A case that first looked like a straightforward running injury became an important lesson in asking better questions, screening more thoroughly, and looking beyond the obvious — lessons Emily Musselman, PT, DPT, still teaches clinicians today.
Early in her career at Ivy Health, Emily Musselman (then Titus) treated a distance runner and elite CrossFit athlete experiencing pain that initially appeared to be a hamstring strain.
It was a reasonable place to start. But when treatment didn’t lead to the improvement Emily expected, she kept looking. She considered the lumbar spine and adjusted the treatment plan. Still, the patient’s symptoms persisted.
That experience would eventually become the subject of Emily’s residency research, take her to the American Physical Therapy Association’s Combined Sections Meeting, and shape the way she thinks about clinical reasoning years later.
And she still talks about the case all the time.
Look at the Forest Before the Tree
When the patient wasn’t responding as expected, Emily began asking more specific questions.
“I talk about this case very often and have lectured on it in three of our residency programs,” Emily says. “It taught me primarily to ask sharpened and specific questions to rule out certain diagnoses. Being vague is not adequate in healthcare when it comes to figuring out what’s ailing someone.”
With the patient’s consent, Emily completed a pelvic examination and identified involvement of the obturator internus, a deep muscle in the pelvis that also plays a role in hip movement and stability. She incorporated pelvic-focused treatment into the care plan, and the patient ultimately returned to running pain free.
But the lesson Emily carried forward was bigger than the outcome of one case. It changed how she approached screening and how quickly she was willing to settle on an explanation for what she was seeing.
“It taught me to full-body screen how someone moves before drawing conclusions,” she says. “You can really miss things if you don’t take a look at the forest before honing in on one tree.”
That thoroughness became an important part of Emily’s clinical reasoning. In the original article, she credited her orthopedic residency training with giving her the confidence to rule out the hamstring and lumbar spine as the source of the patient’s symptoms and continue investigating when those initial approaches weren’t working.
A Case That Kept Teaching
The case became the focus of Emily’s residency research and was selected for presentation at APTA’s Combined Sections Meeting. Years later, she continues to use it when teaching other clinicians because of what it taught her about asking the right questions, screening thoroughly, and being willing to reconsider an initial conclusion.
Her interest in the connection between orthopedic and pelvic health care has continued to grow along with her career. Today, Emily mentors clinicians in the Ivy-HSS Orthopedic Residency and Ivy’s pelvic residency program and guest lectures in the orthopedic, sports, and pelvic residencies.
She has also presented at CSM alongside Ivy colleagues and plans to continue focusing on pelvic health and its relationship to orthopedic diagnoses, particularly the importance of thorough screening among orthopedic clinicians.
For Emily, teaching the case now feels a little different than presenting it for the first time. She isn’t just sharing something she learned. She’s helping other clinicians build the kind of clinical confidence that her own residency helped develop in her.
From Residency to Leadership
A lot has changed since the original story was published.
Emily is now a partner and area director, overseeing four Ivy offices, including her own. Alongside her leadership responsibilities, she continues to mentor and teach within Ivy’s residency programs.
When asked what she’s proudest of in her Ivy journey, she goes back to where much of that growth began.
“What I’m most proud of in my journey at Ivy has been my residency program,” Emily says. “If I had not completed the residency program, I would not have developed the clinical confidence to lead others in practice and learn that I wanted to lead others professionally, as well.”
The program gave her an opportunity to deepen her clinical skills, but it also introduced her to mentorship that would influence the next phase of her career. Emily credits her own leader with providing the kind of support that helped her take on broader responsibilities and, eventually, multi-site leadership.
Now she gets to return some of that investment.
“Another step in developing my leadership has been taking that plunge and returning the guidance I once received to those going through the program currently,” she says.
That cycle — learning from someone, growing into your own expertise, and eventually helping someone else do the same — is one of the parts of residency Emily values most.
Knowing the Clinician in Front of You
Emily’s clinical experience also shapes how she approaches leadership today.
“My clinical background specializing in ortho and pelvic has shaped my leadership by giving me a deeper understanding of how clinicians tick,” she says. “Understanding what drives clinicians, whether they are orthopedic specialty, pelvic or both, helps shape my leadership to tailor my strategies to who is in front of me.”
Leading four offices means working with clinicians at different stages of their careers, with different interests and different ideas about where they want to grow. Emily sees part of her role as understanding those differences and helping people find the support that makes sense for them.
It’s also why she has stayed connected to residency education even as her leadership responsibilities have expanded. Mentoring residents and guest lecturing gives her a way to keep contributing to the programs that had such a significant impact on her own career.
Still Looking at the Whole Picture
Emily has come a long way from the resident presenting one complicated case at CSM. She’s now leading multiple teams, mentoring residents, and thinking about where her own leadership could go next. She hopes to become a regional director someday, while continuing to teach and advocate for thorough screening around pelvic health and orthopedic diagnoses.
But the case that helped start that journey is still part of the conversation.
It reminds her to ask more specific questions, to screen thoroughly, to stay curious when the expected answer isn’t working, and to give other clinicians the support and mentorship that helped her grow.
One patient helped sharpen the way Emily practiced. Residency gave her a place to develop that thinking. Years later, those lessons are reaching clinicians and teams well beyond her own treatment room.
That’s the kind of growth that tends to keep going.