Dr Hannula saw four patients tonight, all four being new patients. I assisted with three of the patients.
The first patient I assisted with had been having persistent shoulder pain for over two years. When beginning the evaluation I learned they had been experiencing some instability throughout some activities. They complained mostly of anterior shoulder pain that radiated down into the hand. They couldn’t really think of any particular MOI, however upon palpation they were extremely hyperflexable. A lot of their family had experienced hyperflexability, however it was something they had never had any problems with before. I had the patient do AROM and they had no pain however external rotation was about 85 degrees on both sides. Upon PROM they had some pain pass that point of AROM. When Dr. Hannula began the evaluation he first asked what one major problem that most people have with shoulders, instability. He then did load and shift, taking the shoulder out about 60% and the sulcus sign, which showed a major gap, positive for inferior instability. Due to the laxity of both shoulders Dr Hannula was not very worried about any tear, just the patient need to strengthen the joint to strengthen the joint. The second patient had dislocated their finger during practice, Alex relocated the finger during practice. The patient was not complain of major pain just some pain when making a fist. I first began with palpation, however there was no deformity I could feel. I next did valves and varus stress tests, both were possible for pain in that joint. Dr. Hannula put stress on the finger checking for a possible fracture after rolling that out he was not too worried about the patient wearing a splint he just suggested them buddy taping for practice or games. The third patient had been hit during a game yesterday. They had been hit in the thigh by another players head/ shoulder. The patient was complaining of severe pain in the medial knee and lateral quad. Upon palpation they did not have any deformities, however was extremely tender. After doing AROM of the knee and hip it was very appreciate that they were very uncomfortable. When shifting the patella lateral and medial they were extremely apprehensive to the motion. Dr. Hannula was very worried due to the amount of pain they were in about a possible fear fracture, however after performing the tap test and squeeze test of the pelvis the worry went down. He also did a apprehension test for the patella and decided the patient may have subluxed the patella and has a quad contusion.
0 Comments
September 10, 2018
Dr. Hannula saw 6 patients two follow-ups and four new injuries, I assisted with two patients. The first patient had torn their ACL a year and a half ago during a game and had surgery last October. They wear a brace during all practices and games, however during their last game while going for the ball planted and heard a pop, their knee was extremely swollen. Dr. Hannula evaluated the patient and was confused as to who the patient had a such a good stop on their knee while doing Lachman’s test. I was also able to do Lachman’s and feel the stop and the laxiety of the knee compared bilaterally. I was also able to jump in on a follow up to help take a stitch out of a patient's leg. Dr. Hannula first showed Sam and I how to do it, then let us take the remaining stitches out. The second patient I assisted with had been having some pain in their shoulder while throwing. Dr. Hannula first began with ROM, the patient had an extreme amount of external rotation of both arms compared bilaterally, however the amount of internal rotation is where the patient was having trouble. Dr. Hannula went through many tests, with only a couple resulting with pain. A couple tests in particular the patient had the most pain, Anterior apprehension, Jobe relocation and surprise. They had a very hard time staying on the table while Dr. Hannula was doing those tests. Dr. Hannula said they need to work on the stability of the shoulder because the posterior capsule was very tight and causing anterior pain. Monday September 3, 2018
Dr Hannula saw six patients, however I only assisted with five. First patient was a new patient, they had been having knee pain since the beginning of preseason and their AT from high school had diagnosed the pain with patellar tendinitis. The pain became very severe while cutting and going up stairs. Dr Hannula observed the patient walking then their Q angle, before diagnosing with patellofemoral pain syndrome. The second patient that I assisted with was seen for medial and lateral ankle pain 3 weeks after spraining their ankle in a game. They had been doing working on strengthening the ankle over the last 2 weeks and showed very good progression. The third patient was a follow up, ACL tear. The fourth patient was a post operational follow up looking for approval for progression. Lastly the fifth patient was an athlete who has hyperextended their elbow in practice then again in a game. Dr Hannula began to supinate and pronate their wrist and quickly noticed that biceps brachii was on contracting on the left arm. He then began with the hook test on the uninjured side, which was easily done. Then allowed in the complete the test on the injured side which was positive. Feeling a positive test on an actual person versus testing them without the injury is two completely different things. Having a positive hook test was an awesome experience because now I know the difference and what I should be looking for. |
AuthorMeg Greene Archives |