Formative assessment 2

29/04/19  Marjon clinic  No. of hours 50

This session was 3 hours long and the first session lasted approximately 2 hours, this was the formative assessment, the client was a 23 year old man who plays volleyball and also goes to the gym. He came in with a tight right gastrocnemius.

The first session was the formative assessment, the client came in with a tight right gastrocnemius, tested there done before treatment was given. The first was an informative assessment this is done by watching the client walk into the clinic while the client does not know. This is to watch their gait and posture while walking. When observing their posture it had shown that they had good posture. ROM was tested in the gastrocnemius and they had FROM. A massage was given to the client this consisted of effleurage, petrissage, tapotements, neuromuscular and METs. ROM was tested again at the end of the session and it had improved on both sides by about 5⁰. Aftercare was given explaining what exercises they could do to help strengthen the muscles and also stretches.

The second client was a 21 year old woman who plays football once a week alongside swimming 3 times a week.

The second client came in as they had a tight upper back they said that this could be from stress. ROM and postural assessments were done and they had slight kyphosis. Massage was given in the upper fibres of traps this was done by using techniques such as effleurage, petrissage, neuromuscular, and METs. ROM was tested after the massage and it had improved on both sides. Aftercare was given to the client to ensure that they would recover from the tight muscles. Relaxation techniques were also taught to the client to help with stress.

Make sure correct techniques are used for the massage, and that the right assessments are done to the client and what they have come to the clinic for.

Clinical reflections 28

25/04/19  Marjon clinic  No. of hours 47

Three clients were seen during this session as it lasted for three hours. The first client was a 27 year old male who goes to the gym 4 times a week. The second was a 19 year old female who swims 2 times a week and the third was a 23 year old male volleyball player who plays once a week and trains two times a week.

The first client was explaining that they were experiencing pectoral soreness this was also in their shoulders on both sides. ROM was tested and they had FROM in both shoulders, a postural assessment was done and this had shown that the client had good posture. A massage was given to the upper fibres of traps, neck and deltoids, techniques used to massage were effleurage, petrissage, and neuromuscular techniques. After the massage to client was told of the aftercare this was to not overuse the muscles and to RICE.

The second client had come in with tight gastrocnemius which was due to them overusing it for the past two days by running which they just started doing. The client had FROM and their posture was good. Their left knee was slightly higher than the other. A massage was given to them this was on both legs and this was also done on their feet. Aftercare was given to the client about resting and making sure they have plenty of fluids after the massage.

The third client came in with lower back stiffness. The clients posture was assessed and they had good posture, their muscle bulk was even on both sides and the right hip was slightly higher than the left. For their treatment a massage was given this included effleurage, petrissage, and deep frictions to help with the pain. Aftercare was given to the client explaining to not overuse muscles otherwise this could slow down the recovery and make their back pain worse.

Try to do taping during sessions as well as massage, this could help with the client after the session has been completed.

Clinical reflections 27

25/04/19  Marjon clinic  No. of hours 44

This was a two hour session and two clients were seen during this. The first client was a 19 year old female who runs 6 times a week and has just started to do more running. The second client was a 18 year old female who goes to the gym 2 times a week.

The first client came in for a calf massage this was because they said they did a longer run than they usually would so they have achy legs from this. ROM was tested and they had FROM, from looking at them standing it was clear that the arch in their foot wasn’t as prominent as it would typically be. A calf massage was given to the client this was done by using techniques such as effleurage, petrissage, and deep frictions, this was done to help ease pain. After the massage aftercare was given to the client this included RICE to let the client rest and to not overuse muscles as it will slow down recovery.

The second client was a women who goes to the gym 2 times a week. The client explained that they had leg day at the gym two days before and that their glutes were sore. Postural assessments were done and it had shown that the client had slight kyphosis, the clients hips were also at different levels. The left hip was higher then the right. ROM was tested and they had FROM without any pain. A massage was given to the client and this included neuromuscular techniques, when doing this there was a knot in one glute that wasn’t in the other which was odd because if there is a knot on one side it is usually on the other side too. After the massage aftercare was given to the client.

Make sure to do stretches at the end of sessions to help with the clients mobility and to help with the muscle tightness. This doesn’t mean it needs to be for every client but it can help in most cases.

Clinical reflections 26

24/04/19  Marjon clinic  No. of hours 42

Two clients were seen during this two hour session. The first client was a 20 year old female who plays volleyball once a week with training also once a week she also play water polo once a week. The second client was an 18 year old female who plays football once a week but also coaches girls football.

The first client came in with lower back pain, and sore glutes. Testing was done, this included a postural assessment by doing this it could be seen that the client had slight lordosis. Her right hip was also slightly higher than the left this was the same with the shoulders, her knees were level. Glute firing was tested and it had shown that her hamstrings were firing before her glutes on both of the sides. Massage was given to the lower back using different techniques. After the massage aftercare was given this included giving the client a few glutes exercise to do.

