Reflection: 8/2/2021

Reflection: 8/2/2021                        hours: 2

What happened:

Today I had a remote consultation with a patient who I have been seeing for a few months with a suspected rotator cuff tendinopathy. When I last saw him (25/1/2021), he had just began exercising again after 3 weeks off with the flu. He did not experience any issues when beginning exercising again however, he spent a lot of time working on his car (polishing) over the weekend which caused him a dull ache in his shoulder. He only experiences this aggravation when working on his car or cleaning the worktop at home, the repetitive shoulder internal and external rotation with the elbow at 90º appears to aggravate his symptoms. He has no pain performing the exercises prescribed or when exercising in his home gym.

We spoke about the importance of considering rest and intensity when performing household chores or other physical activity outside of the gym. It is unfeasible to expect to go to the gym for 6 hours with little rest and not experience pain; performing DIY at home with no rest  is still very physically demanding and therefore may explain why he aggravated his symptoms. I recommended that he factors in his DIY activities into his week when considering his rest days and activity levels to ensure he is not overtraining and aggravating the tendon.

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

It was good to give the patient a different perspective on his activity levels, to show him why his symptoms may be becoming aggravated following DIY.

What else I could have done/areas for improvement:

Identified ways of modifying the patients DIY activities to ease his symptoms.

Links to the exercise science videos, explaining the importance of adequate rest, overload and intensity. 

General Adaptation Syndrome (GAS)

SAID Principle (Specific Adaptation to Imposed Demand)

Fitness Fatigue Paradigm

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