Genuine desire to do PM&R is probably as important as all the other minutiae beyond grades and LOR. Programs want people who want to be physiatrists, not people who couldn't get into something else so PM&R is their back-up plan.
222 is good, it shows you stepped up to the plate and can do well. Apply to as many prgrams as you reasonable can, depending on what you want - top tier only vs middle, small vs large program, any travel restrictions such as monetary as well as what the program does and doesn't train you in. Interviews suck, but too many is better than not enough. You don't want to apply to every program, but is 10 enough, or 20? Not sure. Make an appt with your Dean. (Maybe he's even heard of PM&R 😉)