In the first hour of open clinic I massaged a member of the ladies’ football team who was complaining of tightness in both there left and right hamstrings.
At the start of the session I performed a subjective assessment (what the patient tells you) and an objective assessment as part of the clinical consultation form. From this I could see that the client had more muscle bulk on the right side of the body, the feet were everted and they had slight Varus knees. On palpation there was more tightness on the lateral side of the left hamstring. The final thing I did before starting hands on treatment was testing range of movement (ROM) by using the straight leg raise. I also tested this at the end of the treatment by using an eye balling technique to see if ROM had increased and if so it provides evidence that the massage was of benefit. Due to my poor time management I was only able to do soft tissue massage. I started off with effleurage (the same for any massage) to create heat and to feel for any abnormalities. I then used petrissage to increase the blood circulation to try and remove any toxins. I also used tapotement (hacking) to achieve this and to stimulate nerve endings. It was important for me to use my thumbs, knuckles and forearm so I could get deeper into the tissue. I did not want to use my elbows as I thought it would be too harsh/painful.
Areas for further improvement
I think the most important thing I need to do to improve would be to have better time management skills. This would have allowed me to perform other techniques apart from soft tissue massage in the session. I could have used muscular energy techniques (METs), soft tissue release (STR) or taping to help with the treatment. Another thing that I forgot to do was explain to the client why I was carrying out the particular treatment. This is good to do as it will mean the client feels fully involved in the rehab programme and ultimately may feel more motivated to complete it to the best of their ability.
Things to remember
- Use a bolster underneath the ankles to prevent hyperextension when massaging hamstrings
- You may have to use leading questions when filling out the consultation form to get more information from the client
- Ensure the towelling technique is effective and protects the client’s modesty