Hours gained: 5
Total hours: 11
This session I saw my first initial consultation appointment. The client had complained of pain in her right, posterior calf which came on about two weeks ago but focused more on the distal end of the calve (the midportion of the Achilles tendon) This also happened to be when the client increased her running training. During her subjective assessment, I found out that she had increased her training volume by almost double due to her running in an event soon. I also found that she had not been resting it enough or giving herself time to recover from her runs. She had also changed her running surface from the treadmill to outside. This led me to believe that the injury was Achilles tendinopathy in the reactive stage. I made sure to test all ranges of movement to see which caused pain and what the end feel was like of every movement. During AROM of the right ankle dorsiflexion, the client felt pain and it was stiff as well when compared to the left side. Although I knew it was most likely Achilles tendinopathy I still asked Alex to come and check if I was right. After confirming the diagnosis, I discussed the importance of rest and recovery when increasing training as well as increasing training in increments rather than drastically. I ensured she knew what the reactive stage of tendinopathy was all about and that this stage is reversible as long as rest is carried out. I then did STM on the calf to help relax the gastrocnemius and soleus.
I had two other clients that day which came in for massages mainly. One client complained of stiffness especially in his lumbar back which I did STM on. I also gave stretches: cat and camel, knee hugs, and glute bridges. I didn’t check the facet joints during my objective assessment which could have been adding to the stiffness in the back. Sherman et al (2013) investigated the use of yoga poses when helping lower back pain and found that stretches and yoga poses helped with relaxation and stress reduction. They also helped with flexibility and mobility. The other client had just been training and so was wanting some STM on his legs. I suggested stretches however the client said that he won’t do them anyway. I tried explaining the benefits of stretching but he wasn’t listening to any of it.
The remaining two hours were spent researching into the pathologies we were given as part of our exam. The pathologies included: SLAP tear, hamstring strain, adductor strain, ACL injury, ATFL sprain, Achilles tendinopathy, RC injury, tennis elbow and back/spinal injury. Alex talked me through the basis of SLAP tear again to refresh my memory and then we worked on what exercises would be given to them.
Overall I felt like I could’ve been more confident with my diagnosis of the Achilles tendinopathy. I knew exactly what it was however I still asked Alex to come in and check it. I also need to understand that not everyone will take my recommendations into consideration and do them.
Sherman, K. J., Wellman, R. D., Cook, A. J., Cherkin, D. C. and Ceballos, R. M. (2013) Mediators of Yoga and Stretching for Chronic Low Back Pain. Evidence-Based Complementary and Alternative Medicine. Vol. 2013, No. 1: 1-11.
Evidence-Based Complementary and Alternative Medicine