STYC01 Clinical Reflection 15/03/10

In this hour I treated a client who studies outdoor education and complained of lower back pain from climbing 3 days before. 

Reflective Summary 

As this session was down in the Sport and Health Clinic I did a generic subjective assessment just by asking the client a few questions, rather than filling out the clinical consultation form. I then did a brief objective assessment by observing the height of my client’s hips and seeing if their spine appeared to be in the correct place. I palpated their lower back and felt areas of tightness but no knots. I checked range of movement (ROM) by asking them to perform flexion, extension and side flexion of the lumbar spine to see if there were any limitations in the movement. After this I concluded that it was just muscle tightness from the activities performed a few days before and it was now out of the acute stages so I was able to use soft tissue massage. I started off with using effleurage to create heat and to feel where the tightness was. I introduced petrissage gradually to increase the blood circulation and to get deeper into the muscle tissues by using my thumbs, knuckles, palm of my hands and forearm. I worked on each side of the back for 15 minutes and then did the whole lower back for 5 minutes. From the subjective assessment I found out that the client does not do any stretching after physical activity. This led me to give them stretches to do, particularly for the back. I demonstrated how to perform each stretch then watched them do it so I was able to make any corrections to their technique.

Areas for further improvement 

An area that I need to develop and improve is to explain to the client in more depth what I am doing in the session and why I have chosen to do it. I believe this is important to do as it may allow the client to feel more confident with the treatment that you are performing if you have the correct knowledge and skills. It also engages them in the rehabilitation programme and could allow them to feel more motivated if they know what the diagnosis is and how they can help themselves to improve it. Another slight improvement that I could make would be for me to set up my work station before the client arrives. This could be seen as being more professional but usually the clients arrive with me so they know where to go.

Things to remember 

  1. Use the towels appropriately so you are able to treat the whole area, even if it is difficult to access
  2. Check ROM at both the start and the end of the treatment
  3. Wipe off the bed before the client arrives so you know the working environment is hygienic  
Petrissage kneading technique on the lateral side of the lower back


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