This week was especially exciting. On Tuesday somebody brought the perfect number of bagels so everyone working the morning shift could have one, and on Thursday one of the patients brought mini cupcakes for one of the therapists and her "helpers" (aka whoever saw the box and was hungry) to enjoy. Other than the free food, I was able to interact with the patients a lot and learn more about the field.
I had a pretty simple research question: what exactly happens during a patient's first injury evaluation?
I wasn't as confused as this dog, but I wasn't 100% sure about what happened during these appointments. Luckily, I was able to sit in on my one of my site advisor's knee evals!
The patient is a dancer, who had previously been in physical therapy for Osgood-Schlatter's disease, a common, growth-related knee injury. However, this time the patient's pain was in the other knee, and came about after landing from a jump. The sharp pain was located in the back of the knee and flared during activities such as walking up the stairs. To start, Dr. Jeschien asked the patient to do a squat, but they could only bend slightly at the knee before there was discomfort and pain. After asking questions about the current and previous injuries, he asked the patient to walk back and forth (and back and forth and back and forth) in order to make observations about their gait, which is simply just how they walk. Dr. Jeschien noticed that the patient was bringing their knee in and kicking their foot out with every step, a sign of weakness in the quadriceps muscles. After making these observations, he then measured the patient's strength in both knees by bending and stretching the legs and asking the patient to resist when he pushed against either leg. This all seemed pretty straight forward as I sat in, so I sat in and watched everything, even making mental notes of my own about the patients injury.
However, as the eval went along, Dr. Jeschien was taking notes about each measurement he was taking, which would later help him to create the exercise regimen the patient would follow. Most of the notes were numbers on a scale of 1-5 or 1-10 or plus/minus signs to dictate ability, flexibility, and overall strength. By the end of the about 20 minute eval, Dr. Jeschien wrote up a short "starter" program including 4 exercises that the patient would go through that day and continue to do at home and an ice and electrical stimulation period at the end of the rehab. By the time the patient comes for a second appointment, Dr. Jeschien will write more exercises into the routine based on what he saw during the eval and any new information the patient comes back with.
This week was definitely helpful for my research on both knee injuries and how the individual rehab programs are created. See you next week!
