Monday 2nd August 2021
Hours: 5
Patient presentations:
- Suspected medial meniscus tear
- Shoulder pain localised to superior angle of scapula
- Knee and bilateral hip pain
Reflection Focus
- Knee and bilateral hip pain
Reflection Model
- Gibbs Reflective Cycle 1988
What Happened?
- Patient’s 3rd appointment in clinic. The patient is an amateur runner reporting diffuse anterior knee pain and bilateral hip pain after road running. When completing her runs on a treadmill there is no px present in either the knee or the hips. At this stage of the rehabilitation process the pt reported that their hips were feeling much ‘stronger’ and they wanted to focus on their knee as it was causing them the most discomfort.
What were you thinking and feeling?
- This session was a positive experience. The pt. was happy with their progress, so I felt confident in the exercise prescription to date. I also feel more confident in treating knee pathologies as a lot of my academic writing pieces have revolved around lower limb anatomy, biomechanics and pathologies.
What was good and bad about the experience?
- It was beneficial to identify an opportunity where I could put theory into practice. I felt I led the assessment with confidence and authority which is an element of my practice I know I struggle with. However, the highlight of this experience was certainly the patient’s optimism towards her pain. She was happy with her progress to date and seemed confident that her pain would continue to diminish. Patients who experience any form of psychological distress are at risk of poorer health outcomes and MSK pain, acute or chronic, induces some form of stress. (Jones & Rivett, 2018.) In this instance, the patient wasn’t displaying any fear-avoidance behaviours, she was eager to progress with her rehabilitation and accepted that her pain, although bothersome to her, would reduce. Overall, I believed the patient did not present with any yellow flags and that her psychological resilience to her pain would ultimately aid in her recovery.
Analysis
- This experience has highlighted that there are still many aspects of my practice where I have some theoretical understanding but haven’t necessarily been able to experience a practical application. As a result, I don’t feel as confident in these areas. This is likely due to lack of exposure and challenging situations. For example, I am yet to treat a wrist pathology. Naturally, as I don’t have any patients with a wrist injury I haven’t done much, if any, wider reading in this area. Whereas, knee, hip, back and ankle injuries are more prevalent in the current clinical setting so my wider reading has been around helping these individuals. Although I don’t feel like this is necessarily a bad thing it has helped identify that I should still be keeping up with my theoretical knowledge and expertise in other areas that I am weaker in. I believe that having some theoretical underpinnings helped me to feel confident and self-assured in myself as a student practitioner on this day. Therefore, maintaining self-directed reading and research will be key in me feeling like a well-rounded practitioner.
Conclusion
- I will aim to make a conscious effort, on the occasions where I don’t have a patient, to pair up with someone who has a patient with a pathology I haven’t yet been exposed to.
Revisiting Reflection
References
- Hammerich, A., Scherer, S., & Jones, A. (2018). Influence of Stress, Coping ad Social Factors on Pain and Disability in Musculoskeletal Practice, In Mark A Jones, & Darren Rivett (Eds.), Clinical Reasoning in Musculoskeletal Practice – E-Book. (2nd ed.) (pp.47-70) Elsevier.