In this open clinic session, I had the same client as I did last week so I could continue with their treatment programme. They had twisted their knee 2 weeks ago and were still experiencing a sharp pain during knee flexion.
Even though this client has come before it was still essential for me to complete the subjective and objective assessment on the clinical consultation form to see if any changes had occurred in the last week. The subjective assessment was very similar. However, in the objective section I observed that there was less swelling and bruising around the right knee. During palpation the pain was still on the medial side but it was lower on the VAS pain scale so I knew the injury was improving. When I tested range of movement (ROM) there was still a sharp pain during flexion but during extension there was more of a dull pain. From this, as there had been an improvement after the last treatment, I did the exact same procedure; I elevated the client’s legs to allow for lymphatic drainage to occur by massaging the quadriceps. I used a variety of techniques to achieve this such as effleurage, petrissage (which allows you to get deeper into the muscles) and tapotement. I used my forearms especially, to push the lymph fluid towards the lymph nodes in the groin. I then K taped the clients knee ready for football training that evening by using the patellofemoral taping technique to add support around the injury.
Areas for further improvement
My first improvement would be to revise what information needs to be included in the history of present condition (HPC) box which is part of the subjective assessment. When I filled out this part of the form I struggled for ideas, so this section was quite empty when it needs to be detailed. To help me with this I could learn the acronym OLDCARTS to prompt me with information that I could include. O= onset, L=location, D=duration, C=character, A=alleviating/aggravating factors, R=radiating, T=temporal patterns and finally S=symptoms associated. My client’s feedback was that I could have carried out the massage for a longer period of time however, time is limited in the sessions. Another thing that they said was that the massaging was relaxing. In my opinion this gives me the impression that I could have applied more pressure as a sports massage is meant to be deep and slightly painful.
Things to remember