Igor Tserlyuk, DPT is the owner and Director of Grasmere Physical Therapy and Rehabilitation. Igor is an expert in Orthopedic and Neurological Rehabilitation. In his effort to help others he effectively integrates evidence-based practice and holistic methods to achieve optimal results for his patients.
Tell us about your practice. What sets you apart from other practitioners in your area?
We are an outpatient facility in Grasmere region of Staten Island. We are different from other practices because we integrate all facets of physical therapy treatment into each session, thereby accomplishing much more in less time and with long lasting results.
We’d like to talk about a patient success story you’re especially proud of. Tell us about the patient. How did they learn about your practice? Why did this patient come to your practice? What problems were they experiencing?
I had a walk in patient come in to my office about 6 months ago. She was bound to a wheelchair and was dependent on a home health aid. Her major problem was an unhealed fracture in her foot. Even after multiple attempts at surgical stabilization, the foot would not heal properly. The patient explained to me that because of her foot she was unable to stand or walk on her own.
How did you go about diagnosing him or her?
The patient had significant quadriceps and calf atrophy and had minimal Dorsiflexion activation on evaluation, however exhibited normal reflexes and sensation in the lower extremities. She had marked tightness in the lumbar spine and poor trunk control from prolonged sitting in a reclined position. More importantly, what I noticed throughout my examination was that the patient would repeatedly announce this phrase: “I am broken .” The patient admitted to me that all of the physical therapists she had been to in the past did not attempt to help her. I had a strong feeling that her impairments and functional limitations were a result of a self fulfilling prophecy which was only re-inforced by PTs who did not care about helping this individual.
What treatment course did you decide on?
That night I set up a treatment plan for this patient which would slowly motivate her to understand that she is not “broken” but is in the process of being fixed. It took a few sessions to build rapport with her but once we started rolling she was performing sitting exercises like a champ. In less than four weeks she was ambulating in a rolling walker, and by eight weeks she was strolling by using a single point cane.
What was the impact your treatment had on the patient? How did you help him or her?
The patient is now fully independent and walks with a cane only for balance and stability. She completely forgot about her fractured foot and is able to put full weight through the affected lower extremity. She still suffers from intermittent Low Back Pain from time to time, but at least now we have the foundation to start Neuro-Muscular techniques. More importantly, the patient is happy and is starting to live life again. Every time I see the patient instead of saying “I am broken” she says “I am alive”, and that is something very fulfilling to hear as a health care professional.
What advice would you give PT students today? For instance looking back at your own career is there anything you would do differently?
I would advise current PT students to realize that as you enter the workforce you will encounter different types of patients. Do not look at the patient as a Diagnosis or a set of symptoms to be addressed by your newfound knowledge. Instead, start with the person and then address the symptoms/impairments. If you can understand the patients’ mindset it will be much easier and much more efficient to treat that individual. This is a skill that is attained by being a decent human being, and one that requires patience, sympathy, and an understanding of the human condition.
Please talk about any ways you are trying to impact the community you’re a part of:
As a Doctor of Physical Therapy I believe it is very important to promote our knowledge and understanding to the community. I believe that PTs are under-valued in healthcare because we cannot prescribe or order tests. The reality of the situation is that most patients do not need prescription drugs or X-rays/MRIs to get better. Not only are these a waste of healthcare money, they give the false impression that all diseases are cured only by medication or surgery. Research has shown that medication and/or surgery often are no better than physical therapy in the treatment of many conditions. That is why I am actively involved in YMCA work shops and presentations that serve to educate the public on how we can live better and feel better by preventing disease to occur in the first place.
What is the funniest thing, if any, that has happened to you in practice?
The funniest thing that has happened, on numerous occasions, is patients passing gas while I work on them. There is one particular technique I utilize for Low Back Pain, called “double knee to chest stretch” which has led to a few of these ” awkward situations”. I usually warn the patient before the technique that “whatever happens, happens”. However, only when it actually “happens,” it does become incredibly awkward and silencing.
Anything (that you care to admit) that you would never do again?
One thing I would not do during regular practice is strike up conversations that can potentially become provoking and not therapeutic. Politics, religion, and other ideologies, in my opinion, should stay out of the clinic as they can conjure negative emotions which can ultimately interfere with the healing process.
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