Online Osteopathic Technique Reflective Journal

Wednesday, 14 October 2009

S-CS:Tender Points ... theres so many !!!

Just been sorting through some paperwork (not really productive but makes me feel like I'm doing some college work) and have come across some Tender Point diagrams ... there are so many of them, how am I meant to remember !!!

S-CS: Gastrocnemius Video

Having been taught lots of S-CS techniques I thought I would have a go at filming myself performing one. Not sure the vest looks very professional but it was only a practice run lol

IMS: ENERGY

In clinic today at Bethnal Green the practice nurse spoke to our tutor as she was due to go on holiday tomorrow, however after a Sports Massage she had for shoulder pain she was now getting 'nerve' pain as well. During a free slot I agreed to treat her. During the assessment the tutor pressed hard into a Trigger Point on her supraspinatus. After the tutor left she told me that even that short time with him touching that spot she had felt a relief.

During the rest of the treatment she asked me if I would be able to treat her again as she instantly knew as soon as I started to palpate that I had a healing nature. The conversation soon progressed to my background as a nurse and my believes in positive energy etc and how disappointed I was with my Reiki One attunement as U didn't feel a euphoric rush of positive healing.

She turns out to be a Reiki Master and offered another attunement for me. Now I know this isn't part of Osteopathy and so maybe a tad irrelevant for the purpose of this blog .... but there has to be something in my thoughts of being able to feel/be aware of other peoples energy and IMS ... don't know what the link could be but I'm sure there is one!

S-CS: Strain-Counterstrain of Piriformis with a Lumbar Disc Bulge - does it work ?!?!

Well I'm here in Bethnal Green clinic. Just seen a returning patient with a suspected Disc Bulge of her Lumbar Spine who is receiving treatment whilst awaiting an assessment for a MRI scan. During the treatment I decided that I would try my new technique of S-CS to piriformis side-lying.

No sure I'll be doing this technique again with a patient that is in as much acute pain as this lady was with her low back.

With her side-lying I found the Tender Point so took the leg into Flexion, this wasn't a problem however when I tried to add either int/ext rotation to relive the Tender Point ... this wasn't happening, as in order for her me to support the weight of her lower limb and get her in a position of ease meant I was was putting movement through her pelvis and ultimately her lumbar spine.

Not sure whether this technique wasn't suitable or whether it was more to do with operator error ... I need to do some work on this !!!!

IMS - I so don't get it !!!!

Well I don't start the IMS course till next term, which is a shame as I think for me to get my head round it (almost a joke there) I need as much time and practice as I can get. One of the girls who's had the same cold as me went and asked one of the tutors to do some cranial work on her as she has been complaining that due to her cold she is all congested which is not just stopping the way she feels her sinuses are working but also preventing her from studying ....

The tutor did his cranial work as well as some work on her sacrum and pelvis .... after the treatment she said she felt her head and thoughts were already clearer ... she looked however worse than before the treatment, all tired and drained .... the tutor suggested she went and had a sleep for an hour (which she did) ...

I'm looking forward to tomorrow to asking her how she feels ... shame she needed the sleep as we were ment to be practising Functional Technique together, never mind as it ment I could pop up to The Royal Free Hospital to see how dissertation questionnaires were going ....

Tuesday, 13 October 2009

Technique - Lumbar Spine

13/10/09 - During technique practise we found that we were placing our elbows in the wrong place on the innominate and it was painful to perform the thrust.

29/11/09 - Discussion with Chris Thomas - we don't need to apply so much pressure with the caudal hand during the thrust.

26/12/09 - Discussion with Simon Browning - During LSpine thrust it is more important to make good contact with our ASIS than the pressure that we apply with our caudal applicator. In theory we should be able to thrust with only applying the caudal forearm to stabilise the patient.

04/02/10 - Clinic - Whilst treating a 22 year old female rower with a Rib 12, QL and LS strain I tried to manipulate her LS without success. I found it so difficult to wind up the joint as she was so mobile ... I felt that I had her in so much rotation that her lower extremity was almost 180 degrees from her trunk !!! Need to practise LSpine thrusts with hypermobile patients.

18/02/10 - Side bending thrust Mr Barker - During a clinic tutoral with Mr Barker we were shown how to perform a side bending LSpine thrust. The hand hold was very much like a SI with the caudal hand on the patient pelvis to perform the drop. This technique was very much like the Anterior SI thrust where it feels like I put a lot of strain in my caudal arm. However the technique was very effective and we revised the type of patients that a side bending thrust may be a good technique to use.

14/03/10 - Haven't thrust many LSpines lately ... must find time to practise them as I'm concerned that I wont be able to thrust them like my TSpine thrusts !!!

16/04/10 - Had some positive feed-back from Mr Harding today concerning my LSpine thrusts ... he said that they looked very comfortable for the patient and that the wind-up was very joint specific.

20/04/10 - On watching one of the smaller girls in clinic today attempting to thrust a 6'4" muscular male it was obvious that she didn't have the table low enough as she wasn't able to put her PSIS onto the patients inomminate ... I had to resist offering advice during the technique in front of the patient ... which was hard as I wanted to have a go myself lol.