Marjon Clinic 11th May 2021 for 5 hours

During this clinic session, I conducted a full objective assessment with a client who had a clinical impression of an adductor strain and completed a full clinical assessment for a runner, including a gait analysis on the treadmill.

Reflective Summary

In Sports Science, the analysis of running biomechanics is normally used to either analyse an athletes performance or to understand the underlying mechanisms of injury (Hoenig, Hamacher, Braumann, Zech, & Hollander, 2019). My client requested the gait analysis as they want to be able to run a half-marathon in under 1.50 minutes. As they had had a previous injury, I looked at it from this perspective. I used a linear method of video based observation to analyse the clients running biomechanics by assessing limb kinematics, joint angles and foot strike patterns (Hoenig et al., 2019). A two-dimensional (2-D) video-based assessment of running kinematics is a common clinical approach, given the space, time, and cost burdens present with computerised 3-D analysis (Pipkin, Kotecki, Hetzel & Heiderscheit, 2016). Moreover, I am not trained and do not understand how to use 3D cameras. A biomechanical deficit that I noticed in the assessment was that the client had a stiff knee gait. This is considered an abnormal gait pattern that is characterised by insufficient knee flexion as a result of overactive rectus femoris (Campanini, Merlo & Damiano, 2013). Moreover, inadequate push-off has been indicated as an additional cause in the recent literature. Because of this, I gave the client exercises (A skips and B skips) which would look to increase knee flexion angles.

What Went Well

I was able to fully rationalise the clinical impression of an adductor strain for my first client; they had tenderness on palpation over the adductors and had pain on resisted adduction. Moreover, I felt confident conducting the running specific clinical assessment as I ensured that I researched and understood what I had to do prior to the appointment.

Areas for Improvement Action Plan
Use the Hudl app to calculate the clients running cadence. Next time I conduct a gait analysis, count the client’s steps for 15 seconds then times by four in order to calculate cadence.
Within the clinical notes, I need to ensure I not only record the palpations that produce symptoms but all of the structures palpated. During my clinical exam, ensure that I note down every structure palpated.

Closing the Loop

Since coming back to this reflection, I have had the opportunity to calculate a clients running cadence which could then be compared to the optimal value of 180 steps per minute.

References

Campanini, I., Merlo, A., & Damiano, B. (2013). A method to differentiate the causes of stiff-knee gait in stroke patients. Gait & Posture, 38(2), 165-169.

Hoenig, T., Hamacher, D., Braumann, K. M., Zech, A., & Hollander, K. (2019). Analysis of running stability during 5000 m running. European Journal of Sport Science, 19(4), 413-421.

Pipkin, A., Kotecki, K., Hetzel, S., & Heiderscheit, B. (2016). Reliability of a qualitative video analysis for running. Journal of Orthopaedic & Sports Physical Therapy, 46(7), 556-561.

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