Reflective Essay 2020

Reflective Placement Essay

Introduction

Saints Southwest is a football organisation being an official club partner of Southampton Football Club. Their aim is to be able to provide education, community, football and sporting provisions across Devon, Cornwall and Somerset. The age range for this organisation varies from 2 years old to 18 years old, some of the players have also progressed into the Southampton Football Clubs own academy once they turn 16 years old. Community is involved in their aim because they are always looking for ways to develop and improve the surrounding community, involving them in different football sessions, multi-sport camps, events in local schools and fundraising for charities. Education is involved in their aim because they want to ensure there is maximum opportunity with a positive impact for young people throughout their physical education programmes. Working alongside schools in the Southwest in order to develop the physical education standards. Football development is another aim they focus on as they want to help young players reach their full potential. By delivering sessions each week they aim to identify children with talent and allocate them to a suitable training environment. Soccer tots and Mini saints are names of the two groups that allow the younger children to get involved. Soccer Tots group is for children aged between 2-4year olds and Mini saints is the group for children aged between 4-6year olds. Regional Development squad is for children aged from under 7’s to 11’s who have been recruited from their local development centres. Regional squads are for athletes aged Under 12’s-18’s who compete in football fixtures against other teams in the Junior Premier League and private fixtures with the professional academy teams.

Aims of placement

The aims and objective for this placement is to improve confidence and increase understanding of the rehabilitation skills that are needed as well as increasing knowledge of the human anatomy. To be able to feel ‘job ready’ after the placement is finished, in the hopes to get a job within the football industry once qualified. There were 4 objectives put in place at the beginning of the placement time period in order to achieve these by the end of the time period, “see Appendix A”. Learn and understand the correct rules and regulations of football is one of the objectives to achieve during placement. According to The Football Association (FA) (2020), there are 17 different laws throughout a game of football that needs to be in place, ranging from the field of play, the ball, the goal kick and free kicks. The next objective is to improve first aid skills, this is because the role within the organisation for the placement is to be able to attend as a rehabilitator and be there as a first aider. Making sure that the players are fit and well to play and to make sure if any injuries occurred then they are attended quickly, correctly and professionally. According to Krutsch, et al., (2014) football encounters a high rate of injuries including in youth football therefore, immediate first aid is important to prevent long term injuries.

These aims were short term goals that were set in place for the placement at Saints Southwest. Alongside these short-term goals, there were other goals put in place at the start of second year of university “see appendix F for Personal Professional Development Plan (PPDP)”.

  • Complete and pass second year to advance to third year.
  • Complete all required clinical hours/placement hours needed.
  • Complete degree in 2021 with a 2:2 or above.
  • Secure a paid position job in the sport rehabilitation industry.

Overview of Saints Southwest Placement

During the placement period, I was able to complete 50 hours of clinical practice, treating and assessing injuries in a clinical and pitch-side environment. I was only able to be with this placement for 3-months before the placement was closed due to current circumstances, this limited my ability to complete the full original 100 hours that was set in place. However, during this little time I was able to complete and accomplish a few of my aims and objectives that were set in place at the start “see Appendix A for aims”.

At the beginning of this placement, I was not entirely sure what to expect, I thought I would have to just rely on a professional therapist to ‘show me the ropes’ and help guide myself through all injuries that encounter, however this was not the case. When I arrived I found that the coaches were the first aiders for the club, so due to this, when it was announced that I was joining the club as a rehabilitator and the official first aider I was overwhelmed with loads of messages from players parents trying to book an appointment for their child. On the first day, I had 8 athletes booked in for an appointment due to having injuries that recently occurred. In my reflective blog post (27/01/2020), I explained that I felt super nervous for the first day but for next time to not book so many people in on one day as it effected my skills, due to having to rush to make sure everyone was assessed. I accomplished this aim that I set myself by only booking 3 people in for the following week, so I had more time to assess and treat where needed (reflective blog post- 03/02/2020).

