Hours gained: 8
Total hours: 205
This session I did three massages. The first massage was to help a client who had a tournament in three days and wanted to be as ready as possible for it. I massaged the legs, back, shoulders, and neck as this is what he requested. He didn’t want stretches as his PT already gave him some to do. The next client came in requesting STM for his shoulders as he had a desk job and so had very tight shoulders. I tested ROMS and found that it was limited in flexion because his shoulders were elevated. I massaged his shoulders and helped increase ROM via METs and STRs. The last client I had for STM was a woman who wanted me to release her glutes as she had disc prolapse and found that when her glutes were pushed into, it relieved some of her pain. So, I first massaged her lower back and then did frictions and gluteal release on her glutes, over her piriformis. I asked if she would like exercises as that would really help her, but she refused saying she already has another therapist, but she wasn’t in at this point.
The next client I had was a follow-up of a quadriceps strain. He said that he was feeling better in terms of pain and he’d started walking a lot more. His ROMs were full, just like last time. In the plan for this session was to just massage the hamstring but I also added ultrasound and a review of his exercises as well. I noticed that he was given heel slides whilst standing and thought that that might cause him pain when he was doing it which was the case. I regressed the exercise to heel slides in a seated position. This still worked the abductors and adductors but took out the glute work. I should have added another exercise to work the glute as I had taken it out.
I then shadowed and did general upkeep of the clinic for the next three hours. The first shadow session saw a client who had fallen out of a car and broke his arm (FOOSH injury) which had been operated on and had just gotten the cast taken off. His arm had atrophied quite a bit and so the therapist began with simple ROM exercises. I would have taken a measurement of the forearm so I could compare any changes. The next shadowing session was based on Achilles tendinopathy in the late stage, so the client had no pain and was just strengthening the calves and surrounding structures. The last shadowing session was about a client who had golfer’s elbow. The client still felt pain in his elbow, however, it had been reduced drastically. He had been doing his exercises but found one exercise too hard. The exercise was extension and flexion of the wrist with 1 kg weights. Since this was his second session and pain hadn’t completely gone, the therapist shouldn’t have started on the strengthening of the tendon and muscle.
The last hour I had a client that was suffering from Morton’s neuroma. We checked pain and it had reduced quite a bit. She had been doing her exercises whenever possible, however, some day’s she did miss it. I tested ROMs in the toes to find that the fourth toe didn’t extend as much as the others. I did the mobilisations which help her a lot and then reviewed her exercises. The exercises were still a bit challenging for her, so I didn’t progress them any further.
Overall, I felt like this session went well. I did feel like I could’ve arranged for better exercises of the quadricep strain as they didn’t have the highest activation (Begalle et al, 2012).
Begalle, R. L., DiStefano, l. j., Blackburn, T. and Padua, D. A. (2012) Quadriceps and Hamstrings Coactivation During Common Therapeutic Exercises. Journal of Athletic Training: Jul/Aug 2012, Vol. 47, No. 4: 396-405.