Today, I was once again mostly observing all the therapists working. I did continue cleaning tables, preparing hot and cold packs for patients, and continue preparing HEP2Go work sheets for patients and uploading them to their documents tab. There were some gaps between patients and Jeffrey helped me try a few exercises that patients commonly do when looking to improve balance. Dan and Jeffrey always express how important it is to actually do the exercises that the patients are doing from time to time to better understand how the patient is feeling. The exercises I did were all balance related as Jeffrey had me start by balancing on one leg on both sides. He then had me set a semi-hard foam under my feet and had me then try balancing on one leg again. The foam was obviously a softer and more malleable surface than the ground and thus required my ankles to work a lot harder to help me keep myself balanced and upright. The next thing Jeffrey had my stand on was an inflated circle disk that almost resembled a squished ball. Although Jeffrey asked me to try standing on it with one leg each, he explained that with patients that may need more support, they may ask that the patient have one foot on the ground and one foot on the disk then may have the patient catch and throw a ball or perhaps reach out to touch a ball placed in different locations. After the disk, Jeffrey had me balance on a Bosu Ball with one leg. All these exercises – standing on the floor, the foam, the disk, the Bosu Ball – are often combine with either throwing and catching a ball or with reaching out to touch the ball that would be placing in various locations. Finally, Jeffrey had me try to most challenging balancing method: flipping the Bosu Ball over and trying to stand on it that way. Typically, it’s extremely challenging to stand on the Bosu Ball this way and even more so with only one leg. Jeffrey explained that, for this reason, they typically had patients stand on the upside-down Bosu Ball with both legs and instead do squats.
While I wasn’t trying exercises with Jeffrey, I was observing him, Dan, Parker, and Kim at work. In the morning, Kim had a patient that had stiffness and limited mobility in her neck. Kim is well-versed in dry needling and was dry needling the patients neck and using e-stim along with the needling. I have seen needling done in many other places, but I had never seen it done in the neck. It was interesting because when using the e-stim and needle to achieve a twitch, you could actually see the patients head moving with each twitch, or her shoulders (depending on where Kim was needling). Kim also explained that it’s important, when dry needling, to needle along the entire myofascial line or fascial line. A myofascial line is quite literally a line of connective tissue that runs through your body. Kim explain that it is much more effective to target an entire line than focus on the muscle in only one sections that make up only part of the line. This wasn’t the only time when connections throughout the body, and their importance, were brought to light. Another patient who comes in for back pain was being treated and the therapist told him that his tight hamstrings were a contributing factor to his back pain. It’s incredible how part of your leg is able to greatly affect another area such as your back. Most people would never think to assume that something as small as tightness in a certain area could affect so much more in your body, even when the locations are far from one another on the body.
