Today after Marjon Clinic I had a zoom call meeting with a parent and athlete from Cornwall region team for Saints Southwest. I needed to ensure I was consistent with my questions and to go through a lot of detail when asking about this athletes injury due to not being able to see this athlete face to face in person. Having the only option of a video call limits to what I can and can not do with this athlete which therefore means that I need to ensure my description of movements and or exercises given needs to be clear for the parent and athlete to understand in order for them to perform them correctly.

After the video call I discussed with my supervisor what the next steps are for this athletes recovery and explained that I will create a rehabilitation programme for him to do whilst at home to aid his recovery and reduce the time he is injured. I then spent the last half an hour to create this programme to be sent via email to the parent.

I made sure that I went into a lot of detail in the programme to avoid any confusion however, I insisted that they got back in contact with myself if they needed any further assistance. I also explained that I will be in touch next week to see how the athletes injury is doing and how the exercises have been for this athlete.

Knee Pain Programme

Next Time

It would be easier to see this athlete face to face however because they are in the Truro squad it is difficult for myself to get down there so I ensured that I was available to them through an online service that everyone seems to use recently due to the current circumstances of Covid-19.

Resources for rehab plan

2017-rehab_knee.pdf (aaos.org)

10535Pknee.pdf (ouh.nhs.uk)

Today consists of 3 different locations to travel to. First is the office in Newton Abbot, second location is Shaldon Primary School and then travel to Ashburton for Regional Training session, starting from 11:30 till 20:30.

For the first 3 hours I was in the office creating programmes, replying to parents messages regarding their children and any advice needed, and also discussing with the coaches what we could work on together to ensure we are reducing the number of injuries occurring at regional squad training sessions.

The rehabilitation programme that was created included 3 different exercises; Ankle rolls, isometric holds and seated calf raises. Ankle rolling creating the alphabet was the first exercise as it allows the athletes to move the ankle in all directions (this allows the ankle to become more free and less stiff). Isometric holds was the second exercise using a resistance band (due to the athlete having a band at home) however, this exercise can be performed using a towel, this allows the athlete to stretch the calf muscles. The last exercise was seated calf raises with a progression of standing calf raises. This was given to help strengthen the calf muscles in order for these calf muscles to support the ankle and increase its stability.

I gave these exercises as these can be performed almost straight away after an ankle injury, especially with this athlete as their range of movement was not limited when tested Monday. I ensured I talked the athlete and their parent through the exercises whilst demonstrating how to perform them correctly prior to creating this programme.

15 Exercises for Your Sprained Ankle (healthline.com)

How To Do Calf Raises Properly | HEM Ankle Rehab

Next Time

Next time I would like to be able to create a more in depth rehab programme with progressions and regressions with more weeks rather than just the first week of exercises. Overall I found today beneficial and a learning curve in creating rehabilitation programmes.

At Shaldon Primary School I was an assistant for a coach teaching the Year 2 students in an after school club. One of the students has diabetes and needed to stay near a device which records their glucose levels. A teacher was near by if the device started beeping. The device could not go below a 4 otherwise this means the child is in the hypoglycaemia stage and would need sugar to bring the levels back up. I was a little nervous about being in charge of this device as I have never seen one before and would not know what to do if the child had gone into a hypoglycaemic state.

Next Time

Next time I would like to find out prior to attending any primary schools if there are any medical conditions that we will need to know about especially if it could affect their activity levels. Knowing in advance will allow myself to research about the medical condition if necessary and discover what I would need to do in the worst case scenario. This would allow me to be less nervous and more confident.

At Regional Training session there was four injuries that I needed to oversee. Neck pain from sudden neck extension when going into a tackle in defending the ball was the first injury. This injury I needed to ensure that the range of movement was not reduced, ensure the athlete was not concussed by asking them questions. I needed to ensure they were not concussed/ feeling dizzy or sick otherwise the injury could have been a more serious injury. However after going through range of movement the athlete felt okay to continue after having a 10 minute rest. I ensured to keep an eye on him because a head injury could be prolonged and cause other issues later.

