Clinic Placement:
Date:3rd November
Location: Marjon Clinic
Duration:4 Hours (3pm-7pm)
Supervisors: Alex
1st hour
What happened? I had an online client who was experiencing neck and shoulder pain from working in a hairdresser. I was able to go through most of the assessment and found that it was most probably muscle tightness and not a serious injury.
What went well? I was able to communicate well and put the client at ease making them comfortable to perform the movements online. I took more time than usual which I believe helped the assessment go smoother than usual as I wasn’t panicking and rushing.
What could have gone better?I could have demonstrated some of the movements instead of explaining them so that the patient understood straight away but I wanted to try just explaining them to see how I got on with that. However, I believe demonstrating is a better way
2nd hour:
What happened?My client came in not being able to weight bare. I did a full objective and subjective assessment for the ankle. I taped the ankle and gave early-stage rehab exercises and advice.
What went well? I analysed the patients gait as they came into clinic, so I didn’t have to do it in the assessment. From this I found the patient was struggling to weight bare and knew from this it’s a possible stage 3 sprain. When doing the assessment, I was able to communicate well with the client keeping him at ease during the assessment. I was able to use the Ottawa ankle rule to rule out a fracture, I was impressed with myself for remembering this and found that my patient did not have a fracture.
My taping went smoothly. I used K-Tape as I believe it the best for an ankle sprain as it still allows some movement so that the ankle doesn’t immobilise and become stiff which will slow the healing process. My client said that it felt comfortable and supported, so I believe I did an effective job. As the client couldn’t weight bare, he couldn’t do any movement without pain so I went through how he can try and start putting weight on the injured foot, as well as how to walk properly with crutches. I went through these clearly and got my client to show me after demonstrating where I gave advice, I feel this made my client feel confident he was doing them right and would then hopefully continue at home.
What could have gone better?I was a little on-edge performing the special tests for the ankle as I hadn’t done this for a while. I got my supervisor to come and do them so I could watch. I will need to practice this at home on someone. My patient was confused where the pain was the worst which made the assessment a little hard to correctly diagnose, I think I confused them by doing too many palpations and their pain receptors were not sure. I was a little unsure resisted movement as I think it was too much for the client, but I made them do it anyway. I think next time I will use more common sense and not make a client do resisted movement if I think they probably will feel a lot of pain.
3rd Hour: In this hour I was able to write up my notes and discuss my previous clients with my supervisor. My supervisor gave me advice on the ankle patient for their rehab plan. I enjoyed learning from my supervisor and feel I wrote my notes well. The feedback my supervisor gave me on my notes was that I need to not bullet point as much and turn my subjective into sentences. And during my assessments I need to take charge a little more so that the patient isn’t in charge.
4th Hour:
What happened?This client I had previously seen and had lower back pain. I went through a small assessment of ROM in the TX AND LX and the hips. The client’s ROM had improved slightly since last time as she had been doing the home exercises regularly. However, the pain had not reduced and was not gone. I gave her a lower back sport massage and went through a gym exercise session.
What went well? My assessment went smoothly. I was able to get the client in all the right positions for each ROM movement. I communicated well and feel I have built a good rapier with this client. The back massage went well as I was constantly asking if the pressure was ok. The client said afterwards that she felt the area was more relaxed and warmer for doing the movement. The clients hip kept collapsing on the standing hip adduction exercises and I was able to see this and make the client aware and give tips on how to correct this, so the exercise is being done with the proper technique. I joined in most of the exercises as I feel its motivating when the practitioner isn’t just watching.
What could have gone better?I am not entirely sure what the client’s pathology truly is. As the client has said the pain has not reduced even though they are doing the exercises religiously. I feel as if I need to do a full re-assessment next time to try and pinpoint the true cause of the lower back pain.