I went into my orthopedic rotation expecting a room full of bodybuilder physicians comparing max bench numbers while nurses yelled over the sound of power drills. I figured someone would eventually ask me to spot them while they openly reduced an ankle fracture.
Instead I walked into a world that looked very different. My days were filled with eighty year old patients who managed to break a hip just by walking down the street, mixed with trauma stories straight out of a wilderness survival show. My personal favorite was a 30-year-old guy who managed to slice his medial meniscus with a tomahawk while cutting wood in the mountains. He said it so casually I almost missed it. “Yeah, the tomahawk slipped.” As if that explains everything.
The OR was its own adventure. This was my first experience scrubbing in and gloving+ gowning. If you have ever wondered what it feels like to carry around twenty pounds of lead on your torso while trying to look competent for a 3 hour surgery, I can confirm that the experience builds both character and lower back pain. Vest, skirt, thyroid shield. By the end of the day I felt like a medieval knight.
The rotation forced me to sharpen my physical exam skills. I practiced every special test in the book. Apleys. Drop arm. Neers. Crossover. It is a practical way to remember what muscle you are testing, unless you forget the anatomy entirely, in which case the surgeon in the OR will ask you. Then ask you again. Then ask which muscle does what. Anatomy matters. And ortho will never let you forget it.
One thing ortho gave me was constant reps on special tests. There is nothing like walking into a room, greeting a patient, and then immediately asking them to twist their arm.
Apleys Compression Test
This is the knee test where you push down on the heel and grind the tibia into the meniscus. It feels like you are trying to start a very unlucky lawn mower. If the patient says it hurts, you nod wisely and know inside that they will likely need surgery.
The Drop Arm Test
You lift a patient’s arm up, let go, and wait. If it drops like a dead fish, you have your answer. If it does not, you keep nodding like this was your plan all along. This test made me realize that half of ortho is quietly using gravity as your assistant.
The Empty Can Test
My personal favorite because it sounds like something you would do after finishing a soda. The patient lifts their arm, thumbs down, like they are trying to pour out the last stubborn drops. You push down on the arm. If it hurts, you suspect supraspinatus rotator cuff trouble.
The Lachman Test
You stabilize the thigh, pull the tibia forward, and search for that subtle shift that tells you if the ACL is still in the game. The whole time you try to look confident even though your hands are fighting the patient’s hamstrings.
Hawkins and Neers
Both shoulder impingement tests. Both involve you lifting and internally rotating the shoulder until the patient winces. At first I felt guilty for causing pain on purpose. Then I remembered this is how orthopedics communicates with rotator cuffs.
Thompson Test
You squeeze the calf and watch for plantarflexion. It feels like checking if the Achilles tendon still wants to participate in society. If the foot stays still, you know it quit early.
By the end of the rotation I realized two things. One, ortho special tests are just controlled ways to annoy joints until they confess.
The bright spot that surprised me most was clinic. The pace fits me better. I loved meeting new patients, doing subcutaneous injections in shoulders and knees, taking out staples, and even chatting with reps about new allograft options for shoulder repairs. It felt like a place where learning and patient connection flow naturally, and where I am not required to carry my body weight in radiation protection.
Bottom line: I started this rotation expecting gym bros with hammers. I ended it with a deeper respect for anatomy, a healthier fear of tomahawks, and a new appreciation for outpatient ortho.
#ortho #rotations #3rd year
SOL: Stanzas of Life 
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