So Sorry Jodie and Jo!,
I really did enjoy my Clinical education unit/prac placement this year. I felt like i was for the first time exposed to what physiotherapy is in a practicle sence. Clincial education opened my eyes to see that sometimes what you learn in theory/uni is sometimes not usefull or apllicable to do in a practicle situation.
I felt i was exposed
- a whole range of treatment options for conditions, such as lateral epicondyladure, and post operation conditions.
- i also noted that sometimes the treatment not only changes in doses as the person improves but also that the treatment can change in modalities as the person progresses in their recovery.
- gym sessions
- hydrotherapy sessions
- new machines such as traction devices, and different types of ultrasound/interferential therapy machies.
- i learnt to use my bodyweight to my advantage when treating patients, which is sometimes very important as a girl.
- i also learnt more about objective examination and that basically anything you dont measure you wont know if it improves.
However i was a bit dissapointed with the lack of paticipation and involvment that i
in this particular private practice 60-80% of the patiets were spinal patients and i was a bit annoyed that i didn't get to see more perpipheral problems. The reason for this being that i havent as yet studied the spine, but have studied the perpiphery.
Tuesday, December 2, 2008
Friday, November 28, 2008
WEEK 5 POST 3
Well this is my final post, Sorry its taken so long Jodie and Jo, i didn't realise i hadn't completed it untill i checked my email!!!
Today i performed treatment on a 16 year old boy with extensor tendinopathy. He had limited range of movement in extension, although there was only pain on resisted extension with radial deviation, third finger extension and power grip, there was no pain with unresisted extension. My supivisor decided that we would perform, deep tissue massage with triggerpointing to ECRB and ED, dry needling * although it would have been cool to perform this, my supivisor took over there :P* interferential therapy and also that we would give him some home exercises to stretch out his extensor tendons and strengthen them with some excentric loading.
I performed DTM ( deep tissue massage) with triggerpointing to his extensor tendons , and i progressed it with placing the extensor tendons in a more lengthened position, ie with his wrist in a flexed position. I felt that after treatment although he seemed a little sore, he was able to gain more movement; my supivisor then decided that dry needling the tendons would also be benificial.
On application of the interferential modalitiesi found it difficult to place all the electrodes around his arm without allowing them to touch eachother!. as the forearm is quiet a small area, i later asked my supivisor who said that placing the channels furthur down the forearm is still acceptable as long as the current is still going through the muscles. I still believe that the treatment was successfull.
Teaching the boy the exercises was easy enough as he seemed co-operative and willing to learn. however weather he will do them or not is left to be seen!!!.
In addition to this; on my final day i went to the gym!. My supivisor took me to the gym to look at a patient that he was performing a shoulder rehabilitation for. it was really interesting to see the last stages of rehab; as most of the time while i was in this practice i would only see the initial acute stages, most people managed themselves after a while and it was interesting to look at the different exercises that were prescribed. most being shoulder external rotation, internal roatation abduction and scapular setting with loading sorts of exerecises.
anyway thanks for reading!
Today i performed treatment on a 16 year old boy with extensor tendinopathy. He had limited range of movement in extension, although there was only pain on resisted extension with radial deviation, third finger extension and power grip, there was no pain with unresisted extension. My supivisor decided that we would perform, deep tissue massage with triggerpointing to ECRB and ED, dry needling * although it would have been cool to perform this, my supivisor took over there :P* interferential therapy and also that we would give him some home exercises to stretch out his extensor tendons and strengthen them with some excentric loading.
I performed DTM ( deep tissue massage) with triggerpointing to his extensor tendons , and i progressed it with placing the extensor tendons in a more lengthened position, ie with his wrist in a flexed position. I felt that after treatment although he seemed a little sore, he was able to gain more movement; my supivisor then decided that dry needling the tendons would also be benificial.
On application of the interferential modalitiesi found it difficult to place all the electrodes around his arm without allowing them to touch eachother!. as the forearm is quiet a small area, i later asked my supivisor who said that placing the channels furthur down the forearm is still acceptable as long as the current is still going through the muscles. I still believe that the treatment was successfull.
