Description: Describe what happened:
Today I saw two patients and completed an hours CPD.
CPD took place in the first hour of clinic, we learnt about Tendon Neuroplastic training. I learnt that increased excitability of the primary motor cortex (part of the brain) is associated with more efficient inhibitory pain modulation (Granovsky et al., 2019). Externally paced resistance training and skill training have been associated with an increase in motor control e.g. if the individual has to set the pace themselves or listen to a beat then this increases motor control. This suggests that therapists should advise patients to pace themselves opposed to being given sets and reps to follow, to increase motor control.
Following CPD I had an online triage with a patient suffering from hamstring pain. The lady was an ultramarathon runner and was experiencing pain after 50k normally. This surprised me at first as I was shocked to hear that she runs so far and can run pain free for so long but my supervisor pointed out that this is because she is used to running these distances so her muscle endurance has evolved, consequently she reaches fatigue later.
My second patient was a nine year old boy who we suspected has Sever’s disease. He came in for a face to face appointment in which we looked at his gait and functional movements.
What were you thinking and feeling and What was good and bad?
Neuroplastic training gives therapists an alternative method of rehabilitation which can be incorporated within strength and endurance training for dual purpose. This was really interesting as it broadened my knowledge to considerations for rehabilitation outside of our curriculum which inspired me to read a broader spectrum of research papers, opposed to just doing extra reading on topics covered in lectures.
I felt like I learnt a lot from todays session and felt really inspired to broaden my knowledge in other areas of sports therapy such as tendon neuroplastic training. I was really intrigued by my second patient and noticed a huge improvement in his pain, emotions and movements following 10 minutes of gait training. The main aim was to limit the amount he walks on his tip toes (a coping mechanism to reduce his pain) as this was affecting other areas of the kinetic chain and his biomechanics. By the end of the session he was walking properly using a heel to toe action and I felt proud that we had been able to help him and amazed at how much the simple exercise had helped.
Analysis: What else can you make of the situation?
Todays session made me realise that simple effective tasks and changes to an individuals training or daily activities can make a huge difference to their biomechanics, pain and quality of life. I have always been aware that it is important to restore normal gait after injury, however I was amazed how effective simple tasks (such as asking someone to walk heel to toe while distracting them) can help retrain them to walk properly and be so effective.
I was shocked that the treatment for Sever’s Disease is in fact not about treating the patient (as the condition improves with time) but it is about managing symptoms to improve a patients quality of life. I need to remind myself that Sports Therapists can still make big changes to individuals lives by managing their pain, even if we can’t heal them overnight.
I also learnt that it is not just about improving strength or endurance, but also linking treatment to the brain.
Conclusion: What else could you have done? and Action plan: If it rose again what would you do?
- Learn more about Tendon Neuroplastic training by reading more journal articles
- Be more informative with patients about treatment modalities.