Reflection: 21/10/2020 Hours: 3
Today I saw two patients in clinic; one patient was suffering from lower back pain, the other from general aches and pains. The second patient who was suffering from general tightness across his body was a digger driver and said he had been working overtime recently and pulling himself in and out of the digger was causing him muscle tightness in his arms, shoulders, legs and lower back. He had a high BMI and had been progressively putting on weight over the last two years due a poor diet.
What I was thinking and feeling and what was good or bad:
At first, I felt very uncomfortable explaining to him how high BMI and an unhealthy lifestyle could be making his job harder and putting unwanted and unnecessary strain on the body. By the end of the assessment and after speaking to my supervisor I felt more confident and understood that when treating a patient, it is important to cover all aspects (including lifestyle factors) to achieve the best outcome.
I explained to him how having a high BMI can increase the risk of muscle damage after exercise and is associated with longer recovery which is likely to explain why he is getting pain from getting in and out of a digger (Kim & So, 2018). If he is going no exercise, the effort of pulling himself in and out of a digger, is likely to feel like exercise to him and be hard work. A study by Kim and So, (2018) found that individuals with a high BMI experienced exercises related pain up to 72 hours post-exercise compared to controls (with a normal BMI) who did not. They also found that the inflammatory response in obese individuals relates to decreased muscle regeneration, which can explain the longer recovery time.
I told him that the government guidelines recommended 150 minutes of moderate intensity exercise a week or 75 minutes of high intensity exercise a week, and it would be advisable that he aims achieve this, with the aim of becoming healthier and lowering his BMI, to help manage muscle soreness.
What else I could have done/areas for improvement:
Introduced exercise into his treatment by going on the exercise bike, exercising together or making exercise plans to enhance motivation and adherence to the exercise.
When I next see this patient (in two weeks), if their weekly exercise hasn’t improved, I will try this method.
Kim, J., & So, W. . (2018). High body mass index is associated with the extent of muscle damage after eccentric exercise. International Journal of Environmental Research and Public Health, 15(7), 1378–1380.