05/05/2021 5

I was quite nervous for my first client as the notes for the remote consultation expressed that they were unsure of the clinical impression, and it was upper body. During the assessment, I originally thought that she patient has tendinitis of the supraspinatus. However, when the supervisor came in to double check everything, they found that it was instead a pectoralis tendinitis. My incorrect diagnosis made me feel nervous and incompetent. I had revised upper body injures before this session but still managed to misdiagnose. I will definitely do even more work to try and get my head around upper body injuries. We gave the patient some exercises which again, I wasn’t the most confident in. After the session, I wrote up the notes and created a plan for progressions and regressions for exercises.

Following this, I had an online appointment with a patient with decreased range of movement in external rotation of the shoulder. I felt confident in this online assessment, and I had a good idea of what the injury could be. This helped boost my confidence in my abilities following my previous client. After the appointment, I wrote up what assessments should be done in the next session.

After this, I had another online appointment with potential chronic ankle instability. I am very confident in treating ankles, so I found this appointment quite easy. After the appointment, I wrote down what assessments could be done and wrote down some potential exercises that could be given.

07/05/2021 3

My first patient was the client with the meniscus tear. This week, we progressed his exercises and got him on the anti-gravity treadmill. I forgot how to set the machine up so it was good to have a refresher. I felt very confident when treating this patient as I feel like its my most knowledgeable area. We had some issues setting up the anti-gravity treadmill at first but soon figured it out. I was getting confused about the maths in terms of what % of gravity we should be using for him, and what higher and lower gravity would feel like. This is usually something I would beat myself up about, but I have recently realised that I might have dyslexia or dyscalculia, and I have a screening booked in a few weeks. This made me not feel so bad about getting confused. Following the appointment, I wrote up the notes and created a plan for next week.

After this, we had a patient who has been referred from the osteopathy clinic. The patient was presenting with SIJ dysfunction. We prescribed him with some lower body exercises, targeting mainly where his pain was around the gluteus medius area. I felt quite confident in dealing with this client, even though before I was quite nervous due to them coming from an osteopath. After the session, I wrote up the notes and then wrote down some progressions or regressions for the exercises we prescribed for him.

14/05/2021 5

I felt confident going into clinic today, after having revised upper body injuries and having some good experiences with a multitude of different injuries lately.

My first patient with the patient with a meniscus tear. Today, we were able to get in the gym and run a session. I found this really enjoyable as we were able to do lots of functional and proprioceptive work. The patient also really enjoyed themselves and we both had a laugh which was really uplifting and nice. I think I managed to keep a good balance between professionalism and fun which I am really proud of myself for. The patient was really keen on his exercise progressions, so I am hoping this will help him adhere well at home. After the session, I wrote up the notes and then made a plan for next session.

The second patient was the patient from a couple of weeks ago who had pain in their metatarsal joint in the foot. She has progressed so much which was really lovely and confidence boosting to see. During the session, we were able to run through her exercise progressions with her which she really enjoyed. She admitted that whilst she had completed some of the exercises, she hadn’t completed all of them. So, in order to aid her adherence we let her take videos of us doing the exercises to help her remember then better. I felt this session feeling happy and confident. After the session, we wrote up the notes and wrote down some ideas for exercise progression.

After this, we had an online consultation with a patient who had knee pain. Our immediate clinical impression was either PFPS or meniscus damage. After the session, we wrote down ways to differentiate between each injury and thought of some potential exercises. This patient is very elderly so this is something we are going to have to take into account. At first we struggled with exercises that may be suitable for an elderly man for this injury, so this is something I am going to further look into in case he isn’t that mobile.

19/05/2021 3

My first patient was a patient who we had previously thought had a pectoralis tendonitis. Upon assessment of this patient previously, I thought the patient was presenting with a supraspinatus impingement or a cervical radiculopathy. However, when the intern came in to review what we had found, she informed us that she thought it was a pectoralis tendinopathy. During the session today, one of our supervisors came in to see how we were doing. After discussion, they informed us that they thought this patient was instead presenting with a cervical radiculopathy or a supraspinatus impingement. This was what I had originally thought the client was presenting with, so this restored my faith in my knowledge. After the first session we had we this client, I felt extremely unconfident in my abilities, seeing as I had completely misdiagnosed the injury. However, this event showed me to always question and to always trust myself as a therapist. We gave the patients new exercises, wrote up the notes and made a plan for the following week. After this, I planned for my next client.

My next client was someone I had been seeing regularly who had global muscle weakness and chroic pain. When she came in today, I gave her progressions on her exercises and massages her upper fibres of trapezius. I am really glad I’ve had the opportunity to treat a client with chronic pain, as it is really good experience for the future. I had planned a light yoga session to complete with her, but at the session she stated that she instead just wanted a massage. After the session, we wrote up the notes and planned how to progress her exercises for the next session.

21/05/2021 5

My first patient in clinic was an online consultation with someone who had anterior knee pain. The consultation went well and I am very used to writing up notes and delivering the subjective assessment virtually now. Knee pain is something I had seen a lot of in clinic, so this was quite easy to see what the potential problems could be for this client. After the appointment, I wrote up the notes and made a potential plan for a session for when they come in.

Following this, I had a face-to-face appointment with someone with patella femoral pain syndrome. Again, this is something I have dealt with a lot in clinic so I felt super confident delivering the assessment and giving the player exercises. After this, I wrote up the notes and made a plan for the following session.

After this, I had a patient with a facet joint dysfunction. This is one of the injuries I have dealt with the least in clinic and at my other placement. However, I still felt confident delivering the assessment and giving the client exercises. Sometimes with back pain I struggle with knowing what level of exercise to give each patient but recently I have got a lot better at deciphering what is appropriate. After the session, I wrote up the notes and made a plan for next session.

25/05/2021 1

For this session, I was with a client I treat quite regularly. Last week, I planned a yoga session for her to complete with me, but instead she only wanted a massage. This week, the same thing happened. Although this week, she mentioned that she had some lower back pain so I assessed her lower back. Upon the assessment there was a lot of bruising on her lower back, so I asked her if she had a fall however, she couldn’t recall. Because of this, I instead massages above the bruising after getting confirmation from my supervisor. This is something we are going to keep an eye on and re-assess next week, especially if the bruising is still there. This was something new that I hadn’t dealt with before, but I felt quite confident in my abilities.

28/05/2021 3

My first patient was someone I had been working with for a while. He had torn his meniscus in his medial knee. This week, instead of taking him into the gym I had to regress his exercises as he said that his pain had got worse. This is one of the first times I had to regress exercise as usually the patients I had dealt with had actually improved. But, I felt very competent to do so. Also during this session I gave him ultrasound, which is something I hadn’t done in a while. I had to refresh my memory of the settings but as soon as I did, I felt confident in delivering it. After the session, I wrote up the notes and then made a plan for progressions and regressions next session.

After this, I had an online consultation with a client who seemed to be presenting with golfer’s elbow. The appointment ran smoothly, and I was glad to have a client with an upper body injury as I am usually dealing with lower body injuries. After the appointment, I wrote up the notes and made a potential plan for the session.

Following this, I had a face-to-face client with a patient who had patellofemoral pain syndrome. In this session, we went into the gym and I progressed their exercises further. Again, the knee is the most common body part I’ve had to treat so I felt confident in doing so. Going in the gym was enjoyable and we managed to get the client doing lots of things they hadn’t done before. After this, I wrote up the notes and made a plan for next session.