Hi all,
Thanks for the comments last week regarding how to improve my time management, I have taken on board the suggestions and feel like I am getting into the swing of things a lot better this week. This prac has been the most challenging so far but perhaps the most enjoyable and satisfying. I did learn a valuable lesson this week from one of my follow up appointments.
This particular patient had attended the clinic for LBP and was found to have a hypomobility disorder at L3/4 4/5 5/S1 causing pain into LF and flexion. Well being the conscientious student, I assessed all AROM and comb movements then proceeded to treat each problem with several different techniques. Problem was that in an effort to decrease pain and increase ROM all the treatment techniques and reassessments had left her quite irritable the next day, not the desired outcome.
The next session I discussed the situation with my supervisor who suggested I go back to the original treatment which happened to be only a rotation mobilisation technique at the affected levels which had good effect. I guess what I figured was that the patient would not think a 3x30sec rotation mobilisation was worth the money or would do anything to help with the back pain. I did the treatment as suggested and was surprised to find that she responded well to it and seemed happy enough. I guess I was expecting “I’m not paying for you to take 1hr of my time and wiggle my back for 30 seconds as they treatment”. I have realised this week that especially in the irritable patient, less really can be more.
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Hi Jess,
I was totally as eager as you were to help my patients get better when I started out at MS placement. Initially I was tempted into performing more than one manual treatment for my patients. I recalled, one of my patients got abit sore after too much hands-on. And the other got better. For the pt who got abit sore,it was obvious that I had done too much. As for the pt who got better, my supervisor told me, how would I know what has done the trick for the pt if I had done more than one treatment. So I learnt, with just sticking to one treatment, it helps prevent your pt from getting sore but it also makes followup treatments much easier for yourself, be it just modifying the duration or intensity of mobilisation.
Have a good 3rd week!
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