Monday, November 17, 2008

Pelvic Floor exercises

on my musculo prac i was treating a 30 yo man from the middle east for LBP. he spoke and understood very little english but with mimicking i got him to remove his shirt for me. at first he was a bit uncomfortable in front of me and let me feel his muscle tone, PAIVM and PPIVMs. as the ax/rx session wore on and it got increasingly difficult to find out what caused his pain, where etc... i could feel we were both getting frustrated with the lack of understanding. the asssessment took ages as i had to pantomime out questions and he had to say yes or no. after a long assessment he was diagnosed with non specific low back pain with a hypomobile segment l3/l4 and +++ poor motor control. he had no lumbopelvic dissociation and +++ decreased lumbar lordosis. i treated the hypomobile segment and then i approached the problem of teaching pelvic floor to someone who did not speak english. i gave him a sheet explaining what the pelvic floor was incase his english reading capability was better than his speaking. i tried to explain slowly that his tummy muscles were weak and we needed to strengthen them to help his back. his face of shock when i put my fingers on his TrA to palpate his contraction told me that he had not quite understood and he got quite demonstrative saying that he had no leaking or problem there. i left the session at that for the first day, wrote down some HEP with pictures for him and told him to research the PF and we'd go over it next time. does anyone have any advice on how to approach the situation differently, cuase im not sure how i should have done it differently. i think a) by having a female physio b) being shirtless for a good half an hour and c) me palpating his TrA was too much for the first session, so maybe i should have done less the first time around! the patient's next appointment fell out of my placement time so i booked his appointment with a male physio student was coming after me, hopefully he'd have more success with the patient than i did.

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