Date: 24/03/2021

Hours: 6

Total hours: 46

During this session in the clinic, the first client seen was for a hamstring strain. This was shadowing a peer within the clinic while treatment was provided. The client presented pain within the hamstring and hip. After an objective assessment, the client shown no pain in straight leg raise or hip movements. The client was then asked to go through a variety of functional movements where there was no pain during a squat, however there was an increase in pain during a lunge movement. Upon further assessment of the client’s squat, it was noticed that there was slight knee valgus of the right knee, effecting the performance of the lunge. The client was then provided with a suggested programme to increase strength within the adductors and in the lunge position. After the session, the client was then provided with exercises by their therapist which included improvements on their form during their lunge, hamstring stretching and strengthening including isometrics.

The next client was a follow up appointment for a client presenting pain within the left shoulder which they have had for approximately 1 week. Client has pain when lying down and struggles to get up. Pain displays as a 10/10 when at its worse with a burning sensation within the shoulder blade. The client struggles with night pain and is currently sleeping in a seated upright position.

An objective assessment was carried out with ROM of the shoulder being assessed. The client had no pain in shoulder flexion or extension however some referred pain in the right trap during abduction. No other shoulder movements caused any pain or restrictions. The cervical spine was then assessed where there was some pain and burning in the right trap in flexion and the same in side flexion.

On palpation of the shoulder, there was some tenderness of the upper fibres of the traps. When looking at the C spine, there was no pain from C1-C4. There was also no pain on palpation at the medial, superior border of the scapula, deltoid, or the GH joint. Suggesting a problem with the trapezius muscle and some tightness.

With these symptoms of pain, referred pain and tenderness, special tests were then completed to help rule out other pathologies. The special tests competed was the empty can test, full can test, and the Hawkins Kennedy test were all positive suggesting a supraspinatus impingement.

The clinical impression of this was Tightness UFT and CSP radiculopathy. The treatment provided was soft tissue massage to the left shoulder and upper fibre of the traps with some neuromuscular technique to the traps. The client appeared to have a decrease in pain at the shoulder and neck after treatment, however they were next booked in for a follow up appointment the next week.

After this session, further revision of the shoulder, pathologies and special tests will be completed for future sessions.