Hours gained: 5
Total hours: 83
I had three clients this week, one initial consultation, one follow-up appointment, and then a police officer who got a free appointment with a health check. The first appointment was with the police officer. She came in and mentioned she didn’t have any injuries or previous pathologies. She just wanted a sports massage over her back and shoulders, as she hadn’t had one before. I tested ROMs of her lumbar spine, thoracic spine, cervical spine, and shoulders which were all full. I then went and massaged her back and shoulders and then retested ROMs which were still full. I explained all the side effects of a massage.
I then had the next hour free and so I shadowed one of the other therapists. They had a client who was suffering from pain in his lower back and he diagnosed him with disc prolapse. The therapist massaged the client, gave him exercises, and advised him on doing more extension poses and using heat to relax the spasming muscles.
The next hour I had a follow-up appointment with a client I had seen a couple of weeks ago for an Achilles tendinopathy. She had decreased her training load for the marathon and the pain had started to ease. She mentioned that the exercises didn’t seem to be helping or working anymore and so she booked in for another session with me. I palpated the Achilles tendon where she felt pain, and the tenderness had reduced. I checked her exercises again and found that they were too easy for her so I progressed them. The exercises I gave were; side steps with theraband, calf raises with 1kg weights, farmer walks with 2kg weights, and wall sits with calf raises. These exercises were given to her because they were said to have the best activation (Riemann et al, 2011).
The last client I had was an initial consultation. The client came in complaining of pain in his knee which he felt whilst he was running for the bus. This happened two days ago and as soon as it happened the knee started to swell. He felt pain when putting weight on the leg, fully extending the knee, and fully flexed. Through the objective assessment, I learned that the injury had to be a medial meniscus tear. I tested ROMs to find it limited in the end range of extension and flexion of the knee. This could have been due to apprehension as well. The Thesselley’s test came back positive for pain in the medial side and joint line palpation was very tender in the medial aspect of the knee. These were enough for me to diagnose him with a medial meniscus tear. After a conversation with the client about what it is I put the game ready on. This was due to prominent swelling still being visible. I then started giving him exercises. The first exercise I gave was a seated straight leg raise, lying down and pushing the heel into the table, and then having a towel under your knee whilst sitting down and pushing the back of your knee into the towel. I think I gave good exercises as they inhibit the hamstring and quadriceps muscle which are vital in helping the knee heal. This is due to them taking some of the strain of the knee.
The last hour was spent writing up notes and helping a therapist with a massage as they had dislocated their finger so it was strapped. The massage was on someone’s back and shoulders to help them relieve spasming muscles.
Riemann, B. L., Limbaugh, G. K., Eitner, J. D. and LeFavi, R. G. (2011) Medial and Lateral Gastrocnemius Activation Differences During Heel-Raise Exercise with Three Different Foot Positions. Journal of Strength and Conditioning Research. Vol. 25, No. 3: 634-639.