PRN Physical Therapy''s downtown San Diego clinic at Suite 206 of the 4060 Fourth Avenue Medical Arts Building is the practice base for Tamara Pessin, whose caseload leans heavily on post-surgical orthopedic rehabilitation drawn from the surgeons upstairs. Referrals flow in-building from orthopedic specialists including Dr. Larry D. Dodge, MD on the seventh floor, shortening the hand-off window between surgery and active rehab. The program list runs through balance and fall prevention, blood flow restriction training, Graston Technique, concussion rehabilitation, McKenzie therapy, spine rehab, TMJ treatment, and vestibular rehabilitation. Workers'' compensation and motor vehicle accident injury rehabilitation operate as two of the higher-volume pipelines on the treatment schedule. Chronic pain cases on this caseload rely on McKenzie directional preference testing and graded exposure programming, a mechanical-rehab approach that differs from the nervous-system regulation work done at Inner Balance Institute. Complex lumbar fusion and total joint arthroplasty recovery '' twelve- to sixteen-week staged programs beginning within days of surgery '' represents the most demanding work handled out of this PT suite.