13.05.19 Clinical Hours

This clinic session comprised of three sport massages. First patient (22-year-old male student football player) came in with DOMS in his legs after an intense football match the day prior. Treatment was STM and MET’S (Muscle energy technique) to both hamstrings (Biceps femoris, semitendinosus, semimembranosus), quadriceps (Mainly rectus femoris), and calves (Gastrocnemius, soleus).

The second patient (26-year-old student male runner) came in with complaints of tightness in his calves and acute pain in his left plantar fascia. Treatment was a STM and MET’s to both calves (Gastrocnemius, soleus) and K-tape for the plantar fascia to try and ease the pain by giving it some extra support.

Third patient (20-year-old male football player) with a history of left lateral ankle sprains (ATFL) came in, as he was worried he was going to roll his ankle before his next big football game. Treatment was K-tape for lateral ankle support and advice to strengthen the peroneal muscles as this has been shown to help ankle stability as well as some single leg balance training (Mattacola & Dwyer, 2002).

In the time between patients, me and my work colleagues discussed lateral ankle sprain rehabilitation programmes. Based on a study by Mattacola & Dwyer (2002) the programme started off with PRICE in the acute stage, and from day 5 initiated early rehabilitation which included regaining ROM via foot circling and Active range of motion (non-weight bearing). Once full ROM has been achieved without pain, strengthening work is initiated. This starts off with non-weight bearing isometric calve exercises (E.g. towel, foot against wall, manual pressure by therapist) and then progresses to ecc-con strengthening work (E.g. resistance bands). Once weight bearing has been achieved, strengthening should continue to be progressed into full weight bearing variations (E.g. standing calve raises) and balance training should begin (E.g. single leg stance) Late stage rehabilitation should include functional exercises such as walking/jogging/running forwards backwards and side to side as well as running figure of eights to prepare for a full return to sport.

This was a straightforward clinic session, as it was mainly STM which I am now confident in doing. The taping needs more practice as I struggled to apply it without creases but that will get better with experience. After the clinic session I spent some time revising anatomy of the legs with emphasis on the peroneal muscles as I could not remember their origin and insertions (Cael, 2010). For future reference I need to go over plantar fasciitis diagnosis and treatment as I am not knowledgeable enough is this area.

References:

Cael, C. (2010). Functional Anatomy: Musculoskeletal Anatomy, Kinesiology, and Palpation for Manual therapists (1st ed.). Baltimore: Lippincott Williams & Wilkins, Wolter Kluwer.

Mattacola, C. G., & Dwyer, M. K. (2002). Rehabilitation of the Ankle After Acute Sprain or Chronic Instability. Journal of athletic training37(4), 413-429.

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