Week One

Situation: This week, I was given the opportunity to participate in a physio session of an 18-year-old male patient with recent left minor patellar dislocation. This session was one of a few follow up physio treatments from a prior initial assessment. He presented with recurring anterolateral knee pain as well as increasing posterior knee pain. This was preventing him from returning to work as an apprentice carpenter, and was important that the condition was addressed to allow him to return to work as well as ADL’s.

Task: The main priority of this physio session was to manage the presenting condition to alleviate pain, facilitate healing and promote normal functioning and movement, which would enable him to return to work.

Action: I initially measured his knee flexion and extension to use as a baseline assessment. I then used ultrasound on the anterolateral aspect of his left knee to relieve pain and promote healing as well as massage on his hamstrings to relieve muscle tension as this could have been contributing to his recently acquired posterior knee pain.

Result: After using ultrasound and massage, the patient reported a decrease in pain levels from a 4/10 to 2/10, and was able to gain further range of motion after treatment when compared to his knee flexion and extension at the beginning of the physio session.

Evaluation: The main issue I had was my technique whilst using the ultrasound. As the anterolateral aspect of the knee was quite bony, the ultrasound head was losing contact with the knee and therefore affecting the efficacy and primarily the use of the treatment. There were times during treatment where the contact of the ultrasound head was adequate, but there were more times where contact wasn’t. I need to develop and practice my technique in the future in order to improve the intervention.

Strategies: I continued to practice the use of ultrasound throughout the week with different areas of the body such as the neck in order to improve my technique. I was able to seek advice on ways to improve my application and found I need to employ different strategies such as applying slightly more pressure on the head of the ultrasound as well as using slower circular motions. I used these skills in other sessions and was able to improve on my overall treatment technique.

Initial Entry

I’ve waited two years and the time has finally arrived for my first clinical placement. I am definitely excited and anxious to see what it is truly like to be a physio, see real patients with real conditions, and hopefully witness treatment success and client satisfaction.

I’m going to a private practice musculoskeletal clinic in Mandurah. My first thoughts when I found out it was a private practice were primarily disappointing as I’ll probably be limited in my hands on application of skills and treatment as there are insurance issues associated with students. However, I do like the fact that it’s a musculoskeletal private practice, as I feel most knowledgeable and comfortable in this area of physio.

Nonetheless, after taking the time to think about my true expectations for clinical placement, I realised that although I may be limited in hands on treatment, I’m still going to be able to gain exposure to different musculoskeletal disorders in a real clinical setting. I think the exposure to the clinical environment, liasing with colleagues and experiencing what its like to be a real physio will hopefully be a beneficial and rewarding experience. I’m confident in my communication and musculoskeletal clinical skills, so I’m hoping my first placement will be a positive and successful one.

I’m not sure how the day will be structured. I am working Monday to Friday, 8a.m to 5p.m with an hour for lunch, which I'm sure I will be using to research different conditions and treatment techniques. I know there is a hydrotherapy pool and exercise gym and I will be able to participate in hydrotherapy at some stage during my placement. I’m assuming my day will consist of some physio, some hydro sessions, and some non-contact time, which I’ll either be researching, or doing marketing and promotion for the clinic.

As the student in the facility, I’m not sure what my role will be exactly as it is a private practice and there may be some concerns with how much handling and treatment I'm able to do. I’m hoping that at minimum I will be able to sit in on physiotherapy sessions and participate in hydrotherapy sessions to have a first hand account on professionalism, subjective history taking in a clinical setting and treatment.

My only concern at this stage would be what is expected of me as a second year physio student in a private practice. I’m hoping I’ll be able to get as much exposure and hands on experience as I can, in order to gain the most benefit from the experience. I’m definitely anxious and nervous about starting, but I’m sure once the first week is over, I will feel like a real physio.