1st Year Hours 2018/2019 (50 hours)

1 Massage of the back.

Client complained of a sore back, due to a heavy deadlift training session 3 days prior. Massage lasted for an hour. I was not completely confident during the massage due to it being the first one in the clinic and the massage was not as effective as it could be.

Need to learn how to test range of motion in the back

Need to gain confidence in giving massages in order to make sure they’re effective.

For office use only:

3 overall

Massage 2. The client requested a calf massage due to them doing an increased amount of rugby training on a damp pitch and it was sore for them. I feel like I am effective at massaging the calf and with more techniques learnt I can continue to develop.

Before the massage I could’ve done a postural assessment to make sure that there was no injury that was affecting the ankle which could have a knock-on effect to the rest of the body.

For office use only:

4 overall

1x massage to the hamstrings

The massage was given to the client because they complained of soreness due to squatting. Each massage session I complete I feel like my basic techniques of Effleurage and petrissage are improving.

I could include some more complex techniques such as muscular energy techniques, PIR and RI to broaden my knowledge practically now that I know the theory.

For office use only:

5 overall

The client complained of hamstring soreness due to football training. Alongside the usual massage techniques, I added muscular energy techniques into the session as the second year could give me feedback as to what they should be feeling.

I need to start timing my sessions more effectively as I ran out of time to perform my stretching effectively and the massage could have been had the same effect in a shorter time.

After a few more sessions I feel like I can time sessions better and depending on what muscle group it is I can do more or less massage and more starching to get the maximum effect.

For office use only:

6 overall

This was a good massage as I was able to perform neuromuscular release multiple times on the muscle and I found it a lot easier to identify where ‘knots’ were as opposed to just muscle tightness.

I still need to work on the timing of my massage sessions since I will complete one leg fully and then when I have to move in I will have to rush slightly to complete

For office use only:

7 overall

The client was complaining of a sore back due to their preparation for a powerlifting competition. Due to the nature of the client I used variations on neuromuscular release in order to make the session as productive as it could be.

To learn muscular energy techniques for the back such as PIR and RI

I have learnt the muscular energy techniques for the back and have added them to my skills to implement while performing a back massage

For office use only:

8 overall

The client complained of hamstring soreness due to a heavy squat and clean session 3 days prior, the massage went well, and I was able to engage the client in conversation whilst also talking him through the process of massage and PIR in a way that somebody unfamiliar with anatomy would understand.

The area I want to focus on is my use of lifting and kneading as I feel like I do not use them as effectively as I could with my clients.

I have looked at my application of lifting and kneading in particular and have found that in dense muscle areas such as the hamstring using my knuckles and kneading provides for a much deeper massage.

For office use only:

9 overall

The client had a massage due to a sore back and has previously not had a sports massage. The massage was successful as I was able to make the client feel comfortable and kept them informed as to what I was doing and why

When the same client keeps coming back complaining of pain in the same place I have started to recommend that they stretch outside of the appointments in order to try and reduce the pain and I have found that this helps.

For office use only:

10 overall

Client was complaining of chest and shoulder pain as they are training for a strongman competition. The massage was a success as the client and I communicated well over pressure and the massage finished with PIR stretches

A further improvement I could of made was by doing a small posture check before the massage began to see if their shoulders were rounded as they had such a dense muscle mass an was chest dominamt

For office use only:

11 overall

The client had been complaining of a tight back. The massage was a success as for the client it was their first ever massage. This meant that I had to explain everything to the client and was able to be very clear and explain every process as it happened.

A way at which I could improve is through explaining to my clients about the hygiene levels that a therapist has in order to reduce the spread of injury.

I have found that talking to clients about everything even the simple things such as hygiene puts them more at ease and I was able to have better communication with them over things such as neuromuscular release.

For office use only:

12 overall

The client had been complaining of a tight back and rear deltoids. The massage was a success since I was able to utilise muscular energy techniques to help stretch the latissimus dorsi from origin through to insertion.

I could improve on these sessions by further description of what techniques I am performing and what they do.

I have found through describing what the various massage techniques do it helps to form good communication between myself and my clients.

For office use only:

13 overall

The client was experiencing some discomfort in their back especially in the rotator cuff area. I examined the issue through testing the ROM of the shoulder joint with medial and lateral rotation, and although a good standard of movement was there a numb pain was felt so I went on to massage the rest of the back and discuss exercises to try and manage this injury.

