25/03/19
Sports Massage Clinic
1 Hour

What happened during the session:

During today’s session, I performed a client consultation form, stretching and massage techniques on a client who struggles with tight hamstrings as a result of a recurring injury.
How it all started:
Around 3 years ago, this client did damage to their MCL (medial cruciate ligament in the knee), which left them out of football for 2-4 weeks. Even though the injury was still causing them trouble as they had waited the recommended time period of 4 weeks, my client decided they would return to play before being physically ready to do so.
From the return to play early this client continued to reinjure this area causing them to play in a way that stopped the medial side of the knee from being as painful. In conjunction to this, my client stopped playing sport all together 4 months after the first injury their hamstrings were too tight to kick a ball without causing “excruciating” pain to the back of his leg.
The consultation and initial testing:
I started this session with a consultation form which included testing the client range of motion, I did this by getting the client to do a straight leg raise to the point they cannot go any further. once in this position I measured the distance the client had lifted their foot (heel) from the bed. in the first initial test, the client managed to lift the left leg 30cm from the bed and the right leg was 28cm from the bed.

The MET:
The right leg as shown was expected to be lower than the left leg due to increased pain on palpation and more pain and tension felt compared to that of the left leg. this is most likely to be due to the right leg being the one that was injured. after this initial assessment I continued to so a MET on the client which includes lifting the leg to the clients maximum and getting them to push against you at around 30-40% of their full force for 10 seconds then 5 seconds rest 3 times. This video shows the process.

Once completing the MET I remeasured the Range of motion of the hamstrings once again completing the straight leg raise. the left leg had increased by 15 cm measuring from heel to bed at 45cm and the right leg had increased by 14 cm measuring from the heel to the bed at 42cm.

The massage:
I then proceeded to massage the client which seemed to be very difficult for the right leg as the client was in a lot of pain at the slightest touch. We proceeded with the plan to massage under the agreement that if too much pain was occurring the client would let me know and I would ease off. after massaging each leg for 10 minutes I continued to measure the SLR one final time to get an end result for both the right and the left legs. The left leg (uninjured but still tight) measured at 56cm with an increase of 11 cm from the MET but a total improvement of 26cm from the beginning of the session. The right leg (injured and still painful leg) measured in at 47cm only a 2cm increase from the MET however a 19cm increase from the beginning of the session.

Plan for next session:
As this session has proved beneficial for this client not only has it increased their range of motion the client felt less pain after the treatment than they did before the session started and therefore I would continue next session to perform the same treatment to see if I can further improve their ROM.
hamstrings.
Areas for improvement:

Mistakenly, I did not test the hamstrings when taking out the sciatic nerve by flexing the knee and at the hip and therefore I cannot state that the pain is only coming from the hamstrings as the sciatic nerve has not been ruled out. For the next session, I will test this first and then proceed of adjusting the plan accordingly.
Before starting the session, I did not plan what I was going to do as I have not massaged this client before and therefore, I did not know what I was doing. As I have only recently started doing assessments on the lower limb joints I tested this client Correctly however they were on and off of the massage bed constantly to test different areas and therefore, this can cause pain in the injured athlete. Next session I need to work out the best way to test the client by doing all the tests off the bed and all the tests on the bed together so I limit the unnecessary movement that occurred today.
Before the session, I did not know that I would be needing a tape measure to measure the client’s range of motion. I would usually measure by eyeballing the joint but I wanted a precise measurement due to the SLR being less than half the expected 90-degree angle at the hip. this meant that I had to leave the client to go find the tape measure which was unprofessional. For the next session, I will ensure to be prepared for any scenario proposed by the client and ensure that I have all small items of equipment I may need.