The next injury was an ankle injury, this is an ongoing ankle injury so after going through range of movement, I decided to provide grade 2 mobilisations in dorsi/plantar flexion to provide pain relief and to increase range of movement within the available range.

Microsoft PowerPoint – mobprinciplehandout (physio-pedia.com)

Another injury was an athlete complaining of a stiff neck from ‘sleeping funny’ the night before. Whilst palpating I found the muscles; upper fibres of trapezius and sternocleidomastoid were extremely tight and tender on the athletes left side. I gave the athlete a small soft tissue massage with stretching every 2 minutes to relieve the tension and pain. I used a deep heat balm in order to help speed up the heating process of the tissues due to the muscles being tender to touch I did not want to go too deep.

Lastly I needed to provide general first aid to an athletes finger, He had not realised that he had caught his skin on the top of one of his fingers, looked down and saw blood everywhere! I needed to ensure the athlete was feeling okay by asking if he felt dizzy or sick due to the amount of blood he had lost. I then asked for assistance to clean the blood up due to the blood being all over both hands. Once the blood was clean I was able to locate the source of the cut and apply a plaster to stop the bleeding.

Next time I need to ensure my first aid bag is fully stocked up of sterile wipes as I was running low and needed more whilst cleaning the cut. I also need to ensure that I have a printed version of the NRS pain scale and Glasgow Coma scale as a reference when treating athletes pitch side.

Today I had two virtual appointments booked in at Marjon Sports Clinic.

My first video call appointment was booked for 9am, however we had difficulty with the video part of the appointment so we needed to complete our appointment over a phone call.

This limited what I could do and find out from my client as I could not see them. However I was able to complete most of the questions and went through range of movement just by the client explaining how they feel whilst doing these movements. This did not give me a true definition of whether they  are able to do these movements or even know if they are doing them properly, however due to them booking in next week I will be able to go through these properly next time.

I found this appointment a little difficult due to it being a phone call rather than a video call, however I felt that it went the best it could. I was still able to give advice and prescribe home based exercises by what the client was describing. Next time, maybe I could try a different way to video call them if the Cliniko video call appointment is not working. Maybe trying Zoom or Microsoft teams for the video chat.

In between my two clients I was writing my notes form my first client and creating a plan for my next client.

My second client was also a virtual appointment however this video call did work.

I felt confident doing this appointment due to this client having similar symptoms to a client from the week before, so I had a rough/general idea of what the injury could potentially be. However, no injury is the same so I needed to treat this patient as a completely different injury.

I found this appointment to run smoothly as myself and my client were relaxed and were comfortable with each others presence. I think this because our conversation was flowing into each question rather than a stop start situation. We were able to have a laugh and just in general feel comfortable.

I felt confident with this client as they listened to my advice and appreciated every minute i spent talking with them.

Next time, I would like to be able to go more into depth with my questions to get a better understand of what the injury was and what the client’s outcome of this appointment to be.

Today I have two clients booked in at Marjon Sport Clinic.

What Happened

My first patient was a follow up appointment from previous weeks. Today I reassessed their range of movement as they could not attend their last weeks appointment so I wanted to see if there was any difference to the last time I saw this patient. We then discovered that this patients injury may be potentially something else to what we expected ( which of course is not an issue, we now just need to reassess the given prescribed exercises and change treatment plan). Today I was reintroduced to how to do mobilisations in the hip joint using a belt.

What Went Well

This client felt comfortable, and understood everything we were discussing. Today I found it went really well as I stayed professional throughout, ensured that the patient felt comfortable. As the patient was leaving he felt so appreciative of what we went through today and explained how happy he was as he felt a difference from the treatment he was given today.

Next Time

Next time, I need to make sure I turn up before my patient. I have edited my availability to ensure I give myself an extra 15 minutes to get to clinic due to traffic on the way into Uni. I also need to not feel nervous when discussing with the supervisor of a new treatment method of which I have not done in so long. I know how to do this technique so I need to ensure that I am more confident in myself. Aim for next week: Be on time, be ready and be optimistic in myself.

My second client:

What Happened

My second client was their first face-to-face appointment so I needed to go through all ranges of movements and get a baseline of their strength. I then asked for assistance as this injury was a little difficult to comprehend what is causing the pain. However, after receiving great advice from my supervisors I was able to recognise that there were some weakness in this clients lower limbs, as well as having slight pain in their lower back which could be the cause of the pain.