I could of added a better diagnosis to the client as I had some ideas about the injury such as tendon and nerve issues but with more experience I will become confident in diagnosing injuries

With the start of semester B modules, I have become more confident with the diagnosis of injury and as my anatomical knowledge increases confidence will only increase.

For office use only:

14 overall

I performed a back massage on a client who was complaining or a tightness down the left-hand side of their back this was due to the client performing single armed dumbbell rows in the gym and straining his back slightly. For this session I warmed up the tissue across their entire back with effleurage and light petrissage and then performed muscular energy techniques along with soft tissue release to starch out the muscles accordingly.

I feel like I could improve on this session by not performing massage, this is due to the nature of the client’s needs and what is required to get the best treatment possible.

Upon reflection in some situation just stretching techniques can be more appropriate than massage.

For office use only:

15 overall

The client was complaining of a tight lower back due to being bent over at work all day in a production line. To reduce the clients discomfort I performed neuromuscular release on the knots that had developed in the clients back. Also, I performed some soft tissue release on the glutes to loosen them up to put less strain on the back.

Looking back it is always good to KT your clients if they have small muscular impingements as it will give them the confidence to carry on as they normally do.

For office use only:

16 overall

The client came into clinic about severe delayed onset muscle soreness the in quad group. Because the client had very tight sore quads I used mainly petrissage techniques such as kneading to remove the tightness I also used muscular energy techniques to further stretch the quads out.

I need to keep talking to clients about what they can do outside of massage sessions to keep DOMS to a minimum.

Communication with clients about how to keep muscles loose outside of sessions can aid with massage sessions as knots can be worked out quicker.

For office use only:

17 overall

The client had been complaining of a tight lower back which had developed through squatting. Through assessment I determined that it was tight hamstrings that were causing this problem. I performed effleurage to warm up the tissue. After this I performed soft tissue release and muscular energy techniques in order to reduce the tension in the hamstrings.

To further improve on this massage session I could of implemented some taping either on the clients hamstrings or lower back in order to give them some extra support.

Even though KT doesn’t have solid research behind it I have found that its application greatly increases the clients satisfaction with the treatment

For office use only:

18 overall

The client had been complaining really tight lower legs that were making it difficult to walk, upon assessment I found that the calf were incredibly tight. Other than effleurage and petrissage kneading was the main massage technique I used in order to get the blood flowing deep and remove the toxins. Also I used PIR and RI to stretch out the tibialis anterior.

I need to remember to keep asking the client about their pain tolerances during all massage techniques not just neuromuscular as at times I think I can press to hard and cause unnecessary pain

Although it can seem repetitive sometimes I have found that asking patients about the pressure of the massage is useful as they feel  ore at ease and do not get bad pain during treatment.

For office use only:

19 overall

The client had been complaining of a tight back. This client has been a recurring client with this issue, instead of lots of massage this session I did a small amount followed by extensive stretching in order to save my hands, the client said that the stretches were vey effective and helped to relieve the tightness.

I could of performed a postural assessment to see if there is an issue other than strength training which is causing the client to get a tight back.

I am finding assessments of clients useful as it is helping me to see the other areas that I may need to stretch or tape on clients to help relieve muscular tightness in another area.

For office use only:

20 overall

The client had been complaining of sore rotator cuffs, this is due to the fact that the client had rounded shoulders due to a tight chest. Through giving the client just a chest massage the difference In the rounded shoulders was great. Also I taped the clients upper back in order to remind the client to keep their shoulders back.

I need to make sure that with taping I put down I first layer of adessive tape in order to allow the ridged tape to stick more and last longer.

I have found that adessive tape does really improve the amount of time that ridged tape will stick and be effective.

For office use only:

21

Client complained of tight gastroc and soleus, as well as long term shin splints. Due to the client understanding anatomy and massage therapy I was able to confer with the client about what we both thought would be the most effective treatment.

With the client suffering from shin splints it is important that I palpitate the area even though it may cause pain.

It is much more beneficial to palpitate sore areas as it means that as a therapist I can gauge the severity of an injury through a numerical pain scale.

For office use only:

22 overall

Due to an impact received in a game the client had a strained infraspinatus and teres minor as lateral rotation was a struggle, to help with recovery KT was applied to the rotator cuff as well as stretches to loosen the chest and traps that will of gotten tight due to the client trying to protect his shoulder and take the load off of the rotator cuff.

I could improve this session through prescribing exercises for the client to perform in order to help strengthen the ROM that the client still has even with the injury.

