Authorisation of use of pictures

Sports Rehabilitation

Attending a talk by David Tiberio in October gave me a new insight into how to rehabilitate a patient looking to return to normal function, let a lone returning to sporting function. Tiberio discussed about loading and exploding, explaining that in order to carry out any movement, a small opposite movement occurs first. For example, when getting out of a seat, you almost sit deeper into your chair, loading the muscles needed to get you out of the chair (quadriceps, gluts etc) by applying a small stretch. This enables them to explode allowing you to carry out the movement of getting out of the chair.

I also completed a course held by Robin Lansman on Sports biomechanics and muscle chains. Here we looked at developing the standing exam, the squat test, muscle chains (open and closed chains), sport muscle chains.

I was fortunate enough to have a patient who presented with multiple inversion ankle sprains. Using these two tools, along with my knowledge as a personal trainer I carried out some rehabilitation exercises on this patient. An example of the notes can be seen below.

 Certificate of the CPD course

Gait analysis

in my attempt to grasp a better understanding of gait mechanics and how it could affect a patient I attended a Manus Sinistra talk held by Matt Harris. I also observed Matt Harris at Pure Sports Medicine, seeing him implement this into all his treatments with his patients. He also advised his patients on nutrition further strengthening my want to get a general better understanding on appropriate nutritional advice. Below are pictures of Matt assessing a fellow BSO student's gait, and my assessments of my patients gait in clinic.

Functional technique practise and clinical application

some pictures of me practising tapping the spinal segments of the thorax and moving the segment into its greatest point of ease.

clinic notes of me applying functional technique in clinic on patients, incorporating this into my routine where possible and approriate.

Obstetrics technique practise

Below are my attendance forms to my lectures in obstetrics and osteopathy,

Applying the technique used to assess leg length discrepancy with a patient, 

 the diaphragm release/stretch technique - which can be applied to pregnant women and can be beneficial due to the poor mechanisms of the diaphragm resulting from pregnancy and pressure/restriction produced due to the foetus

 the 8 finger soft tissue technique

 modified posterior SIJ high velocity thrust - as a pregnant woman would not be able to roll on to her front to carry out this technique

 seated soft tissue of the erector spinae muscles - effective and removes the need for the patient to lie prone as the patient would be pregnant and unable to do so

 periscapular muscles soft tissue, using the patients arm to reinforce and direct treatment to specific tissues, muscles and articulation of the shoulder complex

IMS practise and clinical application

Involuntary Movement System practise, attendance and clinical practise. I recently had a headache patient and have applied frontal lift technique in order to elevate his symptoms. There has been an improvement as he has been able to have no headache post treatment for upto 3 days. Prior to treatment the patient would suffer from headaches on a daily occurance.

I attempted to perform balance tension at the sacrum on a patient who experienced pain shooting along her sacrum. She had adhesions removed and this also gave me an opportunity to attempt this technique in order to see if this would relieve her symptoms. 

Study Group

We work hard to ensure we can think of all differential diagnoses, he is a little picture of me with the work my study group and I did on the knee and the mechanism behind high velocity thrusts

Nutrition and osteopathy

I had a very productive talk with a fellow student who is studying nutrition. I explained to her how I was looking to improve my knowledge of how nutrition is linked with osteopathy. She gave me a great link on recipes and the medicinal properties included in these meals

http://www.dalepinnock.com/.

I have yet to fully investigate this but from what I have seen so far it seems very interesting and could be a great help to patients with inflammatory processes going on.

Inflammation is a common cause of symptoms presented in the clinic. My tutor at BSO clinic Mike Stewart continuously mentions how low grade inflammation can be a maintaining factor for the patients symptoms. Therefore with more knowledge on how to decrease inflammation, especially through nutrition (something Mike Stewart is also keen about), then this would result in a better outcome for my patients and their symptoms.

Mike Stewart presented a slide show during a tutorial on inflammation and its underlying effect on the prevention of full recovery for patients. This linked in nicely to my knew knowledge and research into how nutrition can affect inflammation and possibly reduce the effects of inflammation.

My Contract

These are the goals I was aiming to achieve over the past year as a final year student in osteopathy:

Pre-professional learning goals	Activities and methods	Evidence	Assessment / Evaluation
Applying techniques learnt in functional technique in my treatment to patients in clinic	Attending elective class, practicing with peers, and applying when appropriate the techniques to patients	Continuation sheets highlighting specific techniques, feedback from peers, clinic tutors, blog	Feedback from patients to see if these treatments are more or less effective and self reflection. Feedback clinic assessments, CCA’s, New Patient Clinic, OSPE’s
Applying techniques learnt in obstetrics and osteopathy in my treatment to patients in clinic	Attending elective class, practicing with peers, and applying when appropriate the techniques to patients	Continuation sheets highlighting specific techniques, feedback from peers, clinic tutors, blog	Feedback from patients to see if these treatments are more or less effective and self reflection. Feedback clinic assessments, CCA’s, New Patient Clinic, OSPE’s
Applying techniques learnt in IMS in my treatment to patients in clinic	Attending elective class, practicing with peers, and applying when appropriate the techniques to patients	Continuation sheets highlighting specific techniques, feedback from peers, clinic tutors, blog	Feedback from patients to see if these treatments are more or less effective and self reflection. Feedback clinic assessments, CCA’s, New Patient Clinic, OSPE’s
Sport specific osteopathy, rehabilitation	Attend sport specialist osteopathic clinics	Letter signed by osteopath proving my attendance, blog	Apply to patients involved in sport and see their response and recovery from injury via my treatment
Improve my knowledge of gait mechanics	Attend relevant Manus lectures, read relevant books, discuss with tutors	Blog, obtain signed document showing discussions have taken place	Apply this to patients, see if I can assess their gait and possibly improve my patients gait
Improve my knowledge of nutrition and osteopathy	Attend relevant Manus lectures, courses, read relevant books	Blog, obtain signed document showing discussions have taken place	Apply this to my patients, try and improve their diet, be able to give advice on what to eat to improve their overall health
Get a better understanding into Yoga and Pilates	Attend yoga/pilates classes, talk to instructors	Blog, obtain signed document showing discussions have taken place	Enable to advice patients on whether to go to yoga/pilates, which mode of yoga/pilates is best for them, what to expect at these classes

Pilates and its core relation to osteopathy

As I moved into 3rd year at BSO I found myself promoting pilates as a great way to strengthen my patients core and that in the long run this would benefit my patient who had a weak back.

Another goal I took upon myself to get a better understanding of is the benefits and whether it was appropriate for my patients to take part in pilates. I have currently been attending classes at my local gym and have found them to be very useful and challenging. I also discussed the relationship between pilates and osteopathy with an instructor who was studying at the BSO.

The art is not to do as many repetitions as quickly as possible, but to take the time to ensure each movement is done correctly, whilst maintaining a neutral spine. Another positive aspect regarding pilates is the option to increase the level of difficulty which the teacher will explain whilst carrying out the exercise. Level one is the beginners stage but should you want to challenge yourself you can progress to level two, providing you cover the criteria to progress.

This is a great way to strengthen the core muscles, ensuring you are doing all the exercises with a neutral spine and engaging the core muscles whilst doing any exercise. The slow pace is great for anyone who may be suffering from any injuries and like with yoga, as long as you let the instructor know about any injuries they can accommodate the exercise to suit you.