Being an “Exercise Science” major, I have taken many anatomy and physiology courses through my time at the University of South Carolina. Between an “Anatomy and Physiology” and an “Exercise Physiology” course, I have gained very valuable knowledge of the musculoskeletal system.

“Anatomy and Physiology taught me the basics: what muscles form the rotator cuff, their orientation between each other and nearby bones, where their tendons insert, etc. “Exercise Physiology” was a little more unique. This is where I learned the functions of these muscles. How exactly the subscapularis, supraspinatus, infraspinatus, and teres minor all come together to provide the shoulder joint with substantial range of motion.

What these classes do not teach you is that these functions can fail. What happens to cause this variance from what we expect? What does that entail and how do you go about fixing it?

During the summer before my senior year, I was an intern at the USC Sports Medicine Clinic at Palmetto Health Hospitals. I had the pleasure of working under Dr. Guillaume Dumont, an orthopedic surgeon. In the clinic, we saw an abundance of patients with rotator cuff injuries, but one in particular stood out. This gentleman presented with a massive rotator cuff tear. The subscapularis, infraspinatus, and supraspinatus tendons had pulled off of the humeral head and retracted into his shoulder. The magnitude of this injury rendered the rotator cuff irreparable and this man had no functional use of his shoulder. So what happens when the function you have spent multiple semesters learning is no longer true?

Dr. Dumont performed a “total reverse shoulder arthroplasty” surgery. This was this mans only option to regain use of his shoulder. This operation artificially reversed the orientation of the shoulder joint/socket and the new joint used the deltoid to move the shoulder.

In anatomy, you are never taught that the deltoid has the ability to move the shoulder or that the “ball and socket” can be reversed and become a “socket and ball,” (see pictures for illustration). The basics are set up in anatomy and physiology courses; you learn how things should be and what is expected from the body. You need this groundwork in order to learn the exceptions and alternatives for musculo-skeletal functions. The only way to learn these exceptions is through experiences such as those that I have gained from working in Dr. Dumont’s clinic.

It is amazing to see how anatomy works and can be manipulated when it is applied to medicine. In the classroom, you learn the basics and the foundation that you are starting with, but when things go awry, it is fair game for a variety of new concepts to be put to use and you can build upon the foundation that you have had built in the classroom. This is the part of medicine that is best taught with experience rather than a textbook.

Working with Dr. Guillaume Dumont at the University of South Carolina Sports Medicine Clinic taught me to think outside of the box. As a medical student, thinking further and applying what you’ve been taught in the classroom is imperative. If the body worked the way it is taught in textbooks, there would be no need for the field of medicine. This clinic gave me first hand experience of applying what I already knew about anatomy and physiology for different functions than you would typically expect from the body. Taking generic information that has been taught to you and implementing it in a different way that you would expect is what made the field of medicine what it is today. This clinical experience taught me to do just that. This nature of thinking will be exponentially beneficial throughout my journey as a medical student.