What Went Well

I was able to test this clients strength, range of movement and recognise a difference in this clients walking gait without any help. I found that this is getting “easier” for myself to recognise as it is starting to become a more common theme in the clinic.

Next Time

Next time I would like to be able to go through a face-to-face appointment without having to rely on a supervisor to guide me in the right direction. I need to be able to be confident in myself and my knowledge. I also need to read up and research more on the neurological differential diagnosis’ which could cause pain in muscles.

Neuromuscular Disorders | MedlinePlus

Differential diagnosis | Diagnosis | Leg cramps | CKS | NICE

Today,  I “worked” from home, creating and providing rehabilitation programmes for athletes who were injured yesterday at Ashburton Regional Training Session.

For the first hour I created a rehabilitation programme for an athlete who is suffering/complaining of calf pain. This rehabilitation plan was created for the first week to be performed every day to help reduce the tension in this athletes calf’s and to help strengthen the muscles/tendons. Calf pain exercises.

For the second hour I then created a plan for another athlete who I had seen previously for heel pain. He is now complaining of knee pain so I have advised more exercises to be performed at home to help reduce the pain in his knees as well as his heels. These injuries are very common in young boys whilst they are hitting their growth spurt age. Knee Pain

For the final hour I had a video call with a parent and an athlete in regards to a groin injury, this athlete is from the Cornwall division so the only way we could contact each other is via phone call, video call or email. We went through ranges of movement and asked the parent to apply resistance so I could check the strength. We then discussed everything else that was needed to be asked in order for myself to further give advice. I then created a rehab plan for this athlete to complete at home to help strengthen, and reduce pain that he has in the groin region. groin injury rehab

What Went Well

Today I found that programme writing to be quite fun as I research the most common exercises for each injury that can help further prevent pain and reduce the risk of re-injury. For the video call I was a little nervous but I needed to be professional as I was representing Saints Southwest and Marjon on this video call. I needed to ensure I asked all of the questions which needed to be asked, I made sure I was polite and trustworthy so they could trust that I have the athletes best interests at heart.

Next Time

Next Time, I would like to plan my video call session out properly, ensuring I have all of the questions in front of me prior to my online appointment to ensure that I do not miss anything out. I would also like to possibly discuss with the coaches in the office on Thursday to see if we could work on some business structured programmes so they are incorporated in with the Saints Southwest logo etc. And possibly be able to design some basic videos of which the athletes could follow at home prior to messaging me to book in an appointment.

Today my day consisted of three different destinations.

To start off the day I was in the office at Newton Abbot from 9am till 2:30pm creating exercise programmes for athletes, discussing potential exercises which the coach can incorporate into their training sessions to help prevent injuries (strengthening exercises) and plan with the coach what we are going to be providing at the primary school at 3pm.

After the rehabilitation programmes were complete, I needed to create a post that needed to be sent out to all parents that are associated with our Somerset and Cornwall regions, offering my services via online portals (Spond, Zoom and Emails). In this post I explained that I am currently a student in my third year, what I can do for the athletes, what the rehabilitation process is and what I can offer to help further prevent the injury from reoccurring.

At Cockington Primary School, the aim was to focus on “T= Together” from the SAINTS acronym. We ensured that the group of 8 were split into two teams and worked as a team to gain the most points.

After the after school club, I then travelled to Ashburton for our Regional training session from 5pm till 8pm.

In total, there were eight injuries that I needed to oversee whilst at Ashburton training session. These injuries were across age groups, U10’s, U11’s, U12’s and U14’s. A few of the injuries occurred last week, so their parent shad messaged me prior to book in to see me so i can assess their injury and give further advice/treatment. Whilst assessing and giving advice, I advised a few of the athletes with strengthening exercises that will help reduce their pain and help prevent the injury from reoccurring. I then mentioned that I will create rehabilitation programmes for them tomorrow which I will send via either Spond or Email.

