DRAFT: This module has unpublished changes.
5 October 2010
1:40-4:40pm 3 hours
Accumulated Hours: 15
I have decided to stick with hand therapy for mentorship from here on out. Since I began at Physiotherapy I have rotated amongst the therapists employed here. For three weeks now I have shadowed Nicole while occasionally viewing Tracy or Ann’s patients. Technically speaking, Nicole has agreed and plans to be my ‘mentor’ and evaluate me quarterly, help me along for the year, and fill out forms needed for school.
Today I watched the patient for the third time who had a thumb joint replacement surgery followed by a “clean-up” of scar tissue surgery due to tendonitis, swelling, and pain from the first surgery. Nicole prescribed strengthening exercises mainly now that the joint is stable. The patient uses putty, close-pins, and stretching exercises to strengthen the joint and regain motion lost from surgery. I have noticed in the patient that the lower thumb joint has rotated downward and the patient struggles with lifting it without turning the wrist to help it along. The patient also flexes the tip of the thumb involuntarily. Nicole prescribed exercises while paying close attention to training the thumb to remain straight and using the tendons for strengthening. Nicole also told the patient to slowly start doing day to day activities without either the soft or hard splint on.
Tracy got a new patient with elbow, top of lower arm, and wrist pain. All of the symptoms pointed towards tennis elbow, which at first is treated through stretching and decreasing swelling. Tendonitis and tennis elbow are very common thus I would like to and believe I would benefit from researching these two specific injuries. Stretching consisted of holding the wrist up with elbow straight for 15-30seconds followed by stretching the wrist down with the elbow straight for 15-30seconds. With tennis elbow, the patient was recommended to avoid movement of the wrist with the elbow straight (when opening doors for example) to reduce pain with these activities the patient should stand close enough to objects that the elbow can be bent and held closer to the body. The extended repetition of tools (holding a knife to chop food) should be avoided altogether as it causes pain and swelling and irritation. In the beginning, any force (such as bands and splints) against the upper arm would cause problems due to the tightness and irritation in the muscles.
Some injuries come with specific time frames and exercise plans. Tennis elbow however is more opinion based on the therapist and what they believe in. this is exactly what my forum will provide therapists with. From my website therapists can put their input and also see different perspectives of therapy in order to provide patients with the most effective form of rehabilitation.