Teaching the boy the exercises was easy enough as he seemed co-operative and willing to learn. however weather he will do them or not is left to be seen!!!.
In addition to this; on my final day i went to the gym!. My supivisor took me to the gym to look at a patient that he was performing a shoulder rehabilitation for. it was really interesting to see the last stages of rehab; as most of the time while i was in this practice i would only see the initial acute stages, most people managed themselves after a while and it was interesting to look at the different exercises that were prescribed. most being shoulder external rotation, internal roatation abduction and scapular setting with loading sorts of exerecises.
anyway thanks for reading!
Wednesday, November 12, 2008
WEEK 5 POST 2
Today i treated a young patient who had dislocated his patella 7/52 ago.
I had seen my supivisor treat this patient before; and was quiet confident that i could perform this treatment session on my own.
I applied a medial glide to the patella.I then performed DTM on the boys ITB, and lastly finished the treatment with a dose of interferential therapy, that was aimed at stimulating the VMO muscle. i then gave the boy a exercise that aimed at switching on VMO.
Reflecting on my performance (:) there you go Jo!) i think i performed well; i was confident that what i was doing was correct and i continued to ask the patient whether they were in pain, or they felt an ''adequate'' stretch. I probably think that my exercise i prescribed to the kid was maybee a bit to hard for his stage of rehab, so i asked my supivisor who had a look at the child and decided that yes maybee it was a bit difficult. My supivisor then showed me a more effective stregthening exercise for VMO at this stage of the boys rehab. I feel confident now that i could presctribe some good exercises for switching on VMO! :). Overall my supivisor said i did well and i feel as though compared to the begining of my placement i am alot more confident in treating patients.
I had seen my supivisor treat this patient before; and was quiet confident that i could perform this treatment session on my own.
I applied a medial glide to the patella.I then performed DTM on the boys ITB, and lastly finished the treatment with a dose of interferential therapy, that was aimed at stimulating the VMO muscle. i then gave the boy a exercise that aimed at switching on VMO.
Reflecting on my performance (:) there you go Jo!) i think i performed well; i was confident that what i was doing was correct and i continued to ask the patient whether they were in pain, or they felt an ''adequate'' stretch. I probably think that my exercise i prescribed to the kid was maybee a bit to hard for his stage of rehab, so i asked my supivisor who had a look at the child and decided that yes maybee it was a bit difficult. My supivisor then showed me a more effective stregthening exercise for VMO at this stage of the boys rehab. I feel confident now that i could presctribe some good exercises for switching on VMO! :). Overall my supivisor said i did well and i feel as though compared to the begining of my placement i am alot more confident in treating patients.
Monday, November 10, 2008
WEEK 5 POST 1
Today a client walked in with pain in his wrist/hand. From my supivisors subjective assessment i found that: He was a security guard who had been chasing a offender and had tripped, he had fallen onto an outstretched hand ( FOOSH). I also noted that pain was felt both sides of the hand and it was a constant pain that was felt about 20 min after he fell.
My supivisor asked me to do an objective assessment of the patients wrist pain... immediatly alarm bells were ringing and i was thinking a fracture.. the most common being of scaphoid, however he said his pain was on the oposite end to scaphoid, so i started thinking possibly a fracture to other carpal bones....
Immediatly the patient was TOP on his carpal bones. I asked him to do active flexion, extension in supination and pronation. He was very painful on all these movements. ulnar and radial deviation were non painfull.
I performed AP's of his carpal bones and found him stiff in the 2nd carpal row as well as between capitate and hamate. He told me that in particular this was a very painful movement and it was the pain he was experiencing.
My supivisor performed AP on his carpal bones as well as medial and lateral glides to his carpal rows ( my supivisor said it would be a good idea to perform them next time in the objective assessment as he found them a bit stiff..). we then placed interferential therapy on the hand and my supivisor wrote him out a referral for an x-ray.
