May 6th- Day 3

This morning I finally was able to spend some time at Concord Orthopaedics! I was able to sit in and observe an appointment with Dr. Casey and a patient describing pain in her left shoulder. First Dr. Casey took a history of the patient and inquired about any certain instant that the injury may have occurred. The patient let Dr. Cases know where she was feeling the pain, what movements would provoke pain, and how long she had been feeling this discomfort. Next we observed the patients movement and range of motion as well as palpitations of the shoulder. We then followed up with special tests including strength testing and more range of motions tests. Through these steps and the patients x-rays it was determined that the patient has Capsulitis, inflammation of the connective tissue, within the shoulder.

Treatment options included a variety of exercises, the option of having a cortisone injection in the joint, and if the pain was to get worse surgery would be an option. The patient opted to have the cortisone injection which was to be administered right there. While the shot was being administered the patient experienced a vasovagal reaction and fainted. A vasovagal reaction is when the body has an overreaction to a trigger which causes a sudden drop in heart rate which reduces blood pressure. Since the patient already had low pressure and was sitting up, blood flow to the brain was restricted which led to the patient fainting. The patient's eyes quickly dilated and her body became rigid but this only lasted about thirty seconds before the patient became conscious. Upon further questioning it was revealed that the patient has low blood pressure to begin with and combined with her extreme anxiety towards shots and her lack of breakfast (low blood sugar), she was very susceptible to fainting.

Later on in the day I was able to work in Proctor's Athletic Training Room with an athlete recovering from a fracture of his Calcaneus (heel bone). He received surgery over the winter and had multiple pins inserted in his ankle/foot. I had the opportunity to work through a handful of exercises with him to increase range of motion, strength, and improve balance. We began by working with the elastic bands and working on the basic motions of the ankle- plantar flexion, dorsiflexion, inversion, and eversion. We then worked on balance and Chris explained proprioception (the ability to sense stimuli within the body regarding position, motion, and equilibrium) in depth. I worked on improving balance with the athlete by having him stand on his injured foot while I threw a ball to his chest. Since the athlete is only in the beginning of his recovery he was easily fatigued by this exercise so we finished his day off with the use of the BAPS board which continued working on motion with and without weight applied to the injured foot.

The last thing I did today was work on ankle taping. Because I had a softball game to attend I was only able to try a few times on my gracious volunteer and it was quite evident that I will need a lot more practice before I can be trusted with the tape. Hopefully with more practice and using the techniques Chris taught me I will be able to improve my ankle taping ability before the end of senior project!