What Went Well

I found today very busy. I felt a little rushed however, all of the injuries that occurred on the evening seemed to have occurred when I was free and able to see to the injury so the injuries were perfectly timed!  There were a few injuries that occurred/that needed my assistance that were injuries I had great knowledge on (growth pains, ankle rolled etc) so i felt confident in providing the advice given; exercises, stretches and procedures to follow to help ease pain (heat and ice).

Next Time

Next time, I would like to be able to time the booked appointments prior to the training session at the start of the session so it does not effect or take away my time for the athletes who get injured during the training session. My goal by the end of the season is to help the coaches provide exercises and stretches in order to reduce the amount of injuries occurring at their training sessions.

Today I travelled to Torquay Academy for a U12’s football match. I took another student from Marjon with me as he was in charge of the VEO Camera to film the game and analyse the match.

Today’s game consisted of 4 x 20 minute quarters.

Prior to the game starting, a player was complaining of ankle pain. They had slight restriction in dorsi-flexion and eversion. The player asked if I could apply K-Tape to his ankle to give him extra support (and confidence) to play the match. I told the athlete to let me know if their pain persists or gets worse than a 5/6 out of 10 on the Numerical Rating Scale (NRS).

The next injury was an injury that a parent messaged prior to check this players knees. This athletes has recently had a growth spurt so the parent is explaining that this pain in his knees are caused by the recent growth spurt. Whilst assessing the player he had no pain in any of the movements of the knee. However there was slight discomfort across the patella ligament on palpation. I applied K-tape around the knee and across the base of patella to give support and reduce the slight swelling.

The pain continued with the first athlete so I performed mobilisations (mobes) in dorsi-flexion, planter-flexion, and eversion 30 per minute for 2 minutes in Grade 3. This helped increase the range of movement in all ranges after just 2 minutes of mobes. These mobes also helped reduce the pain that was occurring in eversion.

What Went Well

Overall, I found that with today’s injuries I was able to confidently assess the athletes and give the correct advice where necessary. Being able to speak to the coach and give him advice about his players and their injuries or what he should suspect with these injuries or potential future injuries went well and I was able to speak to him professionally and confidently as I have seen these injuries occur so many times due to growth spurts so I feel as though I have a lot of knowledge around the area.

Next Time

Next time I would like to be able to change up the warm up and cool down to make sure that it is adapted to these players who are beginning their growth spurts to help reduce any pain occurring and to help strengthen the surround muscles around the joints. I will need to do  extra reading around what the best exercises will be for a warm up and cool down for athletes at the start of their adolescent ages.

Today we were back at South Devon College in Paignton for our last day of Soccer School Easter Holidays.

I was “buddied” up with a child who has Epilepsy to ensure they were feeling okay for the whole day.

To begin the day. All age groups were grouped into 3 teams per age group. Us coaches then set up a huge circle consisting of 12 stations in order to create a football Olympic tournament. This lasted until lunch time (midday). Prior to starting the Olympic Games I ran a warm up for all age groups so they were ready for the “Olympic games”. I stayed with the younger age groups, helping them with all stations.

After lunch we then went into a sister tournament of football matches. Staying in the same groups as they were in for football olympics (Covid friendly), they played mini matches to add the scores to each coloured team.

During the sister tournament there were a couple of injuries that had occurred.

One athlete had twisted their ankle whilst playing football, I checked their range of movement, palpated the area and all seemed “fine” player was happy to continue playing.

Another athlete had grazed their knee on the astroturf after a slide tackle against their opponent. I had to clean the small wound however, there was no need for a plaster as it was not bleeding. Plus, the player did not want a plaster.

At the end of the tournaments/end of the day. We then went into a penalty shoot out game to determine winners for each age group. This happened by splitting all age groups off into separate groups as it was easy to maintain and control.

What Went Well

The aim of today was for all the players to have fun. I found that today went really well due to having next to zero injuries (only minor). Being able to feel confident and professional around the players, teaching them new techniques and how to play fair between each other.

Next Time

Next time, I need to ensure that all kids are warmed up after lunch ready for the second half of the day, and cooled down properly prior to leaving to go home. Being paired up with an athlete who I needed to keep an eye on was challenging as I was worried if they ran too much or got involved too much that they would have a seizure. So next time I need to be more prepared about how a seizure occurs, even though I know what the procedure is if the seizure occurred, I need to understand the signs and symptoms of why it occurs.