I found it interesting that we still performed physiotherapy on the patient even though we suspected a fracture to hamate. But my physiotherapist replied that the patient had come for phsyiotherapy and doing some physio wouldn't harm the wrist anymore than it had already been damaged.
My supivisor asked me to do an objective assessment of the patients wrist pain... immediatly alarm bells were ringing and i was thinking a fracture.. the most common being of scaphoid, however he said his pain was on the oposite end to scaphoid, so i started thinking possibly a fracture to other carpal bones....
Immediatly the patient was TOP on his carpal bones. I asked him to do active flexion, extension in supination and pronation. He was very painful on all these movements. ulnar and radial deviation were non painfull.
I performed AP's of his carpal bones and found him stiff in the 2nd carpal row as well as between capitate and hamate. He told me that in particular this was a very painful movement and it was the pain he was experiencing.
My supivisor performed AP on his carpal bones as well as medial and lateral glides to his carpal rows ( my supivisor said it would be a good idea to perform them next time in the objective assessment as he found them a bit stiff..). we then placed interferential therapy on the hand and my supivisor wrote him out a referral for an x-ray.
I found it interesting that we still performed physiotherapy on the patient even though we suspected a fracture to hamate. But my physiotherapist replied that the patient had come for phsyiotherapy and doing some physio wouldn't harm the wrist anymore than it had already been damaged.
Thursday, November 6, 2008
WEEK4 POST 2
Today i did hydrotherapy. I was pretty confident that i would be okay if asked to perform/direct clients on what to do because i remeber doing hydro last year- and also remeber doing it for our clinical ed tute!!.
It went fine and most of the time i simply observed.
One particular patient had had a menisectomy, and also still currently had a bakers cyst at the back of her knee. I found it interesting that the physio leading the hydro session was able to do manual therapy on the patient in the water ( she did alot of accessory mobilisations on the knee cap and tibia, with also some massage). My supivisor said thatwater has many benifits for all types of problems; those including.
- provides a 'weightless' feeling for those patients that can not move under the forces of gravity.
- enables a traction force to be applied
- the warmth can create a soothing relaxation feeling to sore muscles.
- has a boyancy force direction ( that can aid in exercising certain muscles etc)
My supivisor said that hydrotherapy is especially important in people with longstanding chronic back pain. She said that there has been alot of research into chronic LBP and they have found that significant relief from pain can be found with traction forces produced during hydrotherapy.
It went fine and most of the time i simply observed.
One particular patient had had a menisectomy, and also still currently had a bakers cyst at the back of her knee. I found it interesting that the physio leading the hydro session was able to do manual therapy on the patient in the water ( she did alot of accessory mobilisations on the knee cap and tibia, with also some massage). My supivisor said thatwater has many benifits for all types of problems; those including.
- provides a 'weightless' feeling for those patients that can not move under the forces of gravity.
- enables a traction force to be applied
- the warmth can create a soothing relaxation feeling to sore muscles.
- has a boyancy force direction ( that can aid in exercising certain muscles etc)
My supivisor said that hydrotherapy is especially important in people with longstanding chronic back pain. She said that there has been alot of research into chronic LBP and they have found that significant relief from pain can be found with traction forces produced during hydrotherapy.
Wednesday, November 5, 2008
WEEK3 POST 1
Well this week started off a little strangly.
In walked a new patient who was in his 50's. I originially observed that he didn't seem to have any "musculoskeletal" problems. I was right. The gentleman had come in with a chest infection. I found this particularily interesting as i was not aware that the general public knew that physio's can help people with sputum clearence etc. The man explained that the only reason he knew phsyio could help with such problems is that when he was much younger he had chest physio for another infection.
Anyway my supivisor then proceeded to perform percussions on the gentleman on a plinth with the headrest lowered. The gentleman came back for 2 more sessions after this treatment and i could tell each time he came back he sounded better.
I was able to listen to the clients lungs and i could hear which lobe seemed to be affected.
I found this client situation very interesting, as i was particularily unaware that chest physio was even really performed in a private practice!
