In my last open clinic session my client complained of a dull ache in the Quadricep muscles.
Reflective Summary
In the subjective assessment my client complained of a dull ache in both quadriceps, but felt more tightness on the right side, possibly due to them being right leg dominant. As part of the objective assessment I observed an increased amount of muscle bulk on the left side (I thought this may have been because in the past medical history (PMH) section the client explain that they had a previous injury to the right ankle so was using/putting more pressure on the left side of the body). However, on palpation there was more tightness on the left side of the body, especially the groin area. The final thing I tested was range of movement (ROM) by using the Thomas test. This tests tightness of the hip flexors and rectus femoris. The client was negative for the hip flexors but positive for the rectus femoris. I decided from this that I would do soft tissue massage of the quadriceps. I used various techniques including effleurage, petrissage and tapotement to increase the blood circulation and neuromuscular technique on the areas of the hypersensitivity.
Areas fur further improvement
I think the first improvement that I need to make would be to revise the special tests that are part of the objective assessment. This is important to do as it will allow me to confidently recall which test should be used to test a specific joint, muscle, nerve or ligament. In this particular treatment I could have applied more pressure as the client was only a 5 on the VAS pain scale. In order to do this, I may have needed to alter the height of the bed so I could have applied pressure using my whole-body weight. The final thing I needed to remember to do was to repeat the Thomas test at the end of the of the massage so I could see if the treatment performed was beneficial. You would hope to see an improvement in ROM if the treatment was effective.
Things to remember
- Give clear instructions to the client so they understand what you are asking them to do
- Ensure the whole muscle can be accessed so the treatment affects the entire area
- Re test the muscle/muscles that have been treated at the end so you can see if the soft tissue massage was effective