Date: 04.02.19
Location: Plymouth Marjon University
Total amount of hours: 30
In this session, treatment was given to a client who is 20 years old, treatment lasted approximately 2 hours. The client competes in water polo and volleyball on a weekly basis. She has complaints of calf pain from previously competing in athletics when she was younger. This has been an ongoing injury since she stopped competing in athletics, however has still caused her problems in her daily life style including sharp pains when she crouches down and walking up and down the stairs.
After completing a consultation form and observing the injury, it was clear that both the client’s calf’s were tight yet the left calf was a lot tighter than the right, and there was a greater muscle bulk of the left calf muscle. The client didn’t feel any pain on palpation, however had a limited ROM during dorsiflexion.
Treatment began with a light effleurage to help warm up the muscle and prepare it for deep tissue techniques. Petrissage techniques such as wringing and kneading were then applied. The client didn’t seem to find any pain during any effleurage techniques however some of the kneading techniques did cause some pain within the gastrocnemius.
After treating the calf using massage techniques, Muscular energy techniques (MET’S) were then used. This will help to increase range of motion through lengthening the muscles. This was achieved by positioning the client she was lying face down with her feet off the end of the bed. By applying a small amount of force against the clients foot, forcing it into dorsiflexion, and asking the client to resist against this counter force, the stretch was held for 30 seconds. This helped to contract and stretch the muscle. This technique was repeated three times, each time adding slightly more force to the foot.
After stretching the gastrocnemius, the soleus muscle was then stretched. To do this, the client was still positioned face down on the bed with the knee flexed to a 90 degree angle and the foot relaxed. To stretch the soleus muscle, the forearm over the sole of the clients foot to help force the foot into dorsiflexion whilst asking the client resist against this force for 30 seconds. This stretched and helped to contract the soleus muscle. This was repeated three times on each leg with more force being applied each time to push the muscle to a new barrier. After these techniques had been applied, the client was then able to achieve a better range of movement within the gastrocnemius and soleus.
ROM was tested again at the end of the session and there were some improvements found in dorsiflexion with no pain during the movement, however full range was still not achieved. The client still had some tightness in the calf muscles after the session, meaning that there may need to be further sessions to help improve the clients range of movement further.
An ankle and knee assessment can be carried out to help determine whether there are any underlying issues which may be affecting the clients calf pain.