In walked a new patient who was in his 50's. I originially observed that he didn't seem to have any "musculoskeletal" problems. I was right. The gentleman had come in with a chest infection. I found this particularily interesting as i was not aware that the general public knew that physio's can help people with sputum clearence etc. The man explained that the only reason he knew phsyio could help with such problems is that when he was much younger he had chest physio for another infection.
Anyway my supivisor then proceeded to perform percussions on the gentleman on a plinth with the headrest lowered. The gentleman came back for 2 more sessions after this treatment and i could tell each time he came back he sounded better.
I was able to listen to the clients lungs and i could hear which lobe seemed to be affected.
I found this client situation very interesting, as i was particularily unaware that chest physio was even really performed in a private practice!
Sunday, November 2, 2008
WEEK 3 POST 2 and 3!
Well> ~the rest of week 3 was fantastic. I'm sorry i havent got around to blogging much but i have written down all the interesting things i learnt last week
On one particular occasion; my supivisor asked me to assess a young patient who had been comming into the clinic for approximatly 3 weeks. He had been comming in because he dislocated his patella following a sports injury.
I was asked to perform a subjective and an objective examination. I 'am getting a bit more comfortable with performing these examinations; practice is helping i think!.
My supivisor said that my subjective examination was great- i just needed to be a bit more direct with my questioning- he said that often comes with practice. He said that my objective examination might need some work, though. He said i could have performed'
- Obers test ( assessing the length of ITB)
- He said i could have obersved the general position of the patella and its tilt and rotation.
- He said i could have observed the "bulk" of VMO.
- and also observed how the patella was being pulled as the quadriceps and the various other muscles tugged on the patella in knee extention.
- my supivisor also said that depending on the stage of rehab that someone like this patient is in ( ie. acute, or furthur down the track in the healing process) you assess different things. My supivisor said that right now in an acute stage he wouldn't be assessing the length of rec fem or gastroch, but later on down the track something like the thomas and thompson test may be useful for physiotherapy treatment. He told me its important to know your short term goals and treat what you want to improve imediatly. somthing like mlatracking of the patella and strength is important ATM as the young boy was falling over.
Again sorry for the lack of blogging but it was my brothers wedding last week and ive been incredibly busy!.
On one particular occasion; my supivisor asked me to assess a young patient who had been comming into the clinic for approximatly 3 weeks. He had been comming in because he dislocated his patella following a sports injury.
I was asked to perform a subjective and an objective examination. I 'am getting a bit more comfortable with performing these examinations; practice is helping i think!.
My supivisor said that my subjective examination was great- i just needed to be a bit more direct with my questioning- he said that often comes with practice. He said that my objective examination might need some work, though. He said i could have performed'
- Obers test ( assessing the length of ITB)
- He said i could have obersved the general position of the patella and its tilt and rotation.
- He said i could have observed the "bulk" of VMO.
- and also observed how the patella was being pulled as the quadriceps and the various other muscles tugged on the patella in knee extention.
- my supivisor also said that depending on the stage of rehab that someone like this patient is in ( ie. acute, or furthur down the track in the healing process) you assess different things. My supivisor said that right now in an acute stage he wouldn't be assessing the length of rec fem or gastroch, but later on down the track something like the thomas and thompson test may be useful for physiotherapy treatment. He told me its important to know your short term goals and treat what you want to improve imediatly. somthing like mlatracking of the patella and strength is important ATM as the young boy was falling over.
Again sorry for the lack of blogging but it was my brothers wedding last week and ive been incredibly busy!.
Wednesday, October 29, 2008
WEEK 3 POST 1
On tuesday my supivisor asked me to do an obkective assessment of a patient with shoulder pain. i knew just a breif run down of his subjective history, wich my supivisor informed me of, however otherwise the patient was new to me. I was pretty nervous about this as this was the 1st objective assessment i had done.
i had only 5 min to perform th eassessment and i wasn't clear as to weather my supivisor wanted me to perform all the possible objective assessments for the shoulded including joint integrity tests etc.
