Date: 14/2/2020
Number of hours: 3
Location: Essential Chiropractic Torquay
Summary:
Patient who previously came for treatment to his dislocated thumb, returned for further treatment. The dislocation had healed and he had been to the hospital for an x-ray to ensure it was back in the joint capsule and that he was safe to have treatment. He had reduced ROM in abduction, adduction and opposition with barely any movement in opposition.
Reflection:
I performed STM on the palm of the hand, focusing on the thenar eminence and the base of the thumb, as this is where most of the swelling had accumulated. I also massaged along the forearm and wrist to increase blood flow and improve lymphatic drainage and venous return to reduce the swelling present, which could be restricting movement. I then performed MET to improve ROM but after 5 repetitions, ROM stopped improving. I then performed mobilisations of the thumb in opposition at a grade 3, which significantly improved ROM and decreased pain. To reduce swelling I applied k-tape in a fan position to the palm of the hand and around the thumb to increase the interstitial space and increase lymphatic drainage, while still allowing for full ROM.
After care: move your thumb as often as possible to encourage full ROM to return. I showed the patient how to perform MET on themselves and advised they do this in opposition, to improve ROM.
Summary:
The patient who had previously came to the clinic for treatment who suffered from increased lordosis and anterior pelvic tilt, returned for a maintenance treatment to keep on top of muscle tightness.
Reflection:
I tested her ROM and it had remained better than the start of her last appointment but still reduced on the left side. I performed STM on the UFT, rhomboids, middle and posterior scalene and MET of her rhomboids to improve ROM. I showed her how to do MET on herself at home for side flexion and advised she does that morning and evening five times on each side and holds each stretch for 15 seconds, to improve her ROM and lengthen her muscle fibres.