Improving Patient Access to Musculoskeletal Treatments and Medical Student Musculoskeletal Education via Free Clinic Services.

Introduction Homeless patients are at higher risk for musculoskeletal conditions but have limited access to treatments. Physical therapy (PT) and osteopathic manual therapy (OMT) are treatments for acute and chronic musculoskeletal conditions. Here, we outline establishing a free specialty clinic to provide PT and OMT to underserved patients. Methods At Eastern Virginia Medical School's Health Outreach Partnership of EVMS Students (HOPES) free clinic, we established a volunteer student, resident, and attending-led specialty clinic to provide exercise therapy, manual therapy, and injections to underserved patients. Results Student volunteering resulted in significant improvement in student confidence with musculoskeletal physical exam skills and their ability to diagnose musculoskeletal conditions. Patients of the clinic reported significant improvement in pain and mobility. Discussion This clinic is a novel activity that improves student musculoskeletal medical education and patient access to musculoskeletal condition treatments. Exposing students to PT and OMT services increased student awareness of the PT scope of practice, OMT's use as a component for patient treatment increased confidence in the appropriate applications of OMT for patient care. Implementing a free PT and OMT clinic at an established free clinic can improve musculoskeletal medical education and enhance patient care for underserved populations.

From Dugout to the Mound: A Tale of Platelet-Rich Performance.

Ulnar collateral ligament (UCL) tears of the elbow are prevalent injuries among throwing athletes and are associated with excessive or repeated valgus forces at the elbow. We present the case of an 18-year-old male baseball pitcher with an 18-month history of progressive right elbow pain, notably worsened during his fastball pitching. Clinical assessment revealed tenderness with dynamic stressing of the right UCL. Imaging analyses, including magnetic resonance imaging (MRI) and dynamic ultrasound, confirmed a high-grade partial tear of the UCL at its origin. Non-operative management was pursued, which included an ultrasound-guided platelet-rich plasma (PRP) injection and intensive physical therapy. Follow-up evaluations at six and 12 weeks demonstrated a noteworthy improvement in subjective pain descriptions and structural healing of the UCL. After the patient completed a therapy and rehabilitation program, throwing activities at full strength were able to be resumed. This case underscores the potential efficacy of conservative approaches in handling UCL tears with the inclusion of PRP as a viable treatment option.