The assessment didn't go to well. I felt it was pretty disorganised and " here-there-and-ëverywhere". I think my supivisor aggreed!.
My supivisor advised me that i should be more systematic in my assessmnet and just assess what seems to be the problem; unique to each individual.
Generally my supivisor said that in objective assesment's we generally always perform
AROM
PROM ( physiological and accessories; unique to the individuals problem)
Muscle tests
Joint integrity tests ( if applicable)
I think next time i will have to take more time to anallyse what is being presented to me; and think about what ""tools"" of assessment i have in my knowlage bank; to stress and test the situation presented to me.
i had only 5 min to perform th eassessment and i wasn't clear as to weather my supivisor wanted me to perform all the possible objective assessments for the shoulded including joint integrity tests etc.
The assessment didn't go to well. I felt it was pretty disorganised and " here-there-and-ëverywhere". I think my supivisor aggreed!.
My supivisor advised me that i should be more systematic in my assessmnet and just assess what seems to be the problem; unique to each individual.
Generally my supivisor said that in objective assesment's we generally always perform
AROM
PROM ( physiological and accessories; unique to the individuals problem)
Muscle tests
Joint integrity tests ( if applicable)
I think next time i will have to take more time to anallyse what is being presented to me; and think about what ""tools"" of assessment i have in my knowlage bank; to stress and test the situation presented to me.
Sunday, October 26, 2008
WEEK2 POST 3
Sunday night and i'm just getting my third post up!.
A patient who had been attending Marmion Physio Clinic for a while; came in for her treatment on thursday. The lady had a history of incorrect patellofemoral tracking and pain as a result; in addition to this she also has arthritis of the joint; enhancing the pain issue.
My supivisor had already come up with a plan, but asked me to perform the treatment.
I was a bit nervous about treating this patient with my supivisor standing so close; however i tried not to show this!.
I performed a AP glide to her tibial tuberosity and a medial glide to her patella; she then had a session of interferential therapy. My supivisor reasoned that this would aid in reduction of pain, and an increase in ROM and would encourage the healing process.
During treatment my supivisor had to adjust the placement of my hands in the AP glide, making sure that the direction of glide was in the plane of the joint line, next time i will have to be concious that the placement of my hands can direct the direction to which the force/glide is moving.
In addition to this the application of interferential theraputic elctrodes was also different to what we had been taught at university. usually we have just been taught to "surround the joint" with the electrodes, however my supivisor showed me that one of the electrodes was to be placed on the patella; and the other one furthur up on the thigh/quadriceps muscle.
My supivisor told me that the reasoning behind placing the electrodes in the unusual place was to direct the current to the patella/superficial area instead of through the joint space.
I think i performed this treatment well.
A patient who had been attending Marmion Physio Clinic for a while; came in for her treatment on thursday. The lady had a history of incorrect patellofemoral tracking and pain as a result; in addition to this she also has arthritis of the joint; enhancing the pain issue.
My supivisor had already come up with a plan, but asked me to perform the treatment.
I was a bit nervous about treating this patient with my supivisor standing so close; however i tried not to show this!.
I performed a AP glide to her tibial tuberosity and a medial glide to her patella; she then had a session of interferential therapy. My supivisor reasoned that this would aid in reduction of pain, and an increase in ROM and would encourage the healing process.
During treatment my supivisor had to adjust the placement of my hands in the AP glide, making sure that the direction of glide was in the plane of the joint line, next time i will have to be concious that the placement of my hands can direct the direction to which the force/glide is moving.
In addition to this the application of interferential theraputic elctrodes was also different to what we had been taught at university. usually we have just been taught to "surround the joint" with the electrodes, however my supivisor showed me that one of the electrodes was to be placed on the patella; and the other one furthur up on the thigh/quadriceps muscle.
My supivisor told me that the reasoning behind placing the electrodes in the unusual place was to direct the current to the patella/superficial area instead of through the joint space.
I think i performed this treatment well.
Thursday, October 23, 2008
WEEK 2 POST 2
Well it was another gruling couple of days :P. But ill just talk about one incident that occurred in that time.
