fitness, and helping people, in addition to being a way of becoming the healthcare provider I wish I had when I was injured. It took me seven years to get from idea conception to graduating from PT school, but I’ve been a licensed PT for almost 4.5 years now,” explain Alexis. “One of my goals in becoming a physical therapist was to develop a part of my practice that involved working with musicians, and I’ve slowly started to grow this sector as patients find me online and reach out to work with me both in-person and via telehealth.”
As Alexis progressed in her career, she became passionate about elevating the practice of physical therapists to become true primary care providers by fully utilizing all the skills that are learned in school. When she was presented with the opportunity to apply to Ivy Rehab’s Orthopedic Residency Program (ORP), she was already interested in pursuing her Orthopedic Clinical Specialist (OCS) and was studying for the exam on her own. However, she found that self-study while working a full-time job made it difficult to stick to a study schedule. The hybrid structure of the Ivy Rehab ORP and the added in-person mentorship provided her with the structure and accountability that she desired to assist in helping to elevate her clinical practice.
While there are various components to the ORP, one requirement is to write and present a case report, which can then be submitted to the state and national chapters for the opportunity to present the case as a poster or platform presentation. Prior to the ORP, Alexis was familiar with the abstract submission process but had never participated. She chose to do her project on a cervical/shoulder case as it required her to be systematic in her approach, and the case details made her think it would contribute to clinical learning for other clinicians.
“This patient came to PT with shoulder pain but then had a change in her symptoms during her plan of care. This led me to suspect that the root cause of pain was perhaps the cervical spine and not the shoulder; however, with additional medical testing, the patient received a diagnosis of polymyalgia rheumatica which can mimic musculoskeletal conditions including shoulder and hip pain,” explains Alexis. “This case not only deepened my understanding of several test clusters for cervical and shoulder conditions, but also helped me improve identification of red flags and initiating more immediate referral to other healthcare providers.”
“The process of writing the report and distilling a complex case into a succinct abstract was challenging especially since this was new to me,” she explains. But it turns out the work she put into the case report paid off, as her research was accepted as a poster presentation at the APTA annual research conference. She goes on to say, “This experience was valuable as I gained additional appreciation for the process, and it gave me the confidence to continue to utilize these newly gained skills to further drive knowledge translation from research into clinical practice.”
Seeing new ways to treat patients
In addition to the training and experience that Alexis gained as part of the process, she also credits her ORP experience with helping her to see new ways of diagnosing and treating patients.
“While this case was completed early in residency, being able to work with my mentors and seeking feedback from them was instrumental in helping me complete additional screening and testing that I may not have done otherwise,” she explains. “This allowed me to more readily identify the changes in the patient’s presentation and adapt accordingly. I consider my self-reflection skills a strength, but the ORP has further refined my self-reflection skills in a positive way.”
The insight Alexis gained through the ORP process solidified her desire to treat the whole patient while also expanding her areas of interest. But above all, she’s still passionate about working with musicians and members of the performing arts community.
“As my career continues to grow, I love to utilize telehealth to take advantage of upcoming regulatory changes like the PT Compact License, to be able to treat musicians who reside outside the state of Pennsylvania,” said Alexis Del Palazzo, physical therapist, musician, and APTA-PA conference presenter. “I’m also interested in developing clinical education to teach other PTs how to treat this patient population, as much of the performing arts PT world focuses on dancers. In addition, one of the opportunities that I’ve had since joining Ivy Rehab has been to become a part of the Performing Arts Clinical Team, which is very exciting for me. I’m looking forward to using my knowledge and skillset to further advance the careers of these talented individuals.”
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Alexis Del Palazzo practices out of the Ivy Rehab Kennett Square, PA clinic, and while she welcomes face-to-face patients in the office, she is available to treat anywhere virtually through telehealth.
