Friday

We had a new client who had been seen by another physio at SDH, who discovered she had torn her Achilles tendon. She was then treated conservatively and was in plaster for 10 weeks. We now see her as an outpatient and saw her on Friday (she had come out of plaster on Wednesday).

1. At first I wasn’t sure what to expect in terms of ROM, swelling, pain etc. The client’s ROM was very good and within normal ranges. There was also no pain which I was surprised about. It was good there was no pain, I’m still getting used to the fact sometimes we have to be a bit mean and make people do things that hurt!! Both feet and ankles were very swollen. The client said they were swollen even before the operation or injury, but now the operated side is more swollen (but only slightly). We gave her some new tubigrip for her legs, to hopefully reduce the swelling. The other tubigrip she had was too short and caused all the swelling to accumulate in her forefeet and toes. We also gave her some exercises to increase strength and since they are active movements will hopefully help pump the swelling. There is a computer program we can use to print off some exercises, which is great as the diagrams help remind the client exactly what they should be doing.

2. There were a few things we did well such as taking the subjective history (which is becoming much easier) and doing the objective (although with this client it was pretty basic). We also modified the exercises we gave her as when she demonstrated them she had a lot of difficulty. We made them easier and plan to progress to the harder ones as she gains strength. One thing to improve the session would be to organize the assessment so we didn’t have to get her moving around so much (i.e. do all the standing ones, then all the supine, the prone etc.) We are getting better at this but still sometimes get the client to move around quite a bit.

3. I felt quite confident as I knew what was going on and what we should be doing as our treatment. I was a little uncomfortable at first touching her legs that were very swollen as I had never really done this before and was worried I’d cause her pain. When she didn’t appear to be in any pain I became more confident and moved the joint properly.

4. Next time I won’t butt in on Matt when he is taking the subjective history. Ok…well I probably will, but I’ll try not to!