My supivisor asked me to performa an initial "practice" subjective assessment of an elderly patient that had been comming in for treatment for the past 30 years. The process went well and my supivisor said that i gathered the correct information. However i think i needed to be more accurate and direct in my questioning. Asking questions that were a bit more closed so i could get a more direct and succinct answer from my patient.
Another point my supivisor advised is that i try to keep my patients on track when they begin to tell me information that is not necessary- I felt this was a bit difficult as i didn't want to appear rude to the patient- by cutting him off. My supivisor said that sometimes you have to be a bit blunt- for the sake of time; but you can put it in a nice way.
One of my supivisors gave me an acronym that he uses for subjective interviews. I think ill use it for future subjective interviews as it keeps me on track with my quesitoning. The acronym was
W- when
O- onset
C- constant/intermittant
S- superficial/deep
N- numbness/ pins and needles/tingling
O- other areas?
R- relationship/ referal
This Acronym will also hopefully make sure that i am thorough with my assesment and don't leave any important information out.
My supivisor asked me to performa an initial "practice" subjective assessment of an elderly patient that had been comming in for treatment for the past 30 years. The process went well and my supivisor said that i gathered the correct information. However i think i needed to be more accurate and direct in my questioning. Asking questions that were a bit more closed so i could get a more direct and succinct answer from my patient.
Another point my supivisor advised is that i try to keep my patients on track when they begin to tell me information that is not necessary- I felt this was a bit difficult as i didn't want to appear rude to the patient- by cutting him off. My supivisor said that sometimes you have to be a bit blunt- for the sake of time; but you can put it in a nice way.
One of my supivisors gave me an acronym that he uses for subjective interviews. I think ill use it for future subjective interviews as it keeps me on track with my quesitoning. The acronym was
W- when
O- onset
C- constant/intermittant
S- superficial/deep
N- numbness/ pins and needles/tingling
O- other areas?
R- relationship/ referal
This Acronym will also hopefully make sure that i am thorough with my assesment and don't leave any important information out.
Tuesday, October 21, 2008
WEEK 2 POST 1
Today a past patient came in with a total knee replacement. The woman had been in before, and had previously recieved treatment, from my supivisor. My supivisor asked me to perform an AP on her tibial tuberosity.
I wasn't patricularily anxious about this patient as i was being watched by my supivisor, and i was quiet familiar with these mobilisations as we have already performed these in our UL musculoskeletal unit.
We performed an AP on her tibial tuberoisty, and a medial glide to her patella to loosen up the ligamentus/ muscular structures ( surrounding the tibiofemoral joint)and improve her ROM. We then performed stretches to her quadriceps and gave her a session of interferential to deal with any pain she was feeling and also to improve the blood flow to the injury site.
During treatment; the woman complained of pain in her knee; i believe as my supivisor later told me that i was performing the AP with "a little to much enthusiasm" and possibly she could have felt pain on her bony prominance, from the constant pressure. He advised me next time to "move my hand placement but still glide in the same joint line plane; in order to spread out the pressure".
Otherwise i was generally happy with the way things progressed today! :).
For furuture cases I think i need to have another look at one of my anatomy books; it seems that particularily in musculoskeletal physiotherapy you need to know your surface anatomy VERY WELL!.
I wasn't patricularily anxious about this patient as i was being watched by my supivisor, and i was quiet familiar with these mobilisations as we have already performed these in our UL musculoskeletal unit.
We performed an AP on her tibial tuberoisty, and a medial glide to her patella to loosen up the ligamentus/ muscular structures ( surrounding the tibiofemoral joint)and improve her ROM. We then performed stretches to her quadriceps and gave her a session of interferential to deal with any pain she was feeling and also to improve the blood flow to the injury site.
During treatment; the woman complained of pain in her knee; i believe as my supivisor later told me that i was performing the AP with "a little to much enthusiasm" and possibly she could have felt pain on her bony prominance, from the constant pressure. He advised me next time to "move my hand placement but still glide in the same joint line plane; in order to spread out the pressure".
