12/03/2021 5
Going into this clinic session I was still feeling quite nervous. However, in clinic today we had a very interesting patient. They came to clinic following an operation to the neck to remove cancerous lymph nodes. Following this the patient had been cleared of any cancers. I found this case very interesting to deal with, despite not knowing what the best thing to do was. I knew the patient needed to gain strength in their neck muscles and upper trapezius, but due to the severity of the issue I had to ask my supervisor if the exercises we were thinking of were suitable. I found dealing with this patient a big learning curve in my journey as this is something I never would have though I would be dealing with. Now, I feel I will be more ready to work with clients who have had serious diseases. Following the appointment, we wrote up the notes and planned what we could do next session with the client if they responded well to the exercises given.
After this, we again ran through different case studies. We ran clinical assessments on each other and then created an exercise plan tailored to their needs. Again, I found this very useful; it was making me a lot more confident in clinic.
Following this, we did an online consultation with a client. It was hard to do observations over zoom, but the subjective assessment suggests that the injury is either disc, facet, SIJ or piriformis. After the session, we discussed what we could do to differentiate between each injury upon objective assessment. Due to the fact I had done lots of revision on clinical assessments, I felt quite confident during this discussion.
19/03/2021 5
After completing the diagnostic and rehabilitation module in February, I am feeling a lot more confident in giving exercise based rehabilitation. Going into clinic today, I was finally starting to feel more like a confident sports therapist who can effectively diagnose and treat injuries.
The first patient I had today was a very interesting one. I was informed before the appointment that she had been referred to the Marjon clinic to be put on the cervical traction machine, to create more space between the vertebrae. Due to the severity of the condition, I wasn’t able to go through an objective assessment over the phone, so instead I completed a very thorough subjective assessment. I felt very confident when taking this online triage, as I was making very detailed notes. The patient liked to chat a lot, so sometimes it was hard to get an answer to the questions I was asking. But, I managed to get the answered that I needed in the end. We invited her in for a face-to-face appointment to use the cervical traction machine which I am really keen to get involved in as it is something I haven’t used before. I always find it very useful to treat clients with more complex issues as it really pushes my learning.
Following this, we had a client for a follow up appointment for their peroneal/calf strain. The client had seen minimal improvement since their last appointment but admitted they hadn’t been completing their home based exercise program as often as they should have been. I felt quite confident giving this client exercises, as lower body rehabilitation exercises is definitely my strongest point due to doing lower body exercises often at the gym myself. My coaching has also definitely got a lot better since the beginning of this year, where my coaching tips were definitely lacking. I could always complete the exercise myself, but was bad at explaining how to do the exercise to other people. Now, I seem to have got the hang of it, which is really nice to see. Following this session, we wrote up the notes and then made a plan for next session including progressions and regressions depending on how they get on with their exercises throughout the week.
After this, we had a client with SIJ dysfunction and L4/5 stiffness. I hadn’t yet dealt with a patient who had SIJ dysfunction so this was really interesting. We gave SIJ mobilisations first as this was the root cause of the pain, and then gave some exercises. Admittedly, I didn’t have any ideas on the sort of exercises I could give this patient, so getting advice from my supervisor was really insightful. This is something I am going to research further as I would like to be more confident in this area. Subsequent to this, we wrote up the notes and created a plan for if the patient were to progress or regress.