Clinical hours – 31/03/2021
31/03/2021 – Marjon Clinic – Online and F2F Appointments – 5hrs
During the first hour, I had an appointment with a client. I have never treated this client before, so they were new, I had noticed before that a supervisor had already done the online triage, so this client was coming in today to use the traction bed following on from a bad back. Traction beds are used as a form of decompression therapy that relieves pressure on the spine (Gudavalli et al., 1997). Due to never using the traction bed, I was excited to see it in use, but due to never using it, the supervisor in the clinic had already set up the bed before the client arrived but talked through how to set it up for the future. As there was nothing for me to do, I sat next to the client whilst the traction bed was working. At the end of the session, I got the client to perform some movements e.g., bear hugs to make sure there no was pain and before the client rushed to their feet.
During the second hour of the session. I typed up the notes from my client before, making sure they make sense and then checking with a supervisor to make sure I have all the important information typed up, just in case someone else took over the client. I also took this time to ask questions and discuss any clinical impressions that I thought the injury could be. After that, the supervisor suggested areas that I could work on, one being confident and believing in myself.
For the third hour of my clinic session, a client that I have done an online triage from the week before was in for their first face to face session. This client was c/o neck pain that was having referred pain into the shoulder. Due to the client still being in excessive amounts of pain, it was hard to perform any movements, the client tried their best to show the limited range of movement (ROM) but was hard due to pain. After fully assessing the client, I performed a massage to the upper neck and shoulders to try and relieve some tightness they were experiencing. After this MET’s were performed to try and help lengthen the muscles in the neck due to having a major operation a few years before, the muscles were shortened. MET’s uses a muscle’s own energy in the form of gentle isometric contractions to relax the muscles via autogenic or reciprocal inhibition and lengthen the muscle (Chaitow & Crenshaw, 2006). After the session had finished, the client was booked in for the following week.
Lunch
This is typically where we take the hour to go and get some lunch, on this particular day I wasn’t feeling too hungry, so I took the time to write the notes from my previous client so when my supervisors were back, they were able to look over my notes and ‘save as final’.
During the fifth hour in the clinic, I have seen another client that I had already seen a few times before. This client has been improving on every session, even if they are few improvements. We continued with the usual treatment we have been doing from the week before. These were some basic movements to help regain full ROM and build strength. After this, the client was then asked to perform these exercises at home, and this will then be re-assessed the following week when they were next booked in.
During the final hour of the session. I typed up the notes from my client before, making sure they make sense and then checking with a supervisor to make sure I have all the important information typed up, just in case someone else took over the client. I also took this time to ask questions and discuss any clinical impressions that I thought the injury could be. After that, the supervisor suggested areas that I could work on, one being confident and believing in myself.
References:
Gudavalli MR, Cox JM, Baker JA, Cramer G, Patwardhan AG. Intervertebral disc pressure changes during a chiropractic procedure. Adv Bioeng 1997;36:215–6. (level of evidence 3a)
Chaitow L, Crenshaw K. Muscle energy techniques. Elsevier Health Sciences; 2006.