Date: 07/12/ 2020

Hours: 4

Total hours: 37

This session in the clinic began with an online consultation with a client who had complaints of shoulder pain. The client was referred by a GP who had diagnosed her with a problem with the rotator cuff. However, upon subjective and objective assessment, this pain did not appear to be related to the rotator cuff.

In subjective assessment the client was asked questions based on past medical history and the origin of the shoulder pain. Due to the symptoms that the client had presented including a tingling sensation down the right arm into all fingers, pain in shoulder abd, ext and Cx left side flexion caused contralateral pain on the right side. During Cx side flexion on the left, it was noted that the client was unable to complete the movement as they had moved the shoulder to meet the ear, which shown a lot of muscle guarding.

The clinical impression of this injury was Cx Radiculopathy – Disc Herniation and differential diagnosis of Cx Radiculopathy facet joint dysfunction.

The client was then seen by another therapist the next day for further assessment.

 

The next client seen was a follow up with a client who had originally attended with low back pain and wanting to increase their upper body strength, the clients’ goals were included into this session to improve whole body strength. This session was based in the gym with the focus being the upper body.

The session began with a 10 min warm up on the exercise bike where an RPE scale was used to assess how difficult the client found the exercise throughout. This then moved onto the upper body workout with a superset of Bicep curls and triceps pull downs using the cable machine. The rest of the session consisted of Dumbbell shoulder press (5kg), Barbell rows and Lat pull downs. Each of these exercises were completed in 3 sets, 8 -10 reps with a 30 second rest between sets.

The second part of the session focused on the core which will help to reduce any back pain with a stronger core. These core exercises included dead bugs, bird dog and glute bridges which was then progressed to a single leg glute bridge as the client was beginning to find this exercise too easy. The cool down consisted of child’s pose, hamstring, pectoral, and triceps stretches. The client said that they felt that these exercises helped relieve some pain and will be continuing them when at home.

The client was then booked for another session for after the Christmas period due to the clinic being closed.

After completion of notes, further planning was made for future gym sessions with this client concentrating on upper and lower body strength and core stability exercises. All of these strengthening exercises will benefit the client and provide a better quality of life during their place of work as a care worker.