21/03/19 Marjon clinic No. of hours 32
Two clients were seen during this two hour session. The first client was 18 year old female runner who runs 4 times a week and does swimming once a week. The second client was a 20 year old lacrosse player who is also female. They play lacrosse once a week with training two times a week.
The first client that came in was a runner, she runs 4 times a week. Because of this she had explained that both gastrocnemius were sore from running. ROM was tested and their posture was too, from evaluating this it shown that their posture was good, but they did have knocked knees. They had FROM in both of the legs with out any pain. While palpating the client there was clear tightness in both legs. A massage was given to both of the legs by using techniques such as effleurage, petrissage and tapotements. METs were also done to help stretch the muscles.
The second client had tightness in their left shoulder, this could have been from playing lacrosse two day before. A postural assessment was done and they had clear kyphosis. The left shoulder was evidently higher than the right, ROM was also tested and although there was on pain it was easy to see that ROM was limited on the left side. Massage techniques were used to help ease the tightness in the shoulder after this was done trigger points were used to stretch the muscles in the neck. ROM was tested again after the session and it had improved on both of the sides.
Give advice on aftercare this includes RICE, making sure to inform them to drink fluids and to do home exercises to build muscle strength.
11/03/19 Marjon clinic No. of hours 30
During this session two clients were seen during the two hour session. The first client was a returning client, they are a 20 year old women who is a first year student. The second client is a 19 year old women who is also a first year student. Neither of the clients play sports but they both go to the gym bout 3 times a week on average.
The first client was a returning client who asked for their back to be massaged again. Before doing anything, the clients posture has shown that they had slight kyphosis ROM was also done and they had FROM. A massage was given focusing on the upper fibres of traps and giving them a neck massage to release tension from their neck which could be from a build up of stress. Afterwards ROM was tested again, and it had shown that it had improved.
The second client was complaining of lower back pain, because of this a postural examination was done, this shown they had kyphosis and that they also had knocked knees. Muscle bulk was assessed in both glutes and this shown that they were even. ROM was tested and they had FROM, from doing palpations it was clear that their lower back was very tight, it was equal on both sides. Massage was given to help with the tightness, neuromuscular techniques where used to help with tension.
04/03/19 Marjon clinic No. of hours 28
Two clients were done in this session, first was a 20 year old women who is a first year student and sits at a desk for most of the day. She was treated a week ago and has come back for further treatment. The second client was an 19 year old male who used to play rugby for a total of 4 years but hasn’t played for two years.
My first client had been treated the previous week and had asked for the same treatment again on the upper fibres of traps. As the client suffers from seizures this can make her muscles tense up, it was informed that she can tell when she is about to have one. Before anything was done a postural assessment was tested and it showed that the R shoulder was higher than the L. ROM was also done, and she had good ROM in both lateral neck flexion and neck flexion and extension. A massage was given to the upper fibres of traps, this included doing the muscles in the neck. After this METs were performed to improve mobility of the tissue and to help ease tightness. ROM was tested again, and it had improved.
The next client that came in said that he had a tight left calf and had been going on for about a week this could’ve been due to him living in the top flat in his accommodation or because he did a long distance walk just over a week ago. Because of this his ROM was tested on both sides, the right was done first and then the left to see the difference on the good and the tight side. His ROM was slightly limited on his left side compared to the right, so a massage was given. After the massage METs were done to help stretch the calf this was done by getting him to move down the couch, so his ankles were off the bed and to then stretch the calf by pushing against a force. ROM was tested at the end of the session and it had improved.
Help explain aftercare, for example tell them what they could do such as RICE. Remember that during postural assessments to test joint level for example testing to see if the knees are level and if the muscle bulk is even on both sides.
25/02/19 Marjon clinic No. of hours 26
There were two clients in this session, the first was 21 year old women who play netball once a week and goes to the gym two times a week. The second client was a 20 year old women who does psychology at university and is a first year and sits at a desk for most of the day but goes to the gym 4 times a week.
For the first client they explained that they were experiencing upper back pain. From talking to the client, it was known that they were a year 3 student who was dealing with stress of all the work that they must do. Before any treatment was given to them range of motion and a postural assessment was done. From the tests that were done it was evident that the left shoulder was higher than the right and that they had signs of kyphosis. Because of this the treatment that was given was an upper fibres of traps massage and METs to help with their range of motion.
The second client was also feeling upper back pain, they said that I could be from stress or from bad posture when sitting at a desk as they slump. From looking at their posture is was clear that they had curvature in the thoracic spine because of this a massage was given to the upper fibres of traps this was done with doing the muscles in their neck also. After the massage tips on how to deal with stress. Range of motion was done after the massage but as this wasn’t done before the massage it couldn’t be compared.
Remember to test their range of motion at the end of the massage to make sure that the treatment has worked. Offer ways to deal with stress from university, this could include things like meditation and relaxation techniques or talking to someone to help relieve stress.
