Hours gained: 6

Total hours gained: 6

During this session, I had four clients who required treatment. All my appointments were follow-ups so I did not have to go through any initial consultations.

This was the first time I treated in the clinic. My first client was a gentleman who came in with lower back pain as he had many lumbar disc herniations and subsequently underwent many surgeries. He usually frequented the clinic to get soft tissue massages (STM) on the lumbar back to loosen up the muscles. The main cause of this visit was due to lifting something heavy. In the objective assessment, he could only do 30° of flexion which he was very apprehensive to do, and extension was around 45°. The STM was directed at the lumbar spine in order to relax the spasming muscles. We discussed the possibility of strengthening exercises and how they could be beneficial however the client refused and said he would not be able to carry them out anyway. After the STM, AROM (active range of movement) was reassessed and lumbar flexion was 45° and lumbar extension was 50°. The plan was STM whenever requested and maybe try talking about strengthening exercises again.

The second client came in with left shoulder pain which had been diagnosed as frozen shoulder. As I did not feel too comfortable with shoulder pathologies yet, Alex decided to sit in with me. The client’s pain had decreased, and he had been able to move around better. However, during his objective assessment, his left shoulder flexion and abduction could only go to 50°. All other range of movements were good. He requested laser therapy which is something that I had never used before. Alex talked me through the steps on how to use it and how we protect our eyes and that of the clients. After the laser therapy, STM was done on the shoulder and upper arm as the biceps were tight. Previously, the client had been given seven exercises which he found were too easy as well as too many, so we went through them and adapted them.

The third and fourth client just requested an STM massage as they felt that their shoulders were tight. Exercises and stretches were given in order to help with the “tightness” felt in the shoulders.

During the other two hours, I researched laser therapy. Low-level laser therapy (LLLT) was firstly developed in the 1960s were they understood the potential laser therapy had in improving wound healing and pain reduction. They also found that laser helped with inflammation and swelling (Chung et al., 2012). Stergioulas (2008) found pain and disability scores went down when compared to no treatment for people who have frozen shoulder. LLLT is said to reduce increase ATP and oxidative stress which improves cell metabolism and reduce inflammation.

Chung, H., Dai, T., Sharma, S. K., Huang, Y. Y., Carroll, J. D. and Hamblin, M. R. (2012) The Nuts and Bolts of Low-Level Laser (Light) Therapy. Annals of Biomedical Engineering. Vol. 40, No. 2: 516-533.

Stergioulas, A. (2008) Low-Power Laser Treatment in Patients with Frozen Shoulder: Preliminary Results. Photomedicine and Laser Surgery. Vol. 26, No. 2: 99-105.