Clinical Reflection 28/09/2020 3-7pm
Before coming to the session, I was feeling nervous as it was going to be a new experience. I had missed my bus which had caused me to be worried about being late to my first time being in the clinic. When I had arrived, I was a few minutes late to what is timetabled in but was not late to the actual session as it started at 3pm, being late was stressful. For the future before getting a new bus, I will plan the time it takes to walk to the stop and double check the bus times to ensure that I am on time and ready for the session.
While in the clinic we had a meeting on how it will be run this year, explaining how health and safety will be in place and how to maintain social distancing. The use of PPE was explained and what order it should be put on and taken off and how to dispose of them properly. Research papers have shown that for PPE to be most effective and safe for workers and patients, the workers must being wearing medical masks, face shields or goggles to cover the eyes, aprons that are ideally waterproof, and gloves, this is what is the world health organisation (WHO) recommends and the UK supports these PPE recommendations (Park, 2020).
References-
Park, S. H. (2020). Personal protective equipment for healthcare workers during the COVID-19 pandemic. Infection & chemotherapy, 52(2), 16

Clinical reflection 05/10/2020 3-7pm
For this session I was note taking while another student was doing the online session. Throughout this session I was nervous as it was the first one with a client, with experience the confidence will grow while doing clinical assessments. During the assessment it was determined, with my supervisors help, that the client had bilateral numbness in both arms down to the index fingers. They also had good ROM and no pain or tightness, after doing the clinical assessment my supervisor helped to determine what the client could have.
The client either had carpal tunnel or a disc herniation which stress was causing symptoms to be heightened.
After the session, the group got together and discussed their clients, talking about what they thought their client had and what exercises and treatment they gave to them to help improve their pain and injuries.
Looking at the session, a few things were missed off while doing the clinical assessment, ROM at the clients wrist and elbow were not taken, to improve in the future I would need to remember to do all ROM at all affected joints. During the session I had also forgot some clinical abbreviations, this slowed down the note taking so to speed up in future sessions abbreviations need to be looked at and remembered.

Clinical Reflections 12/10/2020 3-7pm
The appointment was an online triage with a year 2 student at the university who recently has upped their running mileage and would sometimes run with a group. They had bilateral tightness in their calves down to their Achilles and requested a massage for the next appointment. I felt nervous at the beginning of the session and had technical issue with my laptop, after the issues were fixed, I grew more confident towards the end of the session.
ROM was not completed within this session so will be completed at the face-to-face appointment. Testing for a thickened Achilles tendon will also be done at the next session. Exercises will be given to the client next week after a requested massage is complete.
After this online triage I feel more confident in doing future online triages as I now understand what information I need from the client to take further action, for example what exercises I would need to give and what needs to be done in the next appointment. In future I need to prepare more by doing research on exercises that I could be giving to clients based off the notes they have given me.

Clinical Reflection 19/10/2020 3-7pm
This session was a face-to-face and was the same client from last week, they had recently been running further distances and increasing their speed. Due to this they have been experiencing tightness in their calves and asked for a massage.
ROM was assessed in this appointment as it was not done in the previous session, this was done by starting on the leg that had less pain. The client had excessive extension at the toes, while their ROM was normal range at their knees and ankles. After this a massage was given as this is what the client wanted, the client made a comment to my supervisor and said I had good communication throughout the massage.
My supervisor set a task for me to learn about periodisation to help with my client, they also helped me look at exercises to give to my client to help with their ankle pain.
Areas for improvement in the future is the way that I ask the clients some of the questions and make myself more approachable to the clients, for example when I asked the client about their mental health and stressors they were shut off with me and blunt. My supervisor asked a similar question in a different way and the client opened up more to my supervisor than me. I also need to revise my anatomy at the ankle, as I was not sure where some of the ligaments connected.

Clinical Reflection 02/11/2020 3-7pm
This was the third session had with my university student client, this face-to-face was a session in the anti-gravity machine. Before the session I researched by watching a video on how the anti-gravity treadmill works, this to was ensure that I did not waste time as time can be tight on these sessions. It took me awhile to get used to lifting the metal bar to click it into place, it was set too high for the client so I took note of how high it should be for the next appointment and know for next time that it should be placed just above the hip.
The client was given some exercises, they were also given information on stressors and how to reduce stress, this included reducing caffeine as they drink a lot of caffeine.
Although I did some research before this session, I think some more time spent into researching the anti-gravity treadmill would have made me more comfortable and confident using the piece of equipment. More research needs to be done into exercise to help me with future clients as exercise is the most beneficial treatment, depending on the injury.

Clinical Reflections 09/11/2020 3-7pm
For this session I did not have a client booked in so I helped one of the other students with their clients, this was a online triage. The client was complaining of pain at his thigh after he heard a snap and fell to the ground, they described it as an elastic band snapping.
ROM was relatively good throughout, there was tenderness in side flexion at their lumbar spine, it was also less mobile on the right side. There was also tenderness in their right adduction at the hip, they no longer run up the stairs as it is too painful.
Due to the symptoms the client gave, it was decided that they could possibly have a hamstring tear but the grade was unknown as it happened in April. Client will be coming into clinic next week to have their PROM and RROM tested alongside palpations and Neurological tests.
The client was given some exercises to help them before their face-to-face appointment, after the next appointment, more exercises will be given to ensure they have progressions.
Again during this session some of the clients ROM was missed, this has become a common theme for me when doing clients ROMs, more thought needs to go into doing ROM at each joint as a few movements get missed off.

Clinical Reflections 16/11/2020 3-7pm
This client was the same one as I saw last week on the online triage, they had a suspected muscle tear within their right hamstring. This meeting was a face-to-face appointment so we could see what their AROM and PROM was like while also performing other functional movements.
During this appointment I completed AROM and PROM by starting clearing the joints above and below, after completing these movements I performed the glute firing test, the hamstring fired first on the right leg which is the injured side. I also had the client perform some functional tests, these included sit to stand and stairs, the clients left knee would have some pain while they ran upstairs but walking up the stairs is fine. After this I moved onto palpitations at the greater trochanter and the ASIS which there was no pain present.
After this session I felt like I did a good job in doing the objective assessment and the client gave feedback saying that I did a thorough assessment and thanked me. This session made me grow in confidence as I felt prepared for this session and clients feedback helped me understand what I did well.
Something that I could do in the future to improve is complete a gait analysis on the client, this will help to understand if the client is compensating as they said they felt as though when they walk they compensate.

Clinical Reflection 23/11/2020 3-7pm- total number of hours- 84
This session was with the year two student who I had seen a couple of times, this again was booked in for the anti-gravity treadmill to put pressure off their ankle while during a running session for them. A walk run programme was discussed with them and I explained that it would benefit them by putting less load into their ankle and giving it time to relax.
Unfortunately, the anti-gravity treadmill was double booked which we only found out at the beginning of the session. Due to this I had to quickly think of another session to do with the client, this helped me to develop my quick-thinking skills and to apply it to a session. Because of the double booking we did a gym session, looking at the exercises I had already given to the client I got a resistance band and added some progressions to the exercises. I also got the client to try doing calf raises on a step but these where painful for them so we did calf raises from the floor which again was painful, due to this we did calf raises while sat on a bench which had no pain present.
Learning from this, I would try to start clients off with exercises they are comfortable with, for example I had to regress an exercise twice because it was painful. Starting at the mid-point would be more beneficial to the client, this would be starting with calf raises standing and then if they find that too difficult, regress the exercise and if they find it too easy progress the exercise.