Date: 16.01.2020

Duration: 1300-1600

Individual with whom I worked with: Mick Smirthwaite

Before my placement:

Aims from today’s placement:

We changed the regular Wednesday afternoon placement to Thursday this week because Mick didn’t have so many appointments on the Wednesday.  With this in mind, I anticipated seeing new clients with different musculoskeletal dysfunction to those that I have seen already.  Of course there is also the risk that some of the new patients may not wish to have me in the treatment room during their session.  Fortunately up until now, this hasn’t presented any problems and all of the clients that I have met, have been more than willing for me to sit in on their treatment sessions.

During my placement:

Generally today my role was observational and most of the treatments were straight forward.  Nothing out of the ordinary happened and each appointment was as I expected.

After my placement:

I observed each client as they arrived.  I listened to each client when they explained what their musculoskeletal issue was.  I observed Mick apply soft tissue massage and other treatments as appropriate.

 

Client 1 – attended Mick’s clinic last Wednesday.  She has issues with her left shoulder and some nerve impingement.  Mick massaged the upper fibres of the Trapezius and began to work out a trigger point with a neuromuscular technique (NMT).  The trigger point would not release with manual therapy so Mick used acupuncture to release it.  He also applied a muscle energy technique (MET) at the point of the trapezius’s attachment in the neck and NMT underneath the muscle fibres to loosen the muscle tissue.  He massaged the middle fibres of the Trapezius and Rhomboids and finished the treatment with a deep stretch of the trapezius using traction.

 

Client 2 – was a middle-aged male who usually visits the clinic for treatment for musculoskeletal issues in his lower back.  Mick checked the client’s lower back and there were no issues.  The client mentioned that he had been doing pull ups in the gym and as a result his left shoulder was tight.  There was tension in the upper fibres of the trapezius and also in the Long Head of the Biceps muscle in the left arm.  Mick applied soft tissue massage (STM) using NMT to work out a trigger point in the Trapezius and STR to ease out tension and stretch the LH of the Biceps.

 

Client 3 – This client (female) had misalignment in the hips as a result of one of her feet falling into a small pothole.  There was misalignment in the right hip.  Mick applied mobilisation to the hip.  He also massaged the Quadratus Lumborum (QL) on the right and left side of the lower back, carried out mobilisation of the lumbar spine and left hip.  He also applied slow tissue release (STR) to the gluteus medius muscle in the left buttock.

 

Client 4 – the client was a male in his 60s who has Parkinson’s disease.  He started visiting Mick’s clinic about 8 months ago.  At that time he could hardly walk because his muscles were so tight and they were in spasm and contracting involuntarily. Since receiving weekly soft tissue massage of his legs and changing to a Keto diet, he is now able to walk freely and his muscles are no longer in spasm.  I enjoyed watching Mick apply soft tissue massage to the client’s hamstrings and calves. I observed closely who Mick placed his thumbs and hands during each technique that he applied.  It was very useful to just observe a professional Sports Therapist.

How I felt through-out my placement today:

I enjoyed this afternoon – meeting new clients and observing each treatment applied.  I feel that I am learning a lot from observing Mick’s practice.

Evaluate today’s placement activity:

Today’s placement was a very positive experience and nothing went badly.  I am learning from Mick all of the time and I will definitely be applying some of the massage techniques that I have observed during the past 10 weeks.

A deeper, analytical and critical approach to today’s experiences:

I was very interested in the effect that regular soft tissue massage as had on the client with Parkinson’s disease in reducing rigidity and resting and postural tremors.  There is currently no evidence-based research that categorically confirms that soft tissue massage is effective and works.  I have already researched what Parkinson’s disease is and the signs and symptoms by visiting the Parkinson Society UK website (“What is Parkinson’s? | Parkinson’s UK,” 2020).  I will look for research regarding the effectiveness of STM in relieving symptoms, if indeed there is any.

Draw conclusions – what have I learned from today’s activities and my reflections:

I always learn practical skills from observing others apply them.  I found today very helpful just by observing Mick treating his clients.

Action plan – how will I apply what I have learned from today’s activities & my future professional and personal development:

I will adopt the techniques that Mick uses when applying massage, in my own practice.

Have any questions arisen from today’s placement that I need to discuss with my Placement Tutor or University Placement Tutor:

I had no questions at the end of today’s placement.

Returning to my reflections:

The research regarding the effectiveness of soft tissue massage in reducing the symptoms of Parkinson’s is very limited.  I did however find a recent case study (Casciaro, 2016) that had positive results in reducing resting and postural tremors, and rigidity to a lesser degree.

References:

Casciaro, Y. (2016). Massage therapy treatment and outcomes for a patient with parkinson’s disease: A case report. International Journal of Therapeutic Massage and Bodywork: Research, Education, and Practice, 9(1), 11–18.

What is Parkinson’s? | Parkinson’s UK. (2020). Retrieved June 1, 2020, from https://www.parkinsons.org.uk/information-and-support/what-parkinsons