Exercises can reduce the injury time and therefore are extremely useful to prescribe.

For office use only:

23 overall

The client had been c/o of sore chest due to training chest at the gym earlier that week. The session consisted of light effleurage and tapotements since the client was tender especially in the pectoral region and to go deeper caused a muscular contraction in order to try and protect the tissue and this is not very effective for when the client is wanting to relax through massage.

To improve this session, I should have done PIR on the chest, the only reason I didn’t perform this is due to a lack of ROM in the client and I need to look at other positions that can still put the chest on stretch.

Looking at other ways to put the chest on stretch I have looked to use the massage couch and perform the stretch unilaterally in order to work both sides of the chest equally but still keep the client comfortable.

For office use only:

24 overall

The client has been c/o tight hamstrings in the medial portion especially. To treat the client, I performed a short amount of effleurage, petrissage and tapotements on the hamstring group lasting 10 minutes per leg. From here I used soft tissue release, PIR and RI to reduce some of the tightness that the client was experiencing.

This session went very well as the client seemed to have reduced symptoms after the session, if the client comes back to clinic with the same issue then I have a look at the muscle firing in the client as the glutes may not be firing correctly resulting in overuse of the hamstring group.

Upon returning to this session I have found that performing special test on clients and explaining the impact that these have can give them a greater understanding of how to aid their own recovery.

For office use only:

25 overall

The client had been c/o a tight lower leg from below the patella, but they couldn’t identify a specific area. Upon palpitation I found that the Tib ant and Gastroc were both very tight. In the session I first performed PIR and RI then moving on to a massage consisting of effleurage and petrissage for 15 minutes per leg before returning to stretching by again performing PIR, RI and by additionally doing soft tissue release.

I conducted this massage differently by performing stretching techniques twice, the client didn’t complain that the stretches caused any pain and this treatment method is something that I will look into further.

Although as a practitioner I find stretching very useful I will stick to warming up the client through massage techniques.

For office use only:

26 overall

The client had been c/o a tight back. In this session I performed effleurage, petrissage and soft tissue release to the lats, rhomboids and traps primarily. As well as the rotator cuff group and the erector spinae.

The session went well with the client being interested in anatomy, so they were very responsive with movements and mobility was good meaning that we could talk about functional movements in order to reduce back tightness.

I need to make sure that I am able to explain to someone that is not as versed in anatomy how to perform movements and rehab exercises as much as I am with someone who does understand anatomy to some degree.

For office use only:

27 overall

The client had been c/o a sore back due to a rugby game the day before. Due to the large muscle mass of the client I had to adapt and use my elbows and forearms to get deep into the tissue to perform neuromuscular release. The other techniques performed were the basic massage one of effleurage petrissage and vibrations.

I could have improved this session through the implication of a lumbar spine and hip assessment to see if there is any underlying issues that could result in why the back tightened so much.

The insertion of a lumbar spine assessment in back sessions has been good as it has lead me to be able to actually reassess and perform rehab in the legs as this is an underlying issue for the tightness

For office use only:

28 overall

This massage was a big learning experience as it is not often that I have had to massage quads, the session consisted of a knee and hip assessment to see if there were any underlying issues. Also, the session included effleurage, petrissage, soft tissue release and PIR

I could have only done some portions of the hip and knee assessment instead of the entire thing since I was only focusing on the quads.

I have found that when looking at certain muscle groups for massages it is still important to conduct complete assessments as there could be weakness to certain areas that need to be addressed.

For office use only:

29 overall

In this session the client was c/o tight calfs. The session consisted of an ankle assessment followed by a focus in the soleus through tapotements and stretching.

To further better the effects of the session I could of took the tension off the gastroc through putting the knee in flexion. This would mean that I am primarily working with the soleus.

Through manipulating joints in different ways you can change the primary muscle being affected through massage and this is something that I will continue to keep in mind and use in other sessions.

For office use only:

30 overall

The client c/o tight hamstrings due to a leg session that was performed in the gym as well as the client being involved with football 4/7. As well as general massage techniques like effleurage and petrissage KT was also applied to the medial side of the hamstring in order to target semi mem in the hamstring group as this was the tightest of the three when the massage and PIR were performed.

This session could have been improved through a functional assessment of gait and lumbar spine as it would highlight any potential reasons for an overly tight hamstring group.

Musculoskeletal assessments are a very important part of rehab as the allow a therapist to detect underlying problems that could be leading to potential injury and over tightness.