The second client was a footballer, she came in with tight quads. The quads were ToP this was on both legs but the right one seemed tighter than the left. It was clear that the client had bowed legs, the knees where level and the muscle bulk was even. Massage was given to both quads using various techniques such as effleurage, petrissage, tapotments, and neuromuscular techniques. After the massage ROM was tested and it shown that it had improved.

Research more exercises for the clients to do at home for aftercare and explain why and how they will help in the future.

Clinical reflections 25

24/04/19  Marjon clinic  No. of hours 40

Two clients were seen in this session, two hours were spent on the first client which was a 27 year old male who goes to the gym 4 times a week. The second client was a 19 year old female who swims 3 times a week.

The first client was a gym goer, he goes at least 4 times a week. The client was explaining that they had a tight left deltoid and pectoral, this could’ve been due to weighted exercise that they have been doing in the gym. ROM was done and it showed that he had FROM in both shoulders. Massage was done on the clients deltoids, pectorals and upper fibres of traps. Neuromuscular techniques were used to ease the pain and tension in the neck, back, and shoulders. Vibration techniques were used during the session as the client was tensing their muscles which means it was harder to give treatment. After the session ROM was tested again and it had improved.

The second client was coming in for their tight hamstrings. ROM was tested and their left leg was at about 90 ⁰ and the right was at about 85⁰ ROM. From looking at the knee heights they were the same height, but they have knocked knees. With the hips the left leg was slightly higher than the right. A massage was given to the client to help relieve tension and tightness. When the massage was done trigger points were used to help stretch the muscle. ROM was tested for the second time and it had shown that the client could now get to about 95⁰ on both legs.

Remember to use METs when needed, think about what the clients needs and wants are and think about what techniques would be best for this.

Foramtive reflection 1

23/04/19  Marjon clinic  No. of hours 35

This session was the formative assessment done on a 23 year old who is doing his masters.

During the formative assessment the client said that he had a tight left hamstring so before doing anything, hands were washed with hair tied back and nothing below the elbows. Posture was tested and it showed to be good posture so after this was ROM on both legs this was done by lifting the legs to see how far they got. The right leg was done first and was at about 75⁰ and their left was about 75⁰. After testing ROM techniques were used to massage this included effleurage, petrissage, neuromuscular, deep frictions and METs to stretch to muscles. At the end of the session aftercare advise was given and ROM was tested again to see if it had changed and it improved by about 5⁰.

Make sure to lower the bed for the client to get off. Learn different exercises to teach the client to do at home.

 

Clinical reflections 24

23/04/19  Marjon clinic  No. of hours 37

The first client was a 19 year old female who recently hasn’t been going to gym as much as she used to because they have been focusing on university work. The second client was a 19 year old male who plays water polo once a week with training also being once a week.

The first client was a first year university student and hasn’t been going to the gym as much but has neck and shoulder pain. They have explained that this could be due to focusing on university and having poor posture while standing and sitting. ROM was tested in the neck and they had FROM. While doing a postural assessment it was clear that they had curvature of the thoracic spine because of this a massage was given this was done to the upper fibres of the traps. Once the back and neck was massage the client turned over so their pectorals could be massaged this was to help open up the chest to help improve their kyphosis. ROM was tested for the second time and it had shown that the clients mobility had improved by about 5⁰ on both sides.

The second client came in with left shoulder tightness and EMS, a postural assessment was done and the left shoulder was higher than the right. ROM was tested and they had FROM in shoulder flex/ext. A massage was given in the session this was done to the upper fibre of traps and the left deltoid to help with the muscle tension. After the massage METs were used to help stretch the muscles, after everything was completed ROM was tested and it had improved.

Remember towelling techniques, this includes when the client turn around to make sure that the towel doesn’t move so the client doesn’t feel exposed.

Clinical reflections 23

25/03/19  Marjon clinic  No. of hours 34

Two clients were seen during this two hour period. The first was a 19 year old women who does not play sport but goes swimming regularly. The second client was a 19 year old male who plays water polo once a week and does training twice a week.

The first client was a women who regularly goes swimming in her spare time, she will usually do about 25-30 lengths of the swimming pool. Instead of this she did 45 lengths and because of this she said that her shoulders are aching. ROM and posture was tested before anything, this shown that they although they had good posture their R shoulder was higher than the L. on palpation both of the middle fibres of traps and upper fibres of traps were very tight. And there was PoP the client explained that it was about 4/10 on the pain scale. A massage was given using techniques such as effleurage, petrissage, and neuromuscular techniques. Aftercare advise was given after the massage, this included RICE and hydration.

The second client came in saying that they had sore quadriceps on both legs. This was due to training, he explained that his legs felt tight. During palpating the quadriceps it was clear that the left one was tighter than the right. The knees were level and the clients left hip was slightly lower than the right. Massage was given on both of the quadriceps, neuromuscular techniques were used as there were knots in both legs. Aftercare was given telling the client that they need to rest and to not overuse the muscles as it will slow down recovery.

Remember to do the small things, this includes lowering the bed and to put the bolster under their knees and ankles when needed.