Hours gained: 10

Total hours: 215

This session I had my friend come in for her last treatment session for her disc prolapse. She came in and mentioned that she had no radiating pain and her back pain had also reduced. I measured ROMs and found that it was nearly full. There was still some limitation in rotation. I still put her in McKenzie’s extended position and massaged her lower back. Her muscles felt a lot less tense than when we started. They also didn’t spasm either. I reviewed her exercises and found that I needed to add some rotational and flexion-based exercises. I progressed the glute bridge to single leg glute bridge which she could do. I left the plank exercise but just extended the time she held it to 40m seconds (by 10 seconds). I added seated floor touches and knee sways to help with the rotational ROMs.

I had three massage clients in this session. The first client complained of tight upper traps and deltoids, so I massaged into those areas. I felt several adhesions over the rhomboid area and so worked into those as well. I checked ROMs of the shoulder and scapula and the range was full. The quality of movement did improve though. I gave this client scapular retraction and protraction exercises against the wall and upper traps stretch. The second massage client I had wanted a general leg massage and didn’t have any pathologies or tight muscles. I checked ROMs and they were full too. I massaged his legs and added METs to help increase ROM. He didn’t want any exercises and so I didn’t give any. The last massage was for a raider’s player. He requested a full leg massage and then I helped him with the game ready. I tested ROMs and they were full, so I didn’t do METS. The adductor muscles were especially tight on this client and so I worked deeper into that area. I need to start communicating to the client and ensuring that I’m not adding too much pressure on one specific area as if they’re face down, I can’t see facial reactions. If I massage too deep the client could end up either being in more pain or pain.

I shadowed four clients today. The first client was a follow-up and was diagnosed with patellar mal tracking which was causing pain in the knee. The treatment started with STMs on the quadriceps and then her patella was taped into the correct position. Exercises were given in order to strengthen the quadriceps so they could hold the patella in place. The exercises that were already given were progressed through adding weights. The second shadowing session was about STM of the lower limb to one of the raider’s players. I helped the therapist massage one leg and she took the other. The other session was a follow-up of a previous case I had shadowed in. It was an elderly gentleman with chronic ankle instability. He looked a lot better than before and could even walk properly without his walking aid. He still took it with him on long walks but otherwise, he didn’t use it much. They started by taping the ankle up for stability. They then moved on to the exercises. He could stand on one leg now which was progress. Today they were working on heel-toe walking and backward walking as well. The last client was a massage client who wanted full-back, shoulder, and neck massage as he had a lot of tension and tight muscles. I helped by massaging his lower back whilst she focused on the shoulders.

The last two hours were spent researching SLAP tears as I didn’t think I knew enough evidence-based exercises for this (see pictures below).

Overall, I felt like I had helped a lot of people with their injuries. I also got to see the progression of chronic ankle instability, which is hard to see as the client always has the fear of rolling over their ankle in their head. I also did some research trying to help me grow and understand more.