The end of ISM 1…
This week in ISM, I went on a mentor visit on Tuesday and prepared for Final Presentation Night. In the duration of my mentor visit, I learned the difference between concentric, eccentric, and isometric is in terms of rehabbing patients. Concentric is shortening of the arm, eccentric is lengthening of the arm, and isometrics is tension of the pulling of the arm. This vocabulary came in to mind through a shoulder patient, I observed who originally had a knee/calf injury and now has pain in the shoulder. In regards to preparing for Final Presentation Night, I finalized all of my programs for my classroom to look professional and revised my speech to add more involvement and detail in regards to my final product and conclusion. I am so excited for Final Presentation Night to get to showcase all of my work this year in ISM 1 and have a successful end to the year. ISM this year with my mentor, Amber Ingram, has been an amazing experience through the opportunities she gave me to walk patients through their exercises to all of the knowledge she taught me as she was working with patients. I am so grateful for her and am so excited for what next year in ISM 2 brings.
Speech and Lumbar Patients...
This week in ISM, I worked on my final presentation speech and went on a mentor visit on Monday. In regard to my final presentation speech, I need to make it longer by adding the audience into my presentation. To do this, since there is a lot of exercises in my final product that a lot of people do not know very well, I could bring the audience in by showing them how to do some of the exercises and having them do it with me to know the type of exercise, also point out where the rotator cuff is on the body and what its function is. In duration of my mentor visit Monday, I observed two lumbar spine patients, one also with shoulder pain as well. It was interesting to see these two patients because they relatively had the same injury, although their exercises were different based on where the pain specifically is for them. The only lumbar patient focused on stretching the hamstrings and quadriceps and strengthening the core and the lumbar/shoulder patient had a mixture of shoulder and lumbar exercises focusing mainly on the shoulder and strengthening the core as well. In the duration of next week, I want to revise and edit my presentation and print everything that needs to be printed and finalized.
This week in ISM, I finalized my final product and went on a mentor visit Tuesday. During my mentor visit, I discovered a cause of plantar fasciitis was directed towards the hip or arches. This was interesting because my mom has plantar fasciitis and it is from high arches. I also learned what the tool my mentor uses to measure the patient’s arch in the back going forward and backward which is called a bubble inclinometer. A bubble inclinometer is commonly used during evaluations for back patients or if they have pain in the back and the physical therapist in this case my mentor wants to see the flexibility in their back. Through finalizing my final product, I went back over it and re-worded the first beginning paragraph, which entails the background of the patient coming in from rotator cuff surgery, to make it flow better and more professional for my hypothetical plan in physical therapy. I am so grateful for my mentors tremendous help in the creating of my final product in order to make it look like a true plan would in physical therapy. Over the course of the next week through preparing for final presentation night and rehearsal speech, I want to finalize my presentation to bring it to perfection and completion.
This week in ISM, I finalized my final product with my mentor and went on a mentor visit Friday. During the mentor visit, I got to walk a patient through her exercises who had a knee injury. For one of them, I correctly corrected her on an exercise when you lay down on your stomach and pull your leg up. The patient had a loose foot and I told her to flex her foot more to get more into the area working the calf and quad/hamstring. For another patient, who has an achilles/calf injury, my mentor dry needled. She put the needles on the sides and middle of the calf, little above the knee, and achilles. She did not put electricity on the achilles which was interesting to me because she put it everywhere else, but she said that electricity is not needed there for that patient. For the same patient, my mentor also tissue scraped his calf after dry needling to get more blood flow into the area. Over the course of the next week, preparing for final presentation night late May, I want to add on to my presentation and finalize it along with my speech and get a binder in order to display my final product professionally.
Making changes to Final Product...
This week in ISM, I continued working on my final product and went on a mentor visit Friday. Prior to my mentor visit, I finished the rough draft to my final product in order to show my mentor and get feedback on it. Friday, my mentor looked at my final product and made changes to have it make more sense. I learned that making an exercise plan in physical therapy you go by weeks instead of days; so with that in mind I changed my final product to go by weeks instead and moved some exercises around where my mentor said to start doing them. For exercises with weight, I learned that in the plan you put 1-5 lbs because the patient will progress in weight ending the highest at 5 lbs for post rotator cuff surgery. During the mentor visit, I saw some new patients, one was a low back and hip patient, who was a high school baseball player and my mentor is working on not hyperextending while doing his exercises. I had never thought about that before for low back patients before my mentor said it and I noticed him hyperextending afterwards and learned that is another critique that can be for low back patients.
