Today I worked mainly with Kristina, but her 10am appointment cancelled, so I got to work with TJ for the first time. He had a really interesting case with a teen who recently had a femur lengthening surgery on his right femur. TJ had never treated this patient before, so the hour long session was focused on testing flexibility and improving mobility. I actually got to help stretch the quads and it was surprising just how tight it was post-surgery. I had to hold his ankle still just so his knee flexion could be measured without any slipping since he couldn’t hold it in place himself yet. I also got to see just how far he had come, as he showed TJ that right after the surgery he could barely hang his leg off a table because the tendons in his knee were so tight, and today he got well past 90 degrees.
I also did a few sessions with Tyler again, and even got to see a returning patient from earlier this week. It was interesting to see how much improvement there was in just a few days because this patient was dedicated to doing his at home excersizes. When I saw the patient earlier this week, he came in on crutches, but today he was able to walk in the boot and put some weight on the injured foot without the boot. Tyler used a blood flow restriction machine on this patient, and many others, to make simple exercises harder. When a patient has limited mobility but still needs to build strength, the machine can be used to allow the patient to keep getting stronger while doing the same exercises.
One really cool thing I happened to get to see was dry needling. I had never seen it before, and by chance I was with Kristina in a room when she noticed that one of the staff members was about to have dry needling done. He had 4 acupuncture needles placed in his hamstrings and then the needles were connected to an electrical current. It was intetesting to see his reactions when the needle hit a certain spot in the muscle, and how his muscle would twitch due to the electric current.
With Kristina, I got to see patients on complete opposite ends of the compliency spectrum. Two of her patients were well educated in athletics and how to take care of their bodies. Another two were known for missing appointments and not doing their at home exercises. One huge part of PT is patient compliency. They need to actually do exercises at home to get better. She told me that they do what they can in the clinic to help, but if the patient is known to be non-complient, there isn’t much more they can do, especially with older patients. While it would be nice to get really good patients all day, part of the job is definitely learning how to handle challenging patients.