Otherwise i was generally happy with the way things progressed today! :).
For furuture cases I think i need to have another look at one of my anatomy books; it seems that particularily in musculoskeletal physiotherapy you need to know your surface anatomy VERY WELL!.
Sunday, October 19, 2008
UPDATE
Sorry about the absent blogging! but i've had difficulty accessing a computer!.
My First Week at Marmion Physiotherapy clinic has been very tame. I'm mostly getting to know the patients and observing alot of treatment. At least 60% of the cases that are presented are back and neck problems, so its been a reall learning curve as spinal assessment and treatment are the components of 3rd year.
There was one situation where a gentlemen walked in with LBP. My supivisor assessed him as having a tight pirformis and trigger points in his glute max. I was asked to perform deep tissue massage. I was particularily a bit unconfortable as he was a male and this is quiet a private area, however i ignored my "unconfortableness" and began to converse with the patient. i made myslef hide the unconfortableness and tried to be as professional as possible. I found i even loosened up at the end of the treatment. In a way im glad i had this experience as i learnt that the more relaxed and professional i am, the more at ease my patient will feel; and this is necessary to a sucessfull treatment.
I found that in completing the treatment my patient had more pain relief and greater ROM in hip flexion and medial rotation.
My supivisor advised me to use my elbow next time in treatment as the olecranon is fantastic for applying pressure to knots etc. Next time i will use this technique alswell as it seemes to have a more effective result in 'direct' application of pressue to the problem area.
In the following weeks ill be doing alot of assessments/SOAPIERS and treatment with electrotherapy, massage and getting in the pool- teaching hydrotherapy classes etc.
P.s I promise to be more regular in my following weeks of blogging JO!.
My First Week at Marmion Physiotherapy clinic has been very tame. I'm mostly getting to know the patients and observing alot of treatment. At least 60% of the cases that are presented are back and neck problems, so its been a reall learning curve as spinal assessment and treatment are the components of 3rd year.
There was one situation where a gentlemen walked in with LBP. My supivisor assessed him as having a tight pirformis and trigger points in his glute max. I was asked to perform deep tissue massage. I was particularily a bit unconfortable as he was a male and this is quiet a private area, however i ignored my "unconfortableness" and began to converse with the patient. i made myslef hide the unconfortableness and tried to be as professional as possible. I found i even loosened up at the end of the treatment. In a way im glad i had this experience as i learnt that the more relaxed and professional i am, the more at ease my patient will feel; and this is necessary to a sucessfull treatment.
I found that in completing the treatment my patient had more pain relief and greater ROM in hip flexion and medial rotation.
My supivisor advised me to use my elbow next time in treatment as the olecranon is fantastic for applying pressure to knots etc. Next time i will use this technique alswell as it seemes to have a more effective result in 'direct' application of pressue to the problem area.
In the following weeks ill be doing alot of assessments/SOAPIERS and treatment with electrotherapy, massage and getting in the pool- teaching hydrotherapy classes etc.
P.s I promise to be more regular in my following weeks of blogging JO!.
Saturday, October 11, 2008
Initial Entry
I'm really looking forward to my musculoskeletal placement at Marminon Sports Clinic. Talking just recently to my supivisor; I get the impression that i will be really challenged and stretched at this place. this has got me a bit aprehensive but also very excited.
I am a little worried that im not going to remeber all of my anatomy that well; and im sure that there will be a few situations where im unsure of what is the cause of a certain problem, but im hoping they are in the minority!.
This is a private practice setting so the physios working in this clinical placement work closley with all types of HCP for referals etc. Examples of these HCP could be a doctor, a podiatrist, a OT etc.
I am a little worried that im not going to remeber all of my anatomy that well; and im sure that there will be a few situations where im unsure of what is the cause of a certain problem, but im hoping they are in the minority!.
This is a private practice setting so the physios working in this clinical placement work closley with all types of HCP for referals etc. Examples of these HCP could be a doctor, a podiatrist, a OT etc.
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