In this session, as part of open clinic, I performed treatments on two different clients: one plays in the men’s football C team and the other was a female who is in the BUCs volleyball team.
For the first hour I treated a client who complained of achiness in their lower legs. When I observed their posture and overall body frame I noticed their toes were everted by a large degree and I considered that this could be due to tightness in their piriformis. When I palpated the soleus and gastrocnemius there was tightness (no pain) on the lateral side of both legs. I started the treatment with testing range of movement (ROM) of the quadriceps (flexing the knee), hamstrings (straight leg raise) and gastrocnemius (dorsiflexion of the ankle). I then did effleurage to create heat and petrissage to get deeper into the tissues allowing some tension to be released. I used my knuckles and forearm on the lateral side of the legs where the tightness was as these parts of my body allow me to apply more pressure. I used tapotement (hacking and cupping) that continued to increase circulation as I saw erythema. I then did soft tissue release (STR) of the piriformis by flexing the knee, applying the lock and then externally rotating the knee to maximum range. I repeated these four times and then tested ROM again to see if there had been an improvement.
My other client had a similar tightness in their legs so I did the same assessments to test their ROM. When I observed their body frame they had more muscle bulk on the right side but the tightness was on the left side. I then decided to use soft tissue massage and stretching in order to reduce the soreness. I again started with effleurage and went deeper into the muscle tissue by using petrissage. I then performed muscular energy techniques (METs) which are used to stretch tight muscles and fasica (like my client had) as well as strengthening weak muscles. I used post isometric contraction (PIR) of both the gastrocnemius and soleus. I did not need to use reciprocal inhibition (RI) as there was no injury so it was not necessary to contract the agonist instead of the target muscle.
Areas for further improvement
The first improvement that I need to make is ensuring I am more technical with anatomical terms when completing clinical consultation forms. This is important as other therapists may have to treat my client and be able to understand my notes from previous sessions. Even though I revised anatomy for my exam I need to carry this on so I know where all the muscles are and how each of them are responsible for different movements. If I become more confident with this I will be able to work out what muscle/s need to be stretched for a particular problem/injury. If I became more knowledgeable on the anatomy of the body and did further reading I would be able to explain in more depth why I am performing a particular treatment.
Things to remember