23rd April. Duration:6 hours. (4 clients)
My first client today was at stage 4 recovery from an ankle sprain caused through playing football, which has a propensity for these types of injuries (Waldrop et al., 2021). I assessed his passive/active ROM on his ankle, which were particularly good and provided STR to both his calfs followed by functional football exercises.
Whilst working with a football team I was fortunate to have worked with and experienced several sports therapists, which in hindsight, was a fantastic learning opportunity, which I really enjoyed (Leeder et al., 2021). I was learning in a live sports environment, whilst observing the way football club physiotherapists take care of individual players/patients, observing their professional demeanour, reactions, quickly collecting, deciphering, and using the clinical information before administering treatment as quickly but safely as possible. I was also enlightened as to the responsibility and power they ultimately possess, as the decision to take someone off during vital games was always discussed directly with team managers, but ultimately, if the therapist decided it had to be done, it predominantly happened.
I have gained so much knowledge over the past three years, albeit Covid-19 lockdown, seriously impacted on my ability to learn in a practical setting, which did set me back somewhat, but regardless, I feel my confidence and experience levels are returning, and I am more aware of why and how things are conducted within a live sports therapist’s environment. I have always put patient care at the heart of my learning and through self-reflection (Iliff et al., 2021), adapting this with critical thinking has enabled me to make sound judgments, although I am aware, I still have so much to learn. Critically reflecting (de Schepper et al., 2021) on my experiences to date has shown me that communications with patients, physiotherapists, and their managers; in a sports environment, or within a family situation, produces the best outcomes.
My second client was a swimmer, and presented with a shoulder injury, which she described as an aching pain on the front and outside of her right shoulder joint, which had come on gradually over 4-5 days. I sometimes struggle diagnosing shoulder injuries, hence although I remained hesitant to confirm, from research conducted, this sounded like a clinical sign of impingement syndrome (Bolia et al., 2021). With support from resident clinician at hand, I continued my assessments and special tests (60-degree pain ark; Neer’s sign; Halkind Kennedy Test; Empty can test). I undertook a detailed history and explored their pain during the assessment of their passive/active ROM and found a clear pattern of restricted movement and pain symptoms, which objectively were pointing towards my initial thoughts. I think I need to work slower, and although time is always tight, if I can learn to work more methodically, working through all possibilities; perhaps using a mind map technique, this will assist. I calmed down a bit and was able to logically rule in and out structures at fault to dismiss certain injuries, which really assisted me to come to a clinical diagnosis to move to a treatment plan, which the clinician agreed with (PRICE), to be followed with mobility and stretching after 4-days.
My third & forth clients today were dancers recovering from piriformis syndrome (Fig.1) whom I last treated on 24th March ’21. It was good to see them both, and post passive/active ROM assessments, it was clear they were both recovering well. As a professional dance teacher, I know have a soft spot for this profession, and continued to provide functional exercises to assist them to be more flexible and strengthen their weak areas. I conducted STR on both clients in conjunction with foam rubber exercises.
Fig 1. piriformis syndrome
One important thing I have come to learn is to make time to get to know a client as I believe it is important that as sports therapist professional, we take time to listen to patients’ concerns. I also realize that it is important to provide the opportunity and setting for patients to feel comfortable providing honest feedback about the care that I or others are providing, as minus such feedback it may prove
difficult if not impossible to address potential problems. As a dancer, I knew these clients from teaching, and this certainly assisted to motivate them. I am aware personal rapport is naturally built between the client and the therapist, and sometimes find myself being asked to meet up for a coffee with clients post treatment. However, I know there is a professional and personal boundary line, which must be maintained, regardless of friendships, and in these situations, I have used jokes to lighten the atmosphere.
References
Bolia, I. K., Collon, K., Bogdanov, J., Lan, R., & Petrigliano, F. A. (2021).
Management Options for Shoulder Impingement Syndrome in Athletes: Insights and Future Directions. Open access journal of sports medicine, 12, 43.
de Schepper, J., Sotiriadou, P., & Hill, B. (2021). The role of critical reflection as an
employability skill in sport management. European Sport Management Quarterly, 21(2), 280-301.
Leeder, T. M., Warburton, V. E., & Beaumont, L. C. (2021). Coaches’ dispositions
and non-formal learning situations: an analysis of the ‘coach talent programme’. Sport in Society, 24(3), 356-372.
Iliff, S. L., Tool, G. M., Bowyer, P., Parham, L. D., Fletcher, T. S., & Freysteinson, W.
- (2021). Self-reflection and its relationship to occupational competence and clinical performance in level II fieldwork. Internet Journal of Allied Health Sciences and Practice, 19(1), 8.
Waldrop, N. E., Cain, E. L., Bartush, K., & Ochsner, M. G. (2021). Ankle Injuries in
Football. In Football Injuries (pp. 59-79). Springer, Cham.