Progress and Cupping...
This week in ISM, I worked more on my final product and went on a mentor visit on Tuesday. For my final product, I looked at my mentors notes she gave me and added more to my final product and researched different exercises under the broad topic of exercises that were on the paper my mentor gave me of a sample rotator cuff rehabilitation done by a Texas Rangers physical therapist. This information and the notes I took were helpful to continue my final product and know what I needed to put into my final product in order to make sure it is the most professional and real write-up as a physical therapist would do with this type of patient. On my mentor visit Tuesday, April 10, I saw a technique I had never seen before called cupping. My mentor used cupping on a patient with pain in her quadricep. Cupping is a method of creating a vacuum on a patient’s skin in order to stagnant blood and lymph, improving qi flow. I learned it is another method to produce blood flow in the area like dry needling and tissue scraping. Over the course of the next week, I want to complete my final product in order to get feedback from my mentor and be able to correct those mistakes to make it look professional and good quality.
This week in ISM, I got to see new patients at my mentor visit Friday. I have not gotten to see my mentor working with new patients in awhile, so it was amazing to see the idea I have always heard that exercises and manual therapy differ between the patient. I saw two low back patients, I have previously seen low back patients, but these two had different exercises working in different places. For an IT band injury patient my mentor did a technique I had never seen before called cupping. Cupping therapy is an ancient form of alternative medicine in which the physical therapist put special cups on the patient's skin for a couple of minutes to create suction. My mentor specifically used the technique to create blood flow and relaxation in the muscle because the patient was very tight. The patient said it hurt a little bit, but it was not bad and the only thing that was painful was when my mentor slid the cup across her leg. Preparing for final presentation night in late May, I have added more to my ISM binder which has made me reflect on how much work I have done throughout ISM and more to come till final presentation night. Over the next week, I want to add more to my write-up case study to get my mentors feedback and revise for the final copy of my product.
Changes to Final Product Outline...
This week in ISM, I continued working on my final product. During my mentor visit, Wednesday with my mentor, she helped me with what to put in. We looked at a outline of a post rotator cuff surgery with the use of physical therapy which was done by a Texas Rangers physical therapist. We evaluated one done by the therapist and changed to accomodate the patient who I am doing a hypothetical write-up on for my final product. This was very helpful to know what to put in to my final product and knowing what my mentor would do with this type of patient after surgery. Also, in the duration of the mentor visit I got to walk a patient through her exercises. This patient is in college and likes to travel, but since the patient is having surgery again in the next couple of months my mentor is unsure if it would be reasonable to hike depending on how her surgery goes. Over the course of the next week, I want to fix all the changes my mentor made to my write-up for physical therapy and add more research I have found to put in my final product and get feedback for what I add on.
Changing Final Product...
This week in ISM, I thought of ideas for a new final product other than a case study because of the patient not being in physical therapy anymore to have rotator cuff surgery. On my mentor visit Friday I spoke with my mentor about what to do and what kind of surgery and she gave me some exercises that are good for post surgery patients. These include table slide and wall walk-ups. My mentor said in the beginning process after rotator cuff surgery the main focus is stretching out the shoulder and getting flexibility back in the area. Taking this I have started an outline of a theoretical process write-up on a patient coming from rotator cuff surgery. Using research and the help of my mentor over the course of 12 weeks the first half is focused on passive and assisted motion and the second half is focused on active motion. This change was challenging although with help I know I can get it done and have it in good-polished quality for final product. Over the course of the next week, I want to get feedback from my mentor for what I have so far and what to add more of or less of and good exercises for this type of patient.
Through these two weeks in ISM, in mentor visits the first week I continued working on my case study and saw progress through his exercises. During spring break, my mentor said my case study was discharged because he wanted to have surgery on his shoulder since it was his second time doing physical therapy. Now, over the course of the next weeks I will start writing the case study report and research how to format it in regards to specific information needed. In my mentor visit, Friday during spring break, I got the chance to walk a new patient through her exercises for a knee injury. This patient had to have surgery on her meniscus, so my mentor is working on strength with her. This experience was a little scary and new to me because I had not known the patient previously and had no background, so I was walking her through what my mentor had set up on her exercise program and with the help of my mentor’s assistance guiding me through the process as well. This was a great experience to have and helped in gaining knowledge of physical therapy. The process supported the idea of my final product, but with a different patient and helped me learn to work with a new patient with a different injury and different exercises.