I was originally going to do a post about posture, but after
this article in the Telegraph, I thought it was more appropriate to do a post
about client care and important factors in treatment.
First and foremost, I don’t know the physio in the story and
I don’t know his qualifications. Therefore, I am not going to judge him as a
person, I am merely going to state some important factors that I feel are important
in any treatment.
As a note, I do not perform manipulations. I am not trained
to do them, and personally from what I’ve read in research articles, it’s not
that practical to use them. As a graduate sports therapist we are not taught
them at University but can learn them after the fact. I choose not to use them,
others choose to use them. It’s not right or wrong, it’s personal choice
1)
Clinical reasoning. When we perform treatments,
we need to use clinical reasoning, we do this through muscle, joint and
neurological testing as well as special tests to help identify the potential
cause of the pain. Even when sports massages are performed, I use clinical
reasoning. This involves asking the client where, how and when the pain starts
then performing some postural and movement tests. It’s using this reasoning to determine if
and what treatment should be used. If a client has poor knee flexion due to
tight hamstrings then it’s reasonable to perform massage and muscle energy
techniques to try and improve flexibility, then prescribing exercises for them
to do at home. However, if the client is having pain and numbness it may not be
the muscle but sciatic nerve pain caused by the lumbar discs or gluteal structures, at which point further testing to rule out a herniated
disc would be performed and alternative exercises and treatment would be
prescribed. Clinical reasoning is the baseline at which our treatments are
founded upon.
If a client had attended my clinic with neck pain after lifting an object, and was told by their GP it was muscle pain, I would be inclined to further test him prior to treatment. If there was acute pain in neck extension I would be inclined to send them back to the GP for an MRI. GP's are not always right., they spend very little time with the client and are often pressed to get to the next appointment. Working in rugby I have had players with herniated cervical discs and it is important to find out the level of herniation and then prescribing appropriate exercises or if surgery is required. This often means referring them back out to their GP with a letter explaining what has been tested and your findings, I have done this and it has saved me a lot of problems in the long run.
If a client had attended my clinic with neck pain after lifting an object, and was told by their GP it was muscle pain, I would be inclined to further test him prior to treatment. If there was acute pain in neck extension I would be inclined to send them back to the GP for an MRI. GP's are not always right., they spend very little time with the client and are often pressed to get to the next appointment. Working in rugby I have had players with herniated cervical discs and it is important to find out the level of herniation and then prescribing appropriate exercises or if surgery is required. This often means referring them back out to their GP with a letter explaining what has been tested and your findings, I have done this and it has saved me a lot of problems in the long run.
2)
Informed consent. Informed consent is telling the client what you’re going to do
and why. For instance, when clients attend for injuries I explain what I am
testing, why I am testing and how I am going to do it. I also ask if they have
any questions, as I would rather they ask before I start then after. We obtain
informed consent before and throughout a treatment. If I am performing a sports
massage I let them know what I am doing and why then if I need to move the client around or use a new method, I let the
client know what I am doing and why. It is so, absolutely, important we
maintain verbal contact with our clients and ensure they are aware of what you
are doing. Heck, I even ask client if it’s ok to undo their bra while doing a back
massage, every time, even if I’ve seen them before! It’s not okay to assume if
they were fine with it before that they will be fine with it now. We all know
what assumptions do!
I also always, always, always tell my clients to let me know if something
is painful. I am not there to hurt people, I am there to help. I ask when I
start using deep tissue techniques or stretching techniques to let me know if
it’s painful. It’s common sense.
3)
Listen to your clients. What is the point of
treating a person if they’re not being listened to? It’s important to listen
during the history taking to make sure you understand their pain and what they
want from the treatment. It’s important to encourage them to ask questions, I would
feel awful if my clients were afraid to ask me a question. The real tragedy of
this whole story is that the whole thing could have been avoided if the person
had just been listened to. If he asked the physio to stop, he should have
stopped. End of.
At the end of the day we are all just people and are not
perfect, and we need to understand our own limitations. If I’m not sure how to
perform a technique I won’t use it on a client. If my client says something is
painful, I’ll stop. If my client doesn’t understand something that I am doing,
I’ll explain it to them.
For anyone out there seeking treatment, you shouldn’t be
afraid to seek help. My advice to you is to not be afraid to ask questions. If
you’re looking for a sport therapist or physio, check out their feedback/testimonials or Facebook
reviews. If you’re still not sure, call them! You can get a lot of information
from a person by speaking to them. When you call them, you can ask about their experience
and treatments they use. If you’re not happy, don’t book with them. Go with
your gut if you feel like something isn’t right when you contact them.
Thank you for reading my long rambling post, and if you have any
questions about Prestige Sport Injury Clinic or any of the treatments provided
please do not hesitate to contact me at sara@prestigesportinjury.co.uk
