Eighth Week - Flexibility

Warning, this is going to be a long blog entry! Get yourself comfortable now.

Abstract: The current blog entry captures the usual week highlights and further explores the physio student's health. As in previous entries a metaphor or theme is applied: the metaphor used this week was 'clinical flexibility' but this was poorly executed, as you will soon read (because everybody reads the article after reading an appealing abstract!!). Limitations of this entry include: absolutely no Vancouver style referencing (not even APA style), and it is a long blog entry - bear with me. Upon reflecting to find that there is no results section (and that this isn't even a research article) we may conclude that it's time for a week holiday!

As a sports medic we are relied upon by our team to be on the sideline, no matter where the game location is - within reason. Consequently, we went on a short field trip to Mosgiel. The sunshine wasn't putting on much of a show, but our team sure was. Our team crushed / slaughtered / were victorious by quite some margin! A significant perk of medicing is the opportunity to be sideline, watching some excellent athletic performances. But how well did we perform as medics on Saturday? Well... we arrived on time, set-up a working space in the changing room, strapped and massaged as requested - but then completely forgot to introduce ourselves to the officials and management of the other team... until the second half. Woops! Luckily the injury count was low, with one member from both teams needing treatment for an ankle injury in the second half. The officials showed their disapproval by delaying my entry onto the field (as they control who enters and leaves the playing area). Needless to say, I won't be forgetting this important aspect at the next game.

Academic Journals in the Med-Library

Flexibility is a term that describes the extensibility of tissue, and therefore a body segment's movement, about a joint. As an example; in the clinic a practitioner may conduct an Ober's (IT-band) and Thomas (quadriceps) test to determine whether a muscle contracture (shortening) has occurred. If hypomobility is found, the patient will be prescribed stretches. I'm not going to discuss static, dynamic, ballistic or PNF stretching, rather I shall go on a slight tangent and discuss a psychosocial demand that may leave a person feeling 'stretched'. Last week's exams 'stretched' many students, especially due to class commitments immediately before the tests were taken. It appears that students relish the time before an exam because it is an opportunity to mentally (and physically) prepare. Being flexible is then to be able to overcome adversity (i.e cope with the lack of time to prepare). It is important not to be too far stretched (stressed). Biologically, the idea of muscle deformation (due to elongation forces) is called 'creep', but I'm not about to suggest these stressed students are creeps! Rather that they need to better manage their flexibility programme, as it's getting the wrong results... Are you impressed that I pulled off that metaphor?! ...In other words: learn to be flexible but not become over stretched = be proactive with your learning, prepare and use strategies to manage adversity in order to maximise your performance. Phew, we got there!

As physiotherapists, not only do we treat the physical aspects, but also we manage some psychological aspects of our clients. It is thus quite appropriate to blog about mental health from the student healthcare professionals' perspective. After all, the practitioner needs to be in a good 'head space' to achieve the best client outcomes. All muscle flexibility metaphors aside - stress is a pressing issue in healthcare. As alluded to in the previous paragraph, student's are bombarded with a lot of information. Student healthcare professionals are expected to retain and apply this information. Furthermore, we must be life long learners. This places a great psychological demand on students; this is known as 'stress'. Stress is not always a bad thing (it is a motivator that gets assignments done at the last minute); the keys is 'how to appraise the stressor'. Some student's may not care (this surely isn't us), whilst other's attribute the task to be highly important. High task demands coupled with a perception of not being able to meet these demands is a recipe for anxiety. Anxiety is characterised by a shift in attention-concentration and may lead to a performance catastrophe. Sitting in an exam (under time constraints), knowing that five minutes ago you could recall the structures and functions of the central nervous system, but now you can only remember where the thalamus is. "What's that structure inferior to it? Fornix? Septum Pellucidum? Pineal? Something starting with G? Oh No, I can't think! Time is running out, everybody else is writing fluently and I'm frozen steering at the question!" This is an example of a catastrophe. Moreover, our receptiveness to stress as a psychological trait can have a large impact on our day to day health. Healthcare professionals, like everybody else, are subject to low mood states, anxiety, depression, low self-esteem, sleep deprivation, low task and self efficacies. It is important to identify and address these asap. Psychology is a discipline of its own; rather than discussing each condition individually I challenge you to have a think about psychological factors affecting your life and share your thoughts with a trusted somebody and seek professional counselling (counsellor or psychologist) if you believe it would help. There is a stigma about seeking psychological help, however I advocate that seeking help is a sign of strength. People seek physiotherapists for help with physical problems, so seeking psychological professionals for psychological problems is most appropriate. In recent lectures we have discussed Cognitive Behaviour Therapy, Narrative Therapy, and the Social Problem Solving model of behaviour. It is important for physiotherapists to have a somewhat-in-depth knowledge of frameworks to manage psychological problems. After all, what use are physiotherapists if the client with a rotator cuff injury is too afraid to lift their arm! In conclusion, physiotherapist students: have some psychological strategies to help clients and should confide in a friend or lecturer about psychological issues of their own.

We were given another assignment this week and the semester one exam timetable is out! Let us prepare for our five exams graciously. There is plenty of time to learn the content, practice stress-management strategies, and be flexible enough to enjoy some social life. I found some UK physio student's blogs! These blogs seem to capture the demands of a physio student. Some blogs go beyond the first year of study (as I hope to do with my blog) - so there is hope! I don't feel these blogs are as good as mine... one of their blogs even discussed their recommended text books. So, as ridiculous as it sounds, here are our recommended text books for the first semester:

Social events this week included a BYO (bring your own - alcohol) with dinner for combined lab groups a, b, c & d of second and third year! But the highlight of the week was voluntarily participating in research (as a participant) at the University of Otago, School of Physiotherapy. The research involved recording EMG of muscles surrounding the glenohumeral (shoulder) joint under certain constraints and for multiple simple tasks. The main interest was on muscle stabilisation roles and mobilisation techniques. Although I don't wish to pursue academia, it is interesting to experience the research process as a means to appreciate the how we know (the mechanisms underpinning) clinical methods are effective.

It is a short week this week with Friday being 'Good Friday' for the Easter weekend. Next week is the Mid-semester break, so there won't be a blog entry about that (hence this weeks entry is super long).

Time to get back to nature, explore the outdoors, breathe the fresh air!