Today the U14’s team had a game at South Dartmoor Community College in Ashburton.

Prior to the match, I had a parent and an athlete meet me there to assess an injury that happened a couple of days ago from another age group.

This athlete was from the U11’s Team who has been suffering with heel pain. After assessing his range of movement and his strength/resistance this range is slightly limited in his calf and slightly painful in resisted movements due to the stretch it was causing on his calf’s. After discussing the injury with this parent, I have a clinical impression of growth pains, due to where the pain is located (on the heel growth plate). After the game I had created a rehabilitation plan to be sent to the athletes parent to help reduce the pain. Heel Pain Rehabilitation Programme

Before the match started I ensured that all of the athletes playing didn’t have any injuries (niggles).

An athlete from the U14’s team was complaining of tight calf muscles. Range of movement was not limited and resistance was fine however with a slight pull/stretch in the calves. The athlete foam rolled his calf muscles for 5 minutes on each leg to help release the tension. I then gave this athlete a quick 5 minute soft tissue massage on each leg to further release any tension along with MET’s (Muscle Energy Techniques). I then advised to stretch his calf’s and ensure that he was doing these everyday.

At half time, an athlete from the opposing team asked for some assistance and advice due to falling on his wrist after jumping in the air to help defending their goal against our attack. There was pain on palpation at the distal end of ulna and radius however range of movement was not limited as well as resisted. I advised to keep the wrist moving to avoid any stiffness occurring. Also advised to get a possible x-ray to rule out any fractures if pain persists after 24 hours. However, after seeing myself at pitch side the player wanted to continue to play.

After the match had ended, I took the players through a cool down using dynamic stretches similar to their club warm up, then finished off with static stretches before they left to go home.

Today I felt confident as I know these players, their current injuries and who I needed to keep an eye on due to these injuries. However, whilst watching, the ones that were injured in training this week prior to the match didn’t complain of any pain. This made me feel glad due to knowing that my exercises and stretches that I’ve been giving them to do at home has been working.

Next time, I want to make sure that they all know and understand why stretching is good for them especially after playing a game of football. And to make sure that they are learning and remembering these stretches so they are not always relying on me to show them every time.

Today I travelled to Coombeshead Academy in Newton Abbot for a Soccer School holiday day.

Today I was assigned with the juniors to help assist with another coach.

For today I didn’t need to plan a session due to the other coach taking over and I am there to help assist. I learnt from Tuesday that I needed to find out prior to the day to see if I needed to plan a session.

Today consisted of fun games, learning new skills, penalty shootouts and a large Sister Tournament.

A sister tournament is when there are different teams in each age group that all make up a large team. For example, today there was 4 teams in each age group; pink, yellow, blue and whites.

There were 3 age groups in total, so the teams would play against their age groups and then all the scores will be added up in total to gain a winner. In total there were three teams for each colour, this kept it fair between all age groups.

Today there were a couple of injuries that I needed to see to.

There was an athlete that has an ongoing injury which their parent had contacted me prior to the day to see if I could possibly go through some stretches that this athlete could do alongside some exercises with a resistance band (making sure he was doing the exercises properly).

Another injury was general first aid as they had fallen over on the Astro Turf causing a graze on their knee so I cleaned up the cut and applied a plaster to stop the rubber crumb from getting stuck on the knee.

What Went Well

Today went well due to the minimal injuries and lots of fun. The aim of today was to ensure all the kids had lots of fun for the whole total of 6 hours. I also was able to arrange a cool down session for all of the children at the end of the day. Due to them running around pretty much all day, I felt as if they would need a good cool down to ensure their muscles aren’t aching or sore the next day.

For the cool down we did dynamic stretches and followed by static stretches all sat in a large circle.

What Could Have Gone Better

For the cool down we could have done staggered leaving times and instead of doing an extra large cool down, I could have provided a cool down for each individual age groups.

Next Time

Next time I will ensure that we do staggered leaving to be covid safe and to ensure the parents are all socially distant when collecting their children.