26th March. Duration: 5 hours (3 clients)
Today’s first two clients were serving soldiers recovering from magnetic resonance imaging (MRI) diagnosed lateral meniscus tears (Kim et al., 2021), which did not require surgery. The injuries were thought to have occurred whilst carrying heavy loads in mountainous terrain (Fig 1 & Fig 2). I was shadowing another clinician who had been working with these clients for the past 5 months, and rehabilitation was going well. I found both clients extremely eager to progress, which was interesting to see, as this exuberance was very evident, and I knew I had to match their enthusiasm whilst tempering their eagerness to do too much. We conducted STR first followed by a passive/active ROM examination then quadricep exercises and balance using various biomechanical ankle platform system (BAPS) or wobble board (Heckmann et al., 2021) and proprioception using various balls. It was good to work with another clinician during this session, as the enthusiasm was contagious, and it was evident the clients really enjoyed the team atmosphere, which I will remember to use with clients such as these (McDonald et al., 2021).
The next client was recovering from a broken great toe, caused through a stamp received during a rugby game. Buddy tape had been used to align the toe and was now removed. Examination identified it was healing well, and all signs of bruising and swelling had gone. I conducted a passive/active ROM assessment, which revealed some slight stiffness but no pain, so got the client to conduct self-passive toe exercises using their hands to gently increase ROM through stretching and holding positions for 15 seconds, repeating 2-4 times, followed by similar with toe curls, and towel scrunches, marble pick-ups and finished on resistance band exercises to increase strength. I got the feeling this client had not been doing these exercises at home as he struggled with some, hence in contrast to my previous client’s enthusiasm, I am aware some clients may require more support and assistance to regain their fitness, and I consciously doubled my efforts to be incredibly supportive and enthusiastic (Adizovich, 2021), but am aware ultimately it is the client themselves, who somewhat dedicate their recovery speed.
Fig.1 Knee Joint
Fig 2: Types of Meniscus Tears
References:
Adizovich, K. R. (2021). Sport helps to simulate problem situations and find ways outof them. Middle European Scientific Bulletin, 9.
Heckmann, T. P., Barber-Westin, S. D., & Noyes, F. R. (2006). Meniscal repair and transplantation: indications, techniques, rehabilitation, and clinical outcome. Journal of Orthopaedic & Sports Physical Therapy, 36(10), 795-814.
Kim, S. H., Lee, H. J., Jang, Y. H., Chun, K. J., & Park, Y. B. (2021). Diagnostic
Accuracy of Magnetic Resonance Imaging in the Detection of Type and Location of Meniscus Tears: Comparison with Arthroscopic Findings. Journal of clinical medicine, 10(4), 606.
McDonald, A. C., Green, R. A., Zacharias, A., Whitburn, L. Y., Hughes, D. L.,
Colasante, M., & McGowan, H. (2021). Anatomy Students That are “Team‐Taught” May Achieve Better Results Than Those That are “Sole‐Taught”. Anatomical sciences education, 14(1), 43-51.