For office use only:

31 overall

The client complained of tight calfs and a sore left knee. After a knee assessment it was found that the client had a tight popliteus which with the use of neuromuscular technique the pain and soreness was reduced.

I need to keep refreshing myself with origins and insertions of muscles as with that injury I was thinking that it could have been hamstring insertion but that would be too low for it to be hamstring.

Anatomy is the foundation of all that I will do as a practicing sports rehabilitator and with the practice of this anatomy and constant refreshment it will make me more professional.

For office use only:

32 overall

The client had been c/o tight quads due to running. The session consisted of effleurage, petrissage, tapotements, PIR, RI and neuromuscular release. This led to a good increase in ROM for the client as well as notably less tightness in the quads.

To further improve this session, I could have implemented some active stretches as to spare my hands as with many hours in the clinic it can have a wearing effect on your hands.

I have found that using active stretches and knuckles and elbows is more effective in some cases and can lead to a deeper penetration into the muscle.

For office use only:

33 overall

To improve this session I could have maybe made certain muscles a priority as the client had different areas of tightness such as the lats and traps and if I had priorities then I would be able to focus on specific areas more to increase client satisfaction.

The client c/o a tight back due to overuse at the gym. The

session consisted of effleurage, petrissage, neuromuscular

release on predominantly the lats and rhomboids and soft

tissue release of the traps.

Making the clients different issues a list of priorities can aid both me as a practitioner as I know what areas to give the most focus and the client as they feel like the treatment is more beneficial towards their needs.

For office use only:

34 overall

The client was complaining of a tight lower left back through squatting and pain receding down into the glutes. To try and relieve the discomfort the massage began at the proximal portion of the hamstring onto the glutes and into the lower back.

I need to make sure that the sensation that the client should feel is present throughout the entire massage and that there is no drop-in sensation as this could indicate nerve damage.

It is important that I keep asking for sensation feeling when there is suspected nerve complications as if no session is felt than it may lead to more tissue damage.

For office use only:

35 overall

The client complained of tight calfs due to playing football. Upon palpitation the client was found to have a very tight popliteus. To resolve this issue trigger points were used as a primary technique along with the tapotement of hacking. After this PIR and RI were used to stretch off the gastroc.

To improve this session further I could have identified earlier how it was the popliteus that was the biggest issue, so I could have had more time to perform neuromuscular release.

Looking back at the session the action plan of identification of injuries will be useful going forward.

For office use only:

36 overall

The client had recently trained legs with a focus on the quads and was experiencing severe DOMs. I performed soft tissue massage to the affected area as well as post isometric relaxion and soft tissue release.

The client commented after the session was over that they felt that the massage had reduced DOMS in their quads however they were finding it very painful still.

If I keep up the conversation with clients then they are much more likely to say if they are feeling pain and also I will be able to detect this in their tone of voice.

For office use only:

37 overall

The client had been complaining of a tight back. To remedy this, I used a variety of soft tissue massage techniques including effleurage and tapotements. As well as this I did soft tissue release to the lats and the upper traps.

The client was asking about how they can stretch the back out at home and I didn’t know the answers to their questions and it made me look like I was not as professional as I should be.

I have looked at stretching techniques that clients can do themselves for the main muscle groups looking at how clients can use things such as door frames to take the muscle to its bind point.

For office use only:

38 overall

The client had played football over the weekend and had a tight lower leg. I performed soft tissue massage as well as soft tissue release after asking the client about red flags as is required before any massage session.

It is important to always continue to expand your knowledge as a therapist in the symptoms of red flags and what they are.

I have tried to commit to learning about a new red flag every week and see if I feel if it makes me a more effective therapist.

For office use only:

39 overall

For this session I did a series of soft tissue massage techniques such as effleurage, petrissage and tapotements on the chest and anterior deltoid areas also I did PIR, RI on these same areas and soft tissue release of the traps.

With the chest area I could play around with the movements of the arms in order to put the chest under different amounts of stress while doing the massage.

I have found that putting the arm in different degrees of abduction can affect the massage and how deep I can access the fibres before pain.

For office use only:

40 overall

The client was complaining of a pain at the bottom of their calf. I took this opportunity to revise the ankle assessment I did this through observation of the joint. Clearing the joints above and below. Palpating the area. Assessing active and passive ROM in the affected joint and using special tests such as the Thompsons test to see if there were any issues with the joint. After this is I preformed soft tissue massage on the gastoc and soleus.