On my fourth week of placement I had a client turn up for a walk-in assessment appointment as they didn’t realise they needed to book in prior. Due to having enough time, I was able to assess the athlete and find out what was bothering him (reflective blog post- 24/02/2020). During this limited time, I was able to perform a soft tissue massage however couldn’t go deep into the tissue due to tenderness. I advised the athlete to do some exercises and stretches at home. I created a groin/ hip flexor rehabilitation programme which he could perform at home to help ‘speed up’ the recovery time, “see appendix G- rehabilitation programme”. This was one of the clients that tested by abilities to begin with. At the beginning of the appointments with this athlete, I was worried that I wouldn’t be able to help him recover from this injury, this is partly because of my confidence. However, near the end of the placement period, he had recovered from the injury a lot better than I would have thought and a lot quicker than expected also! The last appointment with this client he explained that there was no longer any pain, still slightly tight in that area however he said that those exercises and stretches seem to be helping a lot (reflective blog post- 16/03/2020). I enjoyed doing this rehabilitation programme for him to perform at home as it helped with my confidence especially knowing that it helped his injury and within the time frame of a groin injury recovery, 4-8 weeks (Su, 2019).

Being able to use my academic skills during my placement time period has helped with my rehabilitation skills because I have been able to assess a client and then go home and research using my academic study skills to find out what the possible pathologies are and how to help treat and recover my client from the injury. Due to a few of the clients having the same injury (Achilles tendinopathy) in the same age group, I was able to research what the possible pathologies could have been due to them all having similar symptoms. I also asked my lecturers for their feedback and knowledge of what the diagnosis could be and what the best way was to handle it. Asking my tutor at university helped me gained more confidence as they agreed with everything I had already done with my clients and what I had advised my clients to do (go get a scan/ x-ray). Due to my clients going through the growing stages of their lives it was important for them to get a medical examination of an x-ray or ultrasound to rule out any other diagnosis’. Once they had been examined, I could then research more to find out which is the best way possible to help aid them to recover with the appropriate exercises and stretches (Reflective blog post- 24/02/2020).

Linking my aims “see Appendix A” to my feedback from placement supervisor “see Appendix D”, I feel as though I have achieved my aims for confidence, coaching skills and rules and regulations for football. In Appendix D, you will find the summative feedback form that was written by my placement supervisor after the placement period had ended. He states that I am “approachable, knowledgeable, enthusiastic, confident and caring”, these skills were the main topic for my aims as I find that being able to do all of these skills will help improve my skills as a rehabilitator and also to learn more about the sport. Without the knowledge and enthusiasm that I have learnt throughout my time at placement, it would have been hard to adapt my skills and improve them. Confidence was a big skill that was drastically needed throughout this placement, this is because, when working with new people and especially the young, with no confidence in myself I feel as though they wouldn’t have the confidence in myself to treat their athletes.

As stated by my placement supervisor “see Appendix C”, I took on cool down sessions with a variety of age groups at the end of their training sessions showing and teaching them correct stretches for the athletes. In my reflective blog post (10/02/2020), I discuss that at the end of this training session I gathered all age groups, ranging from under 9s to under 16 years old, to the middle of the AstroTurf and performed stretches with them, I went round to every athlete making sure they were performing each stretch correctly and applied overpressure where needed. This helped boost my confidence and trust with each athlete as they needed to be able to have trust in me of my knowledge in order to listen and perform these stretches correctly. Having the confidence to do this has a huge effect on each athlete individually, this is because, lack of confidence means lack of trust, if there is no trust between a rehabilitator and the athlete then there is no knowledge to share about injuries and exercises.

My placement journey has helped me prepare for my long-term goals from my Personal Professional Development Plan (PPDP) “see Appendix F”. One of the long-term goals that was set at the beginning of this year was to complete all required placement hours within the correct time frame, this is one of the goals that I was able to complete during this year, even with the current circumstances. I attended all training and game fixtures as much as I could, and I also worked from home advising athletes with some exercises and stretches that they can do at home. On one of the days during my placement I spent five and a half hours creating exercise videos which the athletes can follow at home, this will help with their warm-ups and cool downs (reflective blog post- 24/04/2020). I needed to have the knowledge of how to perform these stretches and exercises correctly and needed the confidence to record myself performing these and upload onto YouTube website in order to send to the athletes who can access from their home computers or devices. Being able to have these skills of recording and creating videos will help adapt my professional skills, these will help with improving my online website and my professional ‘look’, hoping to attract different clients of all ages in the future.

