This week I was able to have a very unique evaluation opportunity. I received multiple phone calls from my sister and my mom while I was clinically experiencing with Hannah. When I checked my phone, I immediately called them back and tried to figure out what was wrong. My sister had had an accident at her gymnastics class where she thought her spotter said to do two backhand springs, but he only told her to do one. He spotted her on the first one, but did not expect her to keep going and did not spot her on her second backhand spring. When she went back the second time, her arms gave out and she landed directly on her back. She had bruising on her spinous processes from the impact, but had intense shoulder pain. There was no bruising or obvious deformity along her shoulder or upper back, but she had pain in the midrange of her range of motion that was relieved when she got to the top of her range of motion. She could not bring her arm across her chest due to pain. I instructed her on how to do an empty can test which was positive. She was point tender in the middle of her deltoid.
When my mom arrived home, I instructed her through FaceTime on how to perform an anterior apprehension test, which was negative. I also instructed my mom on how to perform active and passive range of motion. The active ROM was very painful, but the passive ROM caused no pain at all. I checked back again with her later that night, and she had pain with shoulder flexion around 30 degrees, when before the pain began around 45 degrees. My first concern was that she had injured her rotator cuff muscles; however, that next morning she was still in some pain but was able to function fairly well. She took volleyball off for the rest of the week, and is now ready to play again after some good rest and stretching.
This experience showed me that it is important to keep a level head. I am very protective over my sister, and my first instinct was to advise my mom to take her to the hospital because of her pain level. However, after asking her lots of questions and finding signs as well as I could through the phone, I had to go against my instinct and advise my mom to not take her to the doctor just yet. Luckily, I believe that it was a minor muscular injury that was able to quickly heal with rest. This experience helped to remind me that it is important to be rational, even when the first response tells you otherwise.
This week I had three attempts from the PBL that we did for Beth’s clinical class on head and face injuries.
I have been lucky to be able to clinically experience with a bunch of different preceptors, some who are still at Emory and some who are not. Each preceptor has been unique in their personalities and treatment styles, so I have been able to adopt a lot of their quirks as my own quirks.
The first preceptor that comes to my mind when reflecting on influence is Zach James. I always noticed that Zach never appeared stressed out and would take time with each individual who entered into the athletic training clinic for treatment. Zach made every person feel heard when they were telling about him about what was wrong with them. Additionally, Zach was always encouraging during rehabs with athletes. There was always a positive vibe during the rehab, which made the process much more fun and enjoyable. Now and in the future with whatever job or activity I am involved in, I hope to implement the same kind of positivity, empathy, and ability to stay calm in stressful moments the same way that Zach did during his time at Emory.
Secondly, I think of Hannah. Hannah relies a lot on manual therapy, which is something that I am also a big fan of. I admire that she would choose to do manual therapy over a treatment that may be easier or less time consuming. Her choice to pursue manual therapy over other types of treatment has encouraged me to practice massage therapy and trigger point more, making me much more comfortable performing this treatment on athletes and those in the physical therapy clinic. Additionally, Hannah also presents with a very positive attitude whether she is having a good day or a bad day. I admire the type of care that Hannah shows the athletes. For example, when a volleyball player had a season ending injury a week or so ago, it was evident how much Hannah really cared and how much she wanted to help her athlete. I hope to show these attributes when I am practicing in my profession.
Lastly, I would like to mention Melissa. Melissa truly cares about her athletes, but she refuses to get pushed over or disrespected. Sometimes I have trouble asserting myself to people I do not know very well, but watching Melissa has shown me that there is no reason that I should be disrespected or talked down to. Each preceptor has had an unique impact on how I practice/would like to practice athletic training, and I would have to write a book to speak of it all.
This week I had 3 attempts in my clinical book from the vignettes in our PBL in Beth’s class.
This week I was able to work on my personal clinical goal of gaining a better understanding of the different populations and age ranges that I could potentially be involved with as an athletic training student. This week I was back in the athletic training clinic because of the inability to be at the physical therapy clinic. Because of this, I was back to helping and clinically experiencing with athletes instead of the older, non-athlete population. The difference is exponential, and I feel like I was able to learn from being back in the clinic, as well as apply what I had learned in the PT clinic to the athletic training setting. This week I gained a new appreciation for the athletic training setting because of the upbeat and more rigorous atmosphere. Sadly, it is easy for me to become almost uninterested from time to time in the PT clinic because of the nature of the injuries and the different goals that people in the PT setting have set for themselves. I believe that all the goals set, regardless of the setting, are important, and it has been so beneficial to see the difference in goals between the two settings.
For example, most of the time the main goal for an athlete who is hurt is to get back to competition to play at 100% of their ability. In contrast, some examples of goals in the PT clinic are to be able to walk up a flight stairs without difficulty or to be able to get into a bathtub without assistance. Both of these examples in my eyes hold equal importance in relation to the individual that they belong to, but the path to reach these goals are often times very different. In the AT clinic on Friday, I lead a shoulder rehab on a shoulder injury. The athlete was ten weeks out and was expected to be throwing a baseball again within the next thirty-eight days. However, in the PT clinic, I am assisting with some rehab with a man who had his shoulder surgery in April, and he still has very minimal range of motion. I feel like I have gotten a lot better at reading the patient and understanding the importance between the individual and their wants and needs.
This week I had seven attempts from the PBL #1 that we completed for clinical class with Beth.
This week, I got to evaluate my first patient at the PT clinic. The patient was a 17 year old male soccer player who had a history of hip pain. He had been to the clinic once before for rehab on his ankles; however, hip pain was never mentioned. The patient claimed to have hurt it last spring when he was in season for his high school team, but never saw his athletic trainer or took time to recover. He said that he “just played through it”. He found that the only thing that helped the pain after his high school season ended was to rest. Unfortunately, each time he would try to practice after that, he would experience the pain again. He is taking some time off from his club season because of the pain in his hip/groin area. The patient stated that he feels the pain when he does a deep squat, sprints, walks up stairs, does “over the gate” stretches, and spreads his legs apart as if he were in a butterfly stretch. After completing an initial evaluation, I spoke to Matt and suspected hip flexor tendinitis. He confirmed my diagnosis and we began looking at treatment options. I was able to decide what stretches he took home to do, and the stretches and treatment he had done that day. Additionally, Matt let me decide his treatment for his following visit (with his guidance, of course).
I think that his experience really helped me find my footing in the PT clinic. Thus far, I have felt somewhat uneasy while clinically experiencing at my off-site. I do not feel like it is because of the atmosphere or the people, but because of the difference in populations from the PT clinic to the AT clinic. With that being said, I felt much more confident with this patient though, most likely because of his age and that he is an athlete. I believe this helped towards one of my goals because I have been able to work on rehab progressions. This patient was a good stepping stone into the PT clinic because it was somewhat in my comfort zone, but my limits were still pushed by having to think about how to progress his rehab. Overall, I feel like it was a beneficial step in my learning journey that I can use in the future to gage my progress as I move forward in the PT clinic.
This week I only had one attempt to put in my clinical packet, unfortunately.