When doing the ankle assessment, I don’t need to do all the tests as they are not all relevant. For example, the anterior draw test was not relevant to this specific client and therefore it would have saved me time to not do it.

Being a smart therapist is about testing for things that you are unsure about. The difference is in that situation it was clear that certain problems could be ruled out so they did not need to be tested and instead I could have spent more time treating the participant.

For office use only:

41 overall

As with all clients I observed the are for swelling bruising and redness. I looked for levels of muscle bulk in the pec major, deltoids, traps and pec minor specifically. I treated the area with soft tissue massage on the pec major as the primary muscle to be treated.

To become a better massage therapist, I need to become better at small talk with clients. This is as they are trying to talk, and I find it a struggle to keep up the conversation.

I have found the best way to engage a client in chat is to ask them about their injury and then expand from there. It also makes the time seem to go quicker so I just need to be aware of timings.

For office use only:

42 overall

The client wanted a back massage due to a deadlift session in the gym the day before. Due to the level of DOMS the client had it was difficult to go deep with any petrissage techniques, so I focused more on stretching the lats with soft tissue release and trigger points.

To improve on this session, I could have explained to the client more about the science behind his muscle soreness and explained how massage could benefit him.

I have found that with people who are into fitness the explanations as to why DOMS occur gives them more understanding and theyre more likely to come back for more sessions

For office use only:

43 overall

The client had been complaining of a tight back. The massage consisted od soft tissue massage on the area of the lats, rhomboids and rotator cuff muscles. As well as this due to the client having a problem with lateral rotation indicating an issue with the infraspinatus and teres minor. I used KT to try and reduce the painful symptoms the client was experiencing.

The session could have been improved through an additional explanation to the client about the rotator cuff muscle group and what movements each muscle does.

Adding this further explanation to the clients allows both me to help strengthen my anatomy further but is interesting for the client.

For office use only:

44 overall

The client was complaining of a pain on the back of his tricep. To try and relieve some pressure I applied some soft tissue massage to the triceps brachii predominantly going up onto the shoulders, chest and back area. After this I taped around the elbow joint.

My knowledge of elbow taping was limited so im going to go away and research different types of elbow KT

The more taping types I know the more effective I become as a practitioner.

For office use only:

45.5 overall

1x lower limb stretching session

The client had been complaining of a tight back. The massage was a success as for the client it was their first ever massage. This meant that I had to explain everything to the client and was able to be very clear and explain every process as it happened.

The client wanted their lower body stretched so I did PIR, RI and soft tissue release of the calf, quadricep and hamstring groups.

To improve this session, I could have done a taping technique to the back to give the client more support as they have a job that requires them to be upright a lot of the day and the shoulders can round and cause the tightness in the back

For office use only:

47 overall

1x pre and post event

The client had been complaining really tight lower legs that were making it difficult to walk, upon assessment I found that the calf was incredibly tight. And so were the hamstring group. I applied soft tissue massage to the area and stretching techniques of PIR and RI to release more of the tension in the hamstring group.

I did a pre and post event massage to a client with the main intension of getting my timings to be good. I spent 12 minutes on each stage focusing on the increase of blood flow as the priority of the massage.

To improve these sessions, I could have applied taping to both clients. This is as it would of given them more support and made them more relaxed about injury which would in turn release tension.

For office use only:

48 overall

The client had been complaining of a tight back. The massage was a success as I was confident at speaking with the client and allowing them to feel secure in saying if the pressure was too little or too much. I applied soft tissue massage as well as soft tissue release to the erector spinae and the upper traps.

This session went very well but to continue to improve it is important to keep on expanding on knowledge to stay up to date with the latest stretches and massage techniques.

For office use only:

49 overall

The massage went well this is as when explaining red flags to the client the client said how they had a bad astro-turf burn on their right hamstring. Although this meant that I could only massage the left hamstring it is a success as I was able to easily recall the red flags.

To improve this session I could have given the client some care advice about how to keep the wound clean through the appliance of anti-inflammatory gels and banadages.

For office use only:

50 overall

The client asked for a calf massage due to them feeling like they were tight in that area. The massage was a success as the client was always saying were they felt tight. I performed soft tissue massage soft tissue release and PIR and RI.

To improve this session further I could have given the client some more aftercare advice about how the client could feel dizzy due to blood pressure changes instead of just saying to drink lots of water.

For office use only: