Pathology and clinical reasoning module.-

CPD courses-

One course that would benefit me would be a sports coaching qualification. This is as  it would allow me to develop a better network of individuals around me that could aid me in various aspects of rehabilitation. As well as this it would allow me to develop a better way to talk to athletes I would be working with and outline how different exercises and drills are performed.

Another course that would benefit me as a sports rehabilitator is a refereeing qualification. This is as it will help with my decisiveness and will allow me to be able to trust in myself more to back decisions that I make.

A final course that would benefit me is business marketing course. This is as with sports rehabilitation you have to be able to show how you are better than the competition. The promotion of yourself as a practitioner is of the upmost importance as being self employed requires you to get your own clients in order to be able to carry on earning.

 

Placement

In my second year I want my placement to be pitch side.  When I graduate I see myself working in a more clinical environment but I want to experience the pitch side area to see if I enjoy it. I would like to do my placement over a period of time so that I connect to the players more so they feel that they can come to me with any issues. I would like to do my placement with either a rugby team or a lacrosse team in the Plymouth area outside of BUCS as it will encourage me to engage with new people and develop some networking options in the future.

Placement- year 2 reflective essay

 

For my placement module I worked with Marjon sport and health clinic working with university sports teams as their pitch side therapist. The purpose of this placement was to continue to develop my confidence as a pitch side therapist. Additionally, the purpose of the placement is to enhance my fundamental clinical skills. The main service that this placement offer is to student sports teams in giving them more support to be professional and achieve on the field. Due to there being many sports teams at university there are many times where you have to make a crucial decision about a player, this aids in my development as it allows me to increase my confidence when pitch side, this is then supplemented by supervisors which are very approachable and always on hand if you did need them both in an emergency or to just get an opinion on something. The status of the placement provider is a private entity from the University as it is run under the sports centre. However, the sport and health clinic are one of the primary tools used by the Sports Rehabilitation and therapy degree programmes in order to develop their students. Aside from the pitch side portion of the programme the sport and health clinic offer various opportunities to work with clients prescribed by the National Health Service (NHS) such as a back pain clinic in order to develop further confidence within the students when talking to strangers and having to coach them through exercise.

The aims and objectives of the placement were to develop my understanding around the sports and the teams that I was working with (the Tennis and Men’s Futsal clubs). The reason for this aim is as these are not sports that I have actively played much or surrounded myself with before. I feel like to be an effective member of any team as a pitch side therapist it is important to learn about the different schemas that people need for certain skills. This is so you can identify the most common injuries for the sport and start to formulate action plans for injuries that are more likely to happen, so you are more prepared for when they happen. The next objective of my placement was to improve my communication in an unfamiliar environment. This requires me to come across as an open, welcoming, honest and professional person. This is needed as being a rehabilitator or therapist is a very important role. The leadership team and individual players need to be able to trust you as you will ultimately be making the decisions about player welfare and whether people who have injuries play some games. The final aim of my placement is to develop my clinical skills. A placement is good not just only to help the sports teams, but they can also really help develop my own skills as a practitioner. Placements enable you to fine tune skills and develop personal ways of doing things. My roles and responsibilities on placement varied as I was the primary therapist for these teams. This meant I was responsible for the safety of the players while I was there and ensure that any injuries they develop are treated in the correct way before they return to play. Another responsibility that I had on placement was to aid in the delivery of strength and conditioning sessions and work with a small group or one to one with specific players who were not at full fitness.

During my placements this year I feel like I have been able to make massive progress in an aspect of both personal growth and key fundamentals associated with my course. I feel like I have been able to improve the overall health, performance and knowledge of all the clients that I have worked with over the time I have worked with them. I have constantly conducted myself with the upmost professionalism and ensured that I have put in additional work in outside of the placement to continue to develop my personal understanding of injuries, the sports I’m working with and the best ways to gain and maintain the trust of the players.

I have been able to meet all my placement aims and objectives to a high standard as I have learnt a huge amount about the sports of Tennis and Futsal. This has aided my development as it has affirmed the need for a strong understanding of the sports that I’m working with not only as a way to develop my own enjoyment of the placement but a strong knowledge of the sport allows me as a practitioner to learn common injuries surrounding the sport, an in depth understanding of how these common injuries are occur, and the most effective exercises which can be used to reduce the risk of injury as well as increase the functionality, effectiveness and all round performance of athletes. One time where I was able to demonstrate this was through my treatment of tennis elbow. Tennis elbow is one of the most well-known and common injuries associated with racket sports (Lalli, 2019). The best treatments for tennis elbow revolve around performing the massage technique frictions on the affected area and loading the tendon through isometric and eccentric movements. When I first started to treat my performers for tennis elbow using dumbbells to get the isometric movements (Stasinopoulos, 2017). When speaking to my supervisor about what I use to treat he recommended trying using tennis rackets and resistance bands to get the same effect as using a dumbbell. When utilising this with my team I found them to be much more engaged with the rehab itself. This has lead me to making all of my rehab as sports specific as possible as I find athletes are much more adherent as they can relate the movements to their sport instead of thinking they are doing meaningless gym exercises that is never going to benefit them in the long term (Goddard, 2020). This is perhaps the most important clinical skill that I have been able to develop whilst on placement as it has made me a much more effective practitioner towards people and players who are not as inclined to adhere to what you are asking them to do in the gym. By making it more sport specific you are highlighting the importance of training certain muscles for each sport and you can make athletes see how rehab is important to reach their maximum potential when competing.

 

Another placement aim that I feel I have achieved to a high standard is my professionalism. To be professional as a Sports Rehabilitator you always need to uphold an openness with all your clients. You need to be realistic when your clients are injured and clearly outline the risks that they pose to themselves with their injury, you also need to reassure them throughout their recovery that set backs are to be expected and there is no set time for their full return to play. This is of paramount importance because a players mental health and wellbeing can be affected massively by a setback in their rehab (Lichtenstein, 2019). Another major reason as to why professionalism is important as a practitioner is because you must be able to put your ego aside and do what is best for the clients. This may entail the acceptance that a player is unfit to continue regardless of your best efforts pitch side, or it may entail looking to other specialists for better advice. I can proudly say that on a few occasions I have had to talk to a supervisor to get their opinion on a potential pathology and it has helped with my personal development. A prime example of this is during my placement with the tennis team. A player was presenting with a long-term pain in the front of their hip. I assessed the client for the first time and the pathology that I was drawn to was hip tightness or potentially a grade 1 strain of the iliopsoas hip flexor even though there were some irregularities that the client was showing none of them were severe enough for me to believe it was anything more severe than something that stretching would clear up. The client reported back at a later date saying how the stretches, although reducing pain when doing them, were ineffective as the pain would come back more severe to begin with before returning to normal. Upon a reassessment before I gave the player any more exercise prescription I spoke to my peers in my lectures and got their opinions on what the pathology maybe. Due to their decisions being inconclusive I spoke to my placement supervisor and we had arranged to get the player into the sports clinic to ultrasound (Slayton, 2017) the area for potential labral tears until the outbreak of COVID-19 prevented this from happening. Due to the outbreak I had to contact the player and advise rest as the best temporary solution until the global pandemic is controlled enough that the sports centre can reopen, and the sports clinic is able to treat clients again.

The final aim that I had when starting my placements was to improve my communication skills in an unfamiliar environment (Marken, 2017). This includes being able to explain quite complex clinical terms in a way that someone with less knowledge and experience working with anatomy might have (Yarkoni, 2017). This is a fundamental skill that any practitioner should have. This is because I have found when you explain the physiology of an athletes pain/ injury to them they are more likely to not only to put aside time in their day to perform rehabilitation exercises but they are also more likely to trust you and come to you when they are in discomfort in the future meaning that I can potentially prehab a potential pathology before it gets too serious. One time where this can be demonstrated in my placement is through my placement with the futsal team. A new player to the team asked me to take assess his knees as he has been struggling with pain long before he joined the team, I feel like one if the reasons why such a new player approached me was because I have developed a trust among the existing playing group and when he mentioned he was struggling during the session the others recommended that he come speak to me. I was unable to pin his symptoms to one pathology as the player was testing negative for increased pain in any of the special tests: such as the ligament laxity tests and the meniscus tests (Griffin, 2018). I was again planning on bringing the player into the sports clinic before the COVID-19 outbreak prevented me from doing so.

A key part of experiencing placement is how you reflect on your time and how this helps you grow as a practitioner in your perspective field (Coward, 2019). The documents that we have been given are to be completed after every day at placement is finished. I have made this a priority throughout my placement as I find it useful to go back over my records and find what injuries I must commonly treat so I can then look at ways of potentially reducing the risk of that specific injury. Additionally, reflecting on placement using theories such as Gibbs 1998 reflective practice (Husebø, 368-375) is very useful as it requires you to think about how you would handle situations differently in the future. An example of when I have used this was during my time pitch side with the men’s football team, a player went down with a suspected peroneal injury. The treatment that I prescribed at the time although effective would not be the treatment that I would now give for similar or the same injury going forward. This is as upon reflection I found that holding off on some treatment may give me a more holistic picture of the injury after the initial shock had worn off from the client (Mirkin, 2016). I personally used my reflections to find all the positives of myself as a practitioner (Lopez, 2018). This is as I would always try and find the good things that I did on my placements and use them for my progression. Things like having confidence were something I found myself saying I had a lot of. I see this as a massive strength as if I have confidence in situations that I am not necessarily 100% sure about a demeanour of confidence can go along way into reassuring a client that everything is okay and under control (Fransen, 2017).

As I have previously stated I feel like my placements over the course of the year have been able to progress me massively as a pitch side therapist and they have undoubtably put me in a good position going into my third year where I will work with members of the public in the sports clinic as well as continuing my pitch side placements. I feel like the only negatives of my placements this year were beyond my control. Primarily the COVID-19 pandemic which has meant that I have been unable to fulfil my diagnosis and rehab with certain players due to the unavailability of face to face contact and equipment such as an ultrasound to perform diagnosis and treatment with (Prem, 2020). Personally I see the current climate as an important time to strengthen my psychological understanding of how people react when they are injured as especially with operations being postponed by the NHS and the complete impossibility of first hand assessments due to the nationwide lockdown athletes who are currently injured maybe more subjectable to a deterioration to their mental health which will only impede their recovery from an injury due to the primary factor of decreased adherence to rehab programmes and the lack of motivation when it comes to optimal nutrition which is required to make a strong fast recovery (Vahk, 2018).

 

 

 

 

 

 

References

Coward, M. (2019). Importance of reflection in revalidation. Nursing Management,, 26.

Fransen, K. M. (2017). “Yes, we can!” review on team confidence in sports. Current opinion in psychology,, 98-103.

Goddard, K. R.-D. (2020). Psychological factors involved in adherence to sport injury rehabilitation: a systematic review. International Review of Sport and Exercise Psychology, 1-23.

Griffin, J. T. (2018). A Case Report: Outpatient Physical Therapy Treatment of a Patient with Unilateral Medial and Posterior Knee Pain and Osteoarthritis. University of North Dakota scholarly commons, 7.

Husebø, S. E. ( 368-375). Reflective practice and its role in simulation. Clinical Simulation in Nursing.

Lalli, D. A. (2019). Taming Tennis Elbow. Sports Medicine.

Lichtenstein, M. B. (2019). Do exercisers with musculoskeletal injuries report symptoms of depression and stress? Journal of sport rehabilitation, 46-51.

Lopez, S. J. (2018). Positive psychology: The scientific and practical explorations of human strengths. London: Sage Publications.

Mirkin, G. (2016). “Why Ice Delays Recovery.” . K-active.

Prem, K. L. (2020). The effect of control strategies to reduce social mixing on outcomes of the COVID-19 epidemic in Wuhan, China: a modelling study. The Lancet Public Health.

Slayton, M. H. (2017). U.S. Patent Application No. 540.

Stasinopoulos, D. &. (2017). Comparison of effects of eccentric training, eccentric-concentric training, and eccentric-concentric training combined with isometric contraction in the treatment of lateral elbow tendinopathy. Journal of Hand Therapy, 13-19.

Vahk, A. B. (2018). Effects of Recovery Nutrition on Body Composition and Session RPE in Collegiate Tennis Players . International Journal of Exercise Science: Conference Proceedings , 81.

Yarkoni, T. &. (2017). Choosing prediction over explanation in psychology: Lessons from machine learning. Perspectives on Psychological Science, 1100-1122