Another long-term goal that I have been able to slightly achieve is to secure a paid job in the sport rehabilitation industry. According to my placement supervisor “see Appendix D”, he states that upon completion of my university degree, they would love to hire me as a sport rehabilitator with a secured paid position. When reading this feedback from my placement supervisor it was a huge confidence boost, knowing that they approve of my abilities to work for them officially. The next step to achieving this long-term goal is to complete the other goals in my PPDP, this includes passing this year and advancing onto third year and gaining more experience, and then finally completing my degree hopefully with a 2:2 or above.

For third year, I will need to set more goals to help keep me motivated throughout my final year of university. Accomplishing goals is a huge confidence boost for myself, so making sure there is always goals to complete has an impact on my learning. Being able to have the support around me during my time at university helps a lot especially when helping with goal setting. My personal development tutor (PDT) and university placement tutor (UPT) have been helping me throughout this second year which has greatly helped with my studies and achieving the goals that were set. Before the start of third year I will be planning a meeting with my tutors at university to help me to decide on what other goals I can set which will help my future studies and career.

Conclusion

Overall, I find that working with Saints Southwest as a placement opportunity has helped me to develop my skills with not only adults but with children too. Being able to work alongside children for my placement period has helped be gain extra knowledge of the different pathologies and injuries that can occur as opposed to adults.

This placement has helped me gain pitch side experience as well as in a clinical setting with having my own little physiotherapy room for privacy with my clients. Having to adapt with new surroundings was a challenge and having to travel 3 days a week was out of my comfort zone, so this helped to encourage and motivate myself to have confidence in myself and especially with meeting new people. Being able to treat the younger generation has also helped with my communication skills and understanding skills, this was shown throughout my experience of this placement as I had to change the way I spoke to my clients so they could understand what I will be doing to assess and treat them but also so they understood what they needed to do in helping with the recovery to speed up the time of injury.

Another benefit of working with Saints Southwest was that all the athletes were young, energized and committed. They did not like being injured so with their motivation it certainly helped with speeding up the recovery time of their injuries and the prevention of injuries. All they wanted to do was not miss out on any game time so the quicker they were back on the pitch the better, so this especially tested my rehabilitation skills to thinking on the spot and quickly.

I am thrilled to have been offered a paid position job role with Saints Southwest on completion of my degree so this will help me to set new goals for my PPDP for third year and would love to be able to carry on with my placement module for next year with Saints Southwest.

References

Krutsch, W., Voss, A., Gerling, S., Grechenig, S., Nerlich, M., & Angele, P. (2014). First aid on field management in youth football. Arch Orthop Trauma Surg, 134, 1301-1309.

Su, A. (2019, July 01). Groin strain. Retrieved from Teens Health : https://kidshealth.org/en/teens/groin-strain.html

The Football Association. (2020). The FA Handbook. Retrieved from The FA: http://www.thefa.com/football-rules-governance/lawsandrules

Blog link 1- 27/01/2020 2.5 hours https://sites.marjon.ac.uk/rebeccaewing/2020/03/27/27-01-2020-2-5-hours/

Blog link 2- 03/02/2020 2.5 hours https://sites.marjon.ac.uk/rebeccaewing/2020/03/27/03-02-2020-2-5-hours/

Blog link 3- 24/02/2020 2.5 hours https://sites.marjon.ac.uk/rebeccaewing/2020/04/10/24-02-2020-2-5-hours/

Blog link 4- 16/03/2020 2.5 hours https://sites.marjon.ac.uk/rebeccaewing/2020/04/15/16-03-2020-2-5-hours/

Blog link 5- 10/02/2020 2.5 hours https://sites.marjon.ac.uk/rebeccaewing/2020/03/27/10-02-2020-2-5-hours/

Personal Professional Development Plan (PPDP)

Below you will find my Personal Professional Development Plan (PPDP) that I had created at the start of second year of this degree.

