Thursday

It’s interesting how often clients come in and have been referred for a single problem (such as knee pain) yet have so many other things wrong with them. We generally just treat what they were referred for (unless there is something else related). When I read the referral letters I start thinking about what could possibly be wrong (sometimes a diagnosis is given to us in the referral but we still need to check if it’s correct) and what possible treatments we may use. It is unusual for someone to come in and only have one problem, and generally there is always something unexpected with each client. I now try not to make assumptions as to how each client will present.

Today started off slowly so we showed some initiative and cleaned up the supply trolley. It was such a mess – and unfortunately will probably be messy again in a week. It’s getting harder to fill in some of my spare time so will probably start some exam study or something. We talked to one of the other physios and she said she will definitely call us in to see interesting or different things, as we would like to see as many different conditions as possible. We finished the day by tidying the storeroom and just generally trying to be helpful. It’s not what I had in mind to be doing on prac but we volunteered as we had free time and I really didn’t mind helping out.

One of the clients we had today was a returning client. We had seen him once before. He had a TKR. Last time we saw him he was doing well. This session is discussed below.

1. Our client came in as was just as cheerful as last time. I immediately noticed how much easier he was walking – which he commented on later. The improvement in his knee was obvious. The swelling had gone down a little and his ROM had increased. It is just so good to see one of our clients doing so well and improving so rapidly. He desperately wants to get back to work and I think he is well on his way. We progressed his exercises and told him about the Peripheral Conditioning Class. This is a class run in the gym every Tuesday and Thursday for people who have had things like knee replacements. There are a range of conditions catered for. There is a small circuit and we devise exercises for the clients. Matt and I have supervised some of the classes before but never had one of our own clients there. It would be good if our TKR client would come, however he has been doing very well with his exercises at home.

2. I think we did well with progressing the exercises. We moved up to a harder theraband and increased the time on the bike. For the knee extension exercise we also increased the weight.

3. I felt very confident in that I knew what I was doing and we have a clear goal (set with the client). Having already met this client I knew he was a great guy so I felt comfortable in this session.

4. I don’t think I would change anything – it all went really well. He is doing very well and constantly improving. We offered to write down the changes to the HEP but he said he could remember them and didn’t need it. For other clients perhaps it would be better to write them down (but I’m sure with this one he will remember them).

5. This client is improving but if we had a different client I would have to be a lot more patient and not expect the same results as quickly. This goes back to what I was talking about at the start – people recover in their own time and just because one person with a TKR recovered and was back to work in 5 weeks doesn’t mean all our other TKR clients will do this.

6. Things went well with our first client and seeing the improvement was great. It’s good that we get to see some of our clients returning as we are having a chance to build a rapport, rather than just seeing them once. It’s different from Elle and Jeff, I was talking to them and they get to see the same clients often, so have much more opportunity to build a rapport. I like being able to get to know the clients, rather than just treating them and not knowing anything else about them apart from what their injury/condition is.

7. Our supervisor told us tomorrow we have a client with an Achilles tear who has just come out of the plaster (I think they have been in it for 10 or so weeks). It will be interesting as I haven’t treated this before but I should definitely read up on it!