Date: 14.11.19
Location: Marjon Sports Injury Clinic
Duration: 2 hours
Reflective Summary
I provided pre-event sports massage or taping for the University swimming team members. It was an opportunity for me to introduce myself to some of them as I will be supporting them throughout the season.
First hour – 1100- 1200
The first client was a female swimmer. She wanted her ankle taping because she was due to play netball in the evening. She had turned her ankle during netball about three months ago. A possible ATFL sprain. I worked with a third year sports therapy student. He performed the taping and I observed.
He applied a Figure of 6 ankle taping with rigid tape. The ankle was put into dorsiflexion before applying the tape. The taping comprised of 2 x C strips as an anchor around the top of the ankle – distal Tibia. He applied a stirrup taping from above the medial malleoli to above the lateral malleoli. A stretch was applied to the tape on the lateral side. The stretch was applied to support the lateral side of the ankle. A figure 6 taping was applied twice around the ankle. Two C strips of tape were applied to ankle to complete the taping.
I practised the technique, as previously demonstrated on the 3rd-year sports therapy student, whilst we were waiting for other swimmers to arrive.
We also practised the subjective and objective assessment of the shoulder joint.
The second swimmer, a young male, arrived. He said that he wanted a massage because he had general aching in the upper back from training. We went through the subjective assessment and objective assessment process. I observed the general posture of his shoulders. I looked at the muscle bulk to see if there was any wasting or spasm, checked symmetry of the upper back, alignment. I also checked for any bruising or deformity. The shoulder on the right side was slightly higher than the left. This was probably due to tight muscles. I could also see a large trigger point medial to the inferior medial border of the scapula on the right side of his body. I could see it clearly before carrying out palpation of the bony points, ligaments, tendons and muscles of the upper back.
I cleared the joints above of the cervical spine. The client actively went through Flexion, Extension, Lateral Flexion and Rotation and I applied overpressure at the end of each action.
The thoracic spine was also cleared (arms folded across the upper body and the trunk rotated left and right). We also cleared the movements of the elbow joint (flexion, extension, pronation and supination). There were no issues.
I palpated the bony points, ligaments and tendons where possible and muscles of the neck, shoulder, upper back and chest. I was looking for tenderness or pain.
I took the client through the objective assessment of the Glenohumeral Joint and the shoulder girdle. He did not have any issues. I massaged the upper back on both sides. I worked on the trigger point on the right side of his back. It was very hard. I was not going to be able to massage it out completely but I did loosen it up. There was also a trigger point in the same area on the left side of the upper back. It wasn’t as big but it was more sensitive. I applied NMT to the trigger point but had to use my elbow to enable me to apply more pressure. I did not want to work too deeply and intensely on both trigger points because the client was competing the following day. I did enough to ease both trigger points in order to reduce the tightness in the upper back. The client said that his back felt much freer. I advised him to drink plenty of water.
Second hour – 1400 – 1500
During this hour I worked under the guidance of another 3rd-year sports therapy student.
The first client was a male water polo player but he was also competing in the swimming competition the following day. I observed the 3rd year student massage the client’s shoulders and upper back. He massaged the Trapezius muscle, Rhomboids and carried out mobilisations of the cervical and thoracic spine. He also massaged the Pectoralis Major muscles when the client was in the supine position on the couch. He applied Slow Tissue Release (STR).
Another male swimmer came for a massage, but I was called away to give a pre-event massage to a female swimmer. It felt good to actually go through a full pre-event massage on my own. Good for the confidence. I applied superficial effleurage, petrissage and vibration techniques at a quicker tempo to the shoulders and upper back. The client was very happy with the massage.
References
Areas for further improvement and action plan
Regularly revise and update first aid and emergency trauma knowledge.
Regularly revise anatomy.
Review rigid and k-taping techniques
Returning to reflections at a later date