This plan consists of long term goals and how I will achieve them throughout my university life. These include who could help me achieve these long term goals, how something could effect these goals, and what short term goals can be achieved in the pathway leading to achieving these long term goals.

Personal Professional Development Plan

Summative Assessment

This document below is the final feedback which I received from my placement when my placement period got cut short due to the world pandemic.

Placement Attendance Summative Assessment near the end

Even though the placement period got cut short, I feel as if I was able to complete and accomplish my aims and objectives to the best I could.

  • I feel more confident with my knowledge of anatomy and injuries
  • I feel job ready- especially after this good feedback!
  • After attending majority of the training sessions I feel as though I have gain more knowledge of the coaching techniques they use and adapt them to certain ages.
  • After attending majority of Saturday morning match fixtures I feel like I have gained more knowledge of the rules and regulations of football- I even know the offside rule (bonus!).
  • My first aid skills have improved since the start of my placement period.

Can’t wait until next year!

Formative Assessment

This document was completed halfway through my placement period.

Placement Attendance Formative Assessment midway through

After reading this feedback from my placement, I felt overjoyed and was super excited to keep going with Saints.

My next aims and objectives I wish to complete by the end of my placement period is to become and feel ‘job ready’ and feel more confident with every injury (majority of injuries) that occur.

Part D- Coaching Video

Here you will find a coaching video of the resistance training workout.

Due to current circumstances I had to use a different client than I originally planned for which meant I needed to make alternatives in a few exercises. This resistance band workout can be found here.

I needed to upload this video to YouTube first due to the size of it.

24/04/2020- 5.5 hours

Today I spent 5.5 hours creating a dynamic warm up and static stretches cool down for Saints Southwest Football Academy.

Due to this whole worldwide situation, we are having to all work from home, so if an opportunity to help my placement out during this time of need comes around I certainly take it! I started off by listing dynamic exercises for the warm up which the athletes (ages 7-16) can do at home. I then decided that because it is just a list, they may not have known what each exercise was, so I decided to create a video showing them what each exercise is and how to perform correctly. Performing the exercises correctly will help prevent any injuries from occurring. I decided to create two videos; one of the dynamic exercises and the other the static stretches. I will be uploading these videos to my YouTube channel so then they are there for myself to use in the future if needs be!

Here is a list of the exercises and stretches I have prescribed to the athletes including the videos I created for the athletes to follow;

Warm-up

Dynamic movements- 10 of each

  1. Jumping jacks
  2. Walking knee hugs
  3. Arm circles- both directions
  4. Walking lunges- forwards and backwards
  5. Squats
  6. Leg swings
  7. Inchworms
  8. Press ups

Cool Down

Static stretches- hold for 30 seconds each

  1. Hamstring stretch
  2. V-sit stretch/ diamond
  3. Quad stretch
  4. Lunge stretch
  5. Calf stretch
  6. Bicep stretch
  7. Side flexion
  8. Chest/ tricep stretch 

Script for presentation

Script for video

Page 3- Exercise Prescription:

According to Vines (2015), the rehabilitation process of a shoulder dislocation can be made up of three stages; the first stage occurs straight after the shoulder has been relocated and a sling is prescribed to wear for a maximum of two weeks, the NHS also advises over the counter painkillers and the use of cryotherapy- ice pack for example to relieve any pain. Stage two consists of increasing the range of movement which allows an increase in muscle strength. Stage 3 is to regain neuromuscular control of the shoulder including proprioception where a physiotherapist from the NHS will prescribe exercises to do.

  • For strengthening- isometric/static exercises are best to start off with as there is no movement involved. This can be done by using a wall or a solid object to push against.
  • Rotator cuff exercises- internal and external rotation of the shoulder, abduction and adduction and flexion. Starting off generally using own body weight then to strengthen resistance bands are a good material/equipment to use to add a little resistance to the exercises (making it a little harder).
  • Progression- using other equipment such as an exercise ball for balance (into press up position with feet on ball), a wobble board (hands on the wobble board). These are also known as plyometric type shoulder stability exercises. A swimming pool or hydrotherapy pool can also be used for rehabilitation of the shoulder- using the range of movement exercises for flexion, extension, abduction, adduction, internal and external rotation. These can also be progressed with floats and change of speed. On the last slide there will be a list including all the leaflets that have been used, all available to be retrieved from the internet.

