02.05.19 Clinical Hours

This clinic session I spent one-hour shadowing in the Marjon injury clinic and then provided a soft tissue massage to a follow up patient. The patient I saw (33-year-old male) while shadowing came in with lateral knee pain on both sides. Functional movements (squatting, lunges) and the +ve patella apprehension test indicated that both patella’s were not tracking correctly, and gait analysis showed flat feet. Treatment was STM as it was requested by patient and strength exercises for flat feet, glutes and quadriceps to improve patella tracking.

The second patient (22-year-old female, student) came in as a follow up session and requested a massage for their right shoulder. After going through a brief subjective and objective (shoulder AROM) I provided a soft tissue massage to both shoulders (supraspinatus, levator scapula, trapezius, deltoids) with emphasis on the right side. I then applied MET stretches for lateral neck flexion and external rotation of the shoulder to improve shoulder ROM (Gibbons, 2011).

This clinic session was meant to be longer as I wanted to shadow for an extra few hours. Unfortunately, the injury clinic was not busy, so this was not possible. A positive of this session was that I actively treated patients again, which I have not been for a while due to me concentrating on getting shadowing hours. However, the soft tissue massage made me realise that I should look at the origins and insertions of the shoulder muscles to refamiliarize myself. Finally, the therapist applied what they said was the patella apprehension test to check for incorrect patella tracking but the application was questionable to me as they just seemed to palpate the lateral tibial condyle and the lateral femoral condyle and asked the patient to extend their knee. As this seemed incorrect, I found a study confirming that the patella apprehension test is applied by having the knee in 30° flexion with the patient fully relaxed. The therapist then applies a lateral to medial glide to check for dislocation or incorrect tracking (Manske & Davies, 2016). For future reference, I will go over special tests for the knee, as I could not recall most of the various tests.

References:

Gibbons, J. (2011). Muscle Energy Techniques: A Practical Guide for Physical Therapists (1st ed.). Chichester: Lotus Publishing.

Manske, R. C., & Davies, G. J. (2016). EXAMINATION OF THE PATELLOFEMORAL JOINT. International journal of sports physical therapy11(6), 831–853.

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