Reflection: 16/12/2020                              Hours: 7

 What happened:

Today I had seven patients in clinic, four with lower back pain and three with neck and shoulder pain and stiffness. I have noticed that the majority of the patients that I see have neck or lower back pain which may be due to a lot more people working from home currently and adopting poor postures.

For the last two weeks I have been seeing a lady with a suspected meniscal tear which was causing a lot of swelling in and around her knee. Last week we focused on reducing the swelling and discussed working on her gait, the aim of today’s session was going to be gait re-education and we discussed the importance of restoring normal biomechanics as soon as possible following injury to avoid compensatory movement patterns. However, today she has come into clinic with severe lower back pain and stiffness, which is likely to be caused from overcompensating and altering biomechanics due to her knee pain. There has been found to be a common link between the knee and the lower back with damage to the knee, often causing lower back pain (Suri et al., 2010).

What I was thinking and feeling and what was good or bad:

I felt a little bit guilty that I hadn’t incorporated gait re-education in the session before to try and prevent this patient from experiencing lower back pain. However, this would not have been possible due to the level of pain and lack of knee movement the patient had last week.

What else I could have done/areas for improvement:

Really aim to educate patients on the importance of factors such as restoring optimal biomechanics and gait etc. Check their understanding and make sure they feel confident enough to speak up if they are unsure on what I am saying.

 Action plan:

• Practice educating patients using suitable language.
• Research other common compensatory movement injuries.

References:

 Suri, P., Morgenroth, D. ., Kwoh, C. ., Bean, J. ., Kalichman, L., & Hunter, D. J. (2010). Low back pain and other musculoskeletal pain comorbidities in individuals with symptomatic osteoarthritis of the knee: data from the osteoarthritis initiative. Arthritis Care & Research, 62(12), 1715–1723.