Page 4-

Resistance exercises to strengthen the shoulder to prevent dislocation occurring.

  • Shoulder flexion- seated chest press machine/ front raise using dumbbells (DB)
  • Shoulder extension- seated row machine/ single arm row or bent arm pullover using DB
  • Shoulder abduction- shoulder press machine/ upright row using barbell (BB)
  • Shoulder adduction- latissimus pull down machine or assisted pull ups- body weight (BW)
  • Shoulder horizontal flexion- bench press machine or chest press machine/ bench press (BB) or Flyes (DB) or press up using BW
  • Shoulder horizontal extension- seated row machine/ prone flye (DB)

Page 7- Training techniques:

Resistance training is an exercise that will improve muscular strength and endurance. You can use resistance from your own body weight, resistance bands and free weights such as a barbell, dumbbell or kettlebell. There are also resistance machines that can be found at a gym that can be used. Resistance training is known to improve your bone density and mental health.

Proprioception is having the awareness of the position and movement of the body or body part. This will help drastically when rehabilitating the shoulder from a dislocation as full range of movement needs to be applied before strength training is prescribed. This can be linked to balance training by adding a ball to the exercises from static strengthening to regain the mobility of the shoulder.

Strength training is designed to increase and improve the strength that is being trained. In this instance, the shoulder will need to regain its strength after the dislocation. Strength training can be developed from resistance training by adding more weight to the exercises. However, power and strength are sometimes mixed together due to the importance of the two, not just for sporting activities but for day to day activities (Hutchinson, 2011).

 

References

Guy’s and St Thomas. (2017, march 1). Hydrotherapy for shoulder- exercise sheet. Retrieved from NHS foundation Trust: https://www.guysandstthomas.nhs.uk/resources/patient-information/therapies/physiotherapy/hydrotherapy-for-shoulder.pdf

Hutchinson, A. (2011). Which comes first, cardio or weights? New York: Harper Collins Publishers.

Salles, J. I., Velasques, B., Cossich, V., Nicoliche, E., Ribeiro, P., Amaral, M. V., & Motta, G. (2015). Strength training and shoulder proprioception. Journal of Athletic Training, 277-280.

Steele, J., Fisher, J., Skivington, M., Dunn, C., Arnold, J., Tew, G., . . . Winett, R. (2017). A higher effort-based paradigm in physical activity and exercise for public health: Making the case for greater emphasis on resistance training. BMC Public Health, 17, 1-8.

Vines, A. (2015, August 1). Rehabilitation after shoulder dislocation: Information for patients. Retrieved from NHS Trust: https://www.ouh.nhs.uk/patient-guide/leaflets/files/121210shoulderdislocation.pdf

Part C- 4-week training programme

4 Week Exercise/Activity Programme Overview

Aim: Increase strength/power in both shoulders

Week No Monday Tuesday Wednesday Thursday Friday Saturday Sunday
1 Resistance training Rest Free Weight training + Cardio Rest Resistance training + Pad work Rest Rest
2 Free Weight training + Cardio Rest Resistance training + Pad work Rest Free Weight training + Cardio Rest Rest
3 Resistance training + Pad work Rest Free Weight training + Cardio Rest Resistance training Rest Rest
4 Free Weight training + Cardio Rest Resistance training + Pad work Rest Free Weight training + Cardio Rest Rest

Warm up-

  • Skipping using a jump rope for 5 minutes
  • Shadow boxing in the mirror for 5-10 minutes
  • Light pad work- going through all the punches for 5 minutes

Stretches-

These need to be dynamic and not static as we want the body to stay/get warm.

  • Arm circles- forwards and backwards 10 seconds each direction
  • Arm swings- open and closing the arms 20 seconds
  • Side flexion (both sides) hold for 5- 10 seconds

Resistance training-

These are completed using a resistance band.

