Last semester, I said that I felt least confident when asked to perform an evaluation alone. This has greatly improved this semester. I feel more confident in my knowledge of common injuries and how they present, and I feel that has had a tremendous impact on how I feel while performing an evaluation. I believe that I have improved greatly in my palpations, and this is partly because I have just been exposed to it more. I believe that palpations are something that you can only improve in by practicing it and familiarizing oneself with them. Being able to perform more trigger point work on athletes has played a big role in my comfort level with palpations. By performing trigger point, I have been able to practice feeling for abnormalities within the muscles, feeling where one muscle begins and the other ends, and practicing how hard I need to feel during palpation. Additionally, I have learned to not freak out when the athlete presents with something unfamiliar to me. It’s very rare that an athlete presents with textbook symptoms for an injury, and that is okay. I have learned to take it one bite at a time, and that it is okay to ask for help when I am faced with something challenging.
This past semester, I was not able to experience many rehabs, but I enjoyed those that I was involved in. This semester I was able to be involved in a lot more rehabs, and I still feel the same way about them. I love to see the athlete improve and work hard (most of the time) to get better. I am thankful that I was able to be a part of the rehab process more this semester. Overall, I feel that I have grown as an AT student and in my skill set; however, there have been quite a few problems as well. I feel like I have lost my excitement for the process, and sometimes feel like I do a lot, perhaps too much, learning on my own. I oftentimes have to be “re-taught” things in the clinic because I still do not know the information from class. There have been quite a few times that I have wondered whether or not that this is the best academic track for me, and have done a lot of praying about it. However, I will continue doing my best to keep learning in the AT program as long as I am still here.
This week we had a head and face practical where I received approximately 19 attempts, some of which will hopefully be mastery.
Now that I am back with my primary preceptor, I realize that a lot has changed since the beginning of the semester. However, I do not believe that the changes are just with the rotation that I am on; I believe that the changes translate throughout all of the rotations with all of the different preceptors. Now that I am almost through all of upper and have complete lower, the expectations of me have risen. I have the opportunity to perform more evaluations now than I did in the beginning of the semester, and I believe my preceptors feel as if they can trust me without having to “hold my hand” per say throughout the entire evaluation.
A tremendous change has occurred regarding rehabs. Now I am entrusted with running many rehabs on my own, whether it is in the weight room or in the clinic. This area is one in particular that I have enjoyed because I love being able to see the athletes back in an athletic atmosphere where they are getting to push themselves to be better. Additionally, Chaypin allowed me to create my first rehab this past week. It made me feel as if she trusted me enough to be able to put one of her athletes in my care. Of course she checked over it and gave me feedback, but being able to create a rehab on my own was a huge milestone for me.
Unfortunately, one thing that has not changed throughout the semester is my confidence in the clinic. My confidence level is about the same as when I started this semester despite the knowledge that I have gained in the past 3-4 months. I feel as if the information that I am learning in the classroom has trouble translating to actual application in the clinic. However, once someone in the clinic explains to me the situation that I am struggling with, I can learn from it and am able to apply it to other situations that are similar.
This week I had approximately 3 attempts this week during our head and face evaluation. A lot of the tests for the head and face section are tests that we have covered before in previous sections, so I am unsure of whether or not we will cover them in class. We participated in a concussion debate in class, so my attempts for this week are lower than normal.
This week I have had the opportunity to run many of the rehabs for women’s soccer players. Many of these rehabs have been ankle related, but many have been ACL related as well. A specific ankle rehab that sticks out to me is a one for a soccer player who has struggled with chronic ankle instability and reoccurring ankle sprains. She has been coming in for rehab for almost two weeks and seems to be making good progress concerning strength; however, her balance is a big area of weakness. She often has trouble while performing activities on the BOSU ball, such as cup pick-ups and cup touches. She especially has trouble doing tasks on the blue foam pad that is used to help with balance.
During a specific rehab, she had particular issues with keeping her balance while closing her eyes and standing on one foot on the BOSU ball. It was in the rehab plan to try to keep her eyes closed while moving her head from side to side while doing the same exercise as before. She seemed apprehensive about the task, but tried to do it anyway. She had to catch herself many times and couldn’t seem to keep balanced for more than just a couple seconds at a time. Because she could not perform the activity in an efficient manner, I told her to keep her head still on the second try to see how she would do. She still had a few issues, but overall she was able to perform better. From there on, I told her to alternate between moving her head and keeping it still every two times until she finished the designated number of sets. By doing that, she was able to spend a lot more time on the BOSU ball instead of catching herself or having to reposition back onto the BOSU ball. She was able to do the rest of her exercises in the rehab without alteration. I hope to be able to follow her through the rest of her rehab, to see the improvements that she makes. Additionally, this was a great experience because I was able to implement what I have learned in therapeutic rehabilitation in the clinical setting. What happened during this rehab is not something I have experienced very often, so it was definitely a unique learning experience.
This week we had a wrist, hand, and finger practical. By having the practical, I received approximately 50 attempts, and some of these will turn into masteries (hopefully).
We have made considerable progress on our little clinical question research. Together with the help of our committee, we have found some extremely useful information in discovering whether or not a mineral deficient is the primary cause of muscle cramping in athletes. With the information that we have discovered, we have realized that we may need to change our question. Instead of comparing three minerals, potassium, sodium and magnesium, and their effects on muscle cramping, we may need to begin looking at the comparison between a mineral deficit and muscle overloading. The thought of changing our question this late into the process has definitely been a challenge, but we want to have the best clinical question that we can have that is the most beneficial in the long run. Additionally, in regards to research on our current question, it is very difficult to locate information on each separate mineral. We have found one article that solely mentions a sodium deficit, but no articles yet on magnesium or potassium deficits. This is really surprising to me because of how the majority of people tell those who are cramping to eat a banana due to the potassium in it.
I have been very surprised at some of the information that we have found so far. One article we found mentioned that there was no evidence stating that a deficit in a particular mineral could cause muscle cramping during competition. I also found it interesting that another article states that it is difficult to distinguish the difference between an overload muscle cramp and a mineral deficit cramp. Lastly, one of our articles stated that if the muscle cramp is a result of overloading that muscle, only that muscle and the muscles in that muscle group would be affected by the cramping. On the other hand, if it were a mineral deficit that is the source of the cramping, the cramp would travel across muscle groups to cover a wider area of the body.
Moreover, meeting with Beth about our question really helped us in focusing our research on specific questions that we had. I felt a little frazzled when looking prior to the meeting because I was really unsure of what I was looking for. Now that we have specific question, I believe that we will be able to find better information to attempt to answer our question.
This week I had approximately 42 attempts in our clinical book. We began the wrist, hand, and finger section in upper with Brianne, and received attempts in ROM, MMT, and special tests.