Date:1st December
Location: Marjon Clinic
Duration: 3 Hours (3pm-6pm)
Supervisors: Alex & Mike
What happened? First hour: My first patient was a previous client with a lateral ankle sprain. The patient is now weight baring and has been doing his at home exercises. He wants to improve his confidence in his ankle and get back to a level of being able to play football. I wrote a plan for him with the main components being strength and proprioception. The session went well, I was able to do the subjective while the client was on the bike. I was able to communicate well with the client and believe I made the 5-minute bike warm-up go quickly. The session was actually quite hard to begin with as the client was nervous about all of the exercises and hadn’t really done exercise like this before, so I had to focus a lot on technique and so the session was slower paced than I expected, which meant I had to reduce the reps/sets to get through the whole session. Even though it wasn’t going as planned I was able to adapt under-pressure. My client was a little nervous about doing some of the exercises, but I just made sure to demonstrate each one and kind of put him under pressure to do the exercise without thinking too much. Next time I will make sure to be prepared for a slower session and maybe think about cutting down the number of exercises to get through the session. This did test my knowledge, patience and ability to correct technique, so It was a good learning situation for me. Next time I will take more time to explain each exercise to see if that helps with the initial exercise. When doing the box jumps my client was very nervous about jumping but I was able to encourage him by doing jumps on the floor with him first. Overall, the session went well, and my client was happy.
Second Hour-Writing notes on previous client and researched pathology’s and anatomy.
Third Hour- I had a previous client with lower back pain. The client had manipulations done by us last week for what we thought was facet joint pain. However, the client had very bad pain afterwards and couldn’t walk which means that the treatment was wrong, and we again need to rethink treatment. My supervisor went through another assessment and found that it would be disc herniation. As extension was very limited and causing pain. My supervisor did treatment using a technique I had never used before called lying extensions with the clinician shifting the hip to one side, keeping the shoulders and back straight. While this happens, the client goes as high into extension where it doesn’t cause pain and hold for 5 seconds. By doing this it’s a way of getting into extension without causing the client pain and building up the strength. The supervisor had to apologise to the client and explain the thought process of the treatment last week. This session taught me that it’s really hard to truly determine the right diagnosis and sometimes you may get it wrong. It’s taken a few weeks to get to the right diagnosis.