  • Pull apart- arms out in-front of you with a slight bend at the elbow, ensuring there is always tension in the band- open and close the arms.
  • Triceps pull- holding the band behind your back vertically, the bottom hand bringing the band around to the side of the body, the top hand making sure the elbow is pointing up, extend that arm up and down again, making sure there is always tension in the band
  • Lat pull down/ overhead pull downs- wrapping the band around a machine (i.e. pull up bar) starting with your hands above your head, pull down either side of your body with the finishing position being your arms are out straight either side of you, and release.
  • Bicep curls- standing on the resistance band you can the option to curl one arm up and a time or both at the same time. Ensuring the elbows are stuck to your body and that your wrists are strong. Your hand position can either be palms up (in a fist) or thumbs up.
  • Seated row/ or standing row with an external rotation
  • External rotation- attaching the band to a solid object, gripping hold of the band in the hand furthest away, keeping the elbow into your side and open and close the forearm to your body.
  • Internal rotation- in the same position, use the arm closest to the band that is connected to the object (machine for e.g.) and open and close your forearm keeping your elbow attached at your side.
  • Upward row- standing on the resistance band, starting with your arms down, pull both elbows up past your ears and push down again.

Free Weight Training-

These are completed with a 5kg or 10kg weight.

  • Front raises
  • Bent arm pullover
  • Bench press
  • Prone flye
  • Bicep curls

Using smaller hand weights; gentle jog on the spot while punching hand weights in-front. Ensuring that the arms are rotating causing the fists to rotate (from thumb up to thumb sideways).

Cardio burst exercises-

  • Touch and jump
  • Squats/ squat jumps/ box jumps
  • Lunges/ lunge jumps
  • Burpees
  • Mountain climbers
  • Star jumps
  • Jogging on the spot for 20 seconds then sprint for 10 seconds.

Cool down

Static stretches

  • Hamstrings- legs straight out in front, then legs apart (V-sit)
  • Quads- standing, hand on the wall for balance, one leg up behind gasp hold of your ankle and bend your resting knee.
  • Calf’s- push into the wall/solid object, stand in a lunge position, front leg bent back leg straight, making sure toes are facing forward (should feel the stretch in the back leg)- then switch legs
  • Hip flexors- move your hands off of the wall/object, slightly bend the back leg and push your weight in the hips forward, you should feel the stretch in the back leg at the front (top of thigh)
  • Triceps- arm straight across the chest, wrap the other arm under and pull into the body, making sure you stretch both arms
  • Side flexion- feet together, both arms up, lean down to one side and then the other.
  • Biceps- place your palms on the lower part of your back and squeeze your elbows together.

Resistance training:

Exercises

Reps Sets + rest timings Weight

Pull aparts

Lat pull down

Tricep pulls

10 each with 10 quick pulses 3 + 1-minute rest between each set Resistance band- medium
Bicep curls

Upward row

Standing row

10 reps with 10 quick pulses 3 + 1-minute rest between each set

Resistance band- medium

External rotation

Internal rotation

20 reps 3 sets

Resistance band- medium

Free weight training:

Exercises

Reps Sets + Rest timings Weight

Front raises

Bicep curls

Bent arm pull over

10-12 reps 3 sets + 1-minute rest between each set 5kg plate
Bench press 8-10 reps 3 sets + 1-minute rest between each set

20 kg barbell

Prone Flyes 10-12 reps 2-3 sets + 1-minute rest between each set

5kg dumbbells in each hand

Cardio Bursts:

Exercises

Reps Sets Weight

Touch and jump

10 reps 3 sets Own body weight

Squat jumps

Jump lunges

Burpees

Mountain climbers

Star jumps

Jogging + sprint

1.5/3 kg in each hand

 

Part B- 5-10minute video of chosen pathology

Here is my 5-10 minute presentation for Part B of this assignment.

In this video you will find extra detail on the exercise prescriptions and training techniques, covering the other parts slightly. Attached to this post you will find a script of the video of everything that is spoken about in the presentation.