CLINICAL REFLECTION – 4/3/19 (2nd reflection)

Date Location Total Amount of Hours Overview of Session
4/3/19 Marjon Sports Clinic 2 hours First client complaining of back pain on and off for 18 months following a period of overuse at the gym.

 

Second client tight calves following half marathon training.

 

Reflective Summary Areas for further Improvement plus action plan
Client complaining of pain along their left medial border of scapula and down their mid back. On palpation there was tightness along erector spinae in the middle of the back and along the medial border of scapula. I tested the client’s ROM in FLEX, EXT, ABD, ADD, depression, elevation, retraction and protraction. The client had reduced ROM in FLEX and EXT but good ROM elsewhere.

I checked contraindications and then performed STM and STR for 20 minutes in each area (over the rhomboids, posterior deltoids and latissimus dorsi) to reduce the myofascial trigger points and relax the muscles to reduce tightness.

 

After performing STM I re-tested ROM and noticed an increased ROM in EXT, however FLEX ROM remained the same, therefore I performed MET to stretch the pectoralis major. On re-test of ROM I noticed a large improvement, this is because the pectoralis major is one of the main muscles involved in shoulder flexion.

 

I advised that the client performs some stretches of the pectorals following a gym session, to reduce muscle tension and to increase flexibility.

 

The second client had tight calves due to running three times a week in preparation for an upcoming half marathon. The client reported that they had always suffered from tight calves and had previously torn their achillies tendon in the left leg four years prior. I checked contraindications and ROM. Upon palpation I noticed a few trigger points along the centre of the left calf. I used NMT to deactivate the myofascial trigger points and STM to lengthen the muscle fibres, increase flexibility and decrease muscle tone. I then lifted the leg to isolate the sartorius and repeated the NMT and STM. I used MET to lengthen the calf muscles and frictions along the achilies tendon. I retested ROM and noticed an increase in both calves.

–       Try using PIR as an alternative or additional technique for treatments.

 

–       Use k taping more frequently to support injuries.

 

–       Research more ideas for appropriate stretches to give clients to perform themselves at home.

 

Returning to reflections at a later date
Both PIR and RI can be effective techniques and useful in different scenarios depending on the client’s pain level. Continue to explore both techniques to ensure I feel confident identifying when each one should be used.

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