Currently on my musculoskeletal prac, I'm having a lot of trouble assessing joint mobility/stiffness. During PPIVMs and PAIVMs along the spine, changes are very subtle, especially when the entire spine is equally stiff. I don't have a wealth of experience with these assessments so I have no idea of "normal" segmental moblity. I try to form an opinion on what I've felt, then my supervisor comes along and has a feel for herself, and usually has totally different opinions from me.
I've come to a conclusion that accurate PPIVM and PAIVM assessment not only takes time and experience to develop, you also require an accurate and consistent teacher to teach and check every finding you have made. The 4 weeks I have in this prac seem very insufficient. I just wonder how possible it is to have this sort of guidance if we are new grads working in a private clinic. Did you guys find that you had a grasp of it by the end of your placements?
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3 comments:
Hi Steve,
Good point, and do not stress :) I think that all students find this difficult and 4-5wks is definately not enough time to feel totally confident with your results all the time. Its a bit like manual handling + observation in Neuro!! It will take lots of experience to fine tune the skills.
I guess we'll all need to stand by what we believe to feel and find most important to treat and go with it. Then just adapt to the patients respone to treatment... didnt work? ok I'll try the other level I also though too be stiff etc. :)
hey steve,
being in country placement doing my second musculo placement (pretty much) I am still having alot of trouble with that. i agree with Kym that you have to trust yourself with what you feel and with experience I believe this skill will sharpen and be more accurate at what we are feeling. So don't stress as i am sure physios out there who know what they are feeling came a long way to become competent too.
Hi Steve,
You are definitely right to say that 4-5 weeks is not sufficient to know everything there is to know about musculo.
AS for knowing what you are feeling with passive accessory findings, don't fret. It takes time and no one gets it the first time round. with more and more backs that you feel, you will definitely be able to pick up subtle differences.
Trust yourself, your hands and what they feel. Be confident and just give yourself time. You'll get there soon enough.
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