01/02/19 Marjon clinic No. of hours 24
The client was a 27 year old male who goes to the gym 5 times a week and trains weights.
The client started off with saying that a couple day before that they had chest day at the gym which caused them to have sore and tender pectoral muscles. A postural assessment was done on the client and they had slight kyphosis this could be a sign that their pectorals were tight. To help loosen to muscles a massage was given, this included techniques such as effleurage, petrissage, neuromuscular techniques and tapotements. These were done to help stretch the muscle fibres which would help open up the chest more meaning their kyphosis would not be as bad in the future. During the session the client asked for the pressure to be lighter, this means that during the neuromuscular techniques the pressure was too hard for their pain threshold, so a lighter pressure was used.
Remember to test range of motion before giving treatment, this is very important as result from the session will be shown when range of motion is done again at the end. METs could also be done during the session.
11/01/19 Marjon clinic No. of hours 23
19 year old female who plays lacrosse and water polo 2 times a week.
The client come in and spoke about their shoulders and upper fibres of traps be sore, they said this could be from all the training they do for their sports. Form the postural assessment their right should was higher than left, this could be due to the fact that they are right handed so the muscles in the shoulder are tighter. Range of motion was tested with the neck and it had shown that it was limited on the right side compared to left. A massage was given to their deltoids and upper fibres of traps. This consisted of doing effleurage, petrissage, and neuromuscular techniques on the areas that was needed. After the massage METs were used to help improve the range of motion and were then tested again to see if the session had helped improve their state.
Make sure that my instructions are clear so the client understand what movements that needs to be done to perform certain actions.
4/1/19 Marjon clinic No. of hours 22
20 year old female who just started to go to the gym 4 times a week after only going around 1 or 2 times a week.
Client came in complaining of tight upper fibres of traps, they explained that it could be due to stress or that they started to take the gym more seriously or that it could have been from a recent seizure. Upon examination their posture showed that they had kyphosis and that the left should was higher then the right. This client in particular suffers from seizures and had recently had one so the tight muscles in the traps could be a result from this. During the massage multiple knots were found in their upper traps on left and right side and neuromuscular techniques were used on them to release the knots and help with the tension. The back of the neck was also massaged as the upper fibres of traps go down the neck as well as the back. Some METs were used to help release tension at the end of the session. METs are used to put the muscle on bind and the hold it there for 10 seconds while the client resists the force this is done a few times.
Before the massage starts a range of movement test needs to be done to see how the techniques used in the session helped with the tension and tightness.
6/12/18 Marjon clinic No. of hours 21
19 year old male who is an ex rugby player, he hasn’t been playing for two years.
Client was explaining that their quadriceps were sore but not for any particular reason, they do live on the second floor in their halls so could be due to walking up the stairs. Effleurage was done at the beginning of the massage and is used to warm up the muscle tissues ready for petrissage. After this tapotements were used to increase blood circulation. After the session some stretching techniques were used to improve their flexibility and range of motion. This included laying on the bed and get the client to get their heel to touch their glute and to push their hip into the couch to get a stretch in the quadriceps.
Remember to test the clients range of motion before every session, doing this will show if the range of motion has change after the treatment.
4/12/18 Marjon clinic No. of hours 20
Client is 18 year old female runner who runs 6 times a week.
The client was complaining of calf tightness after doing a 5km run two days before the massage. Before the massage was given the client said it was mainly affecting their left calf. To start off with the clients range of motion my doing plantarflex and dorsiflex at the ankle, their range of motion was good. The massage started by doing effleurage techniques that were followed by petrissage techniques. During the massage one of the techniques done was splitting the gastrocnemius, this can be painful so asking the client about the pressure was important during this. To get into the soleus muscle the knee was flexed which causes the gastrocnemius to relax.
Make sure that stretching techniques are done after the massage, also show the client different stretches that they could do at home.
29/11/18 Marjon clinic No. of hours 19
One client was given treatment in this session, this was a 22 year old male who plays hockey once a week and going to the gym 2 times a week with hockey training once a week.
The upper fibres of traps was what the client explained that they were experiencing tightness in. Before any treatment was given a few tests were done, this included range of motion of the clients neck. The client did lateral flexion in the neck on both sides, the left side has less range of motion than the right. Flexion and extension of the neck was also performed, and the client had full range of motion in these movements without any pain. Because of the results a massage was given on the upper fibres of traps using techniques such as effleurage, petrissage and deep frictions this was to improve the mobility in the soft tissue. After that trigger points alongside METs were used to improve the clients range of motion which means they wouldn’t experience as much tightness. After the treatment was done the clients range of motion was tested again this had shown that the treatment has worked as they could get their neck further in neck lateral flexion on the left side.
Try to fit the treatments to one hour per client and offer another treatment session a week later if they wish to have further treatment.