not convinced...

Has anybody else had this experience, when they propose to their supervisor what they think is wrong with the pt, and then get shut down, but then 2 weeks later you were able to prove them that you were right all along???

I know we don’t have very much clinical experience but I had this patient, this is my neuro prac by the way, who has a persistent flexed posture resulting in your classic crouching gait (go back to Connie’s notes if you’re not sure, by the way those notes are pure gold on pathological gait). We tested tone, we tested ms length. Tone testing was unremarkable, and with ms length there was a definite decrease in hip flexor length, and generalised hamstring shortening. The patient was generally very tight and found it very hard to let go during passive movement which didn’t help. We got him into prone still persistent hip flexion (13degs on left and 11 on the right)…. We spoke to his wife and she had mentioned that he had always walked very bent over…. I then proposed to my supervisor that he probably has a hip flexion contracture…. Bad move…

The supervisor made a point after this to mention to all the students that we all needed to start thinking more on the neuro side of things because when you are studying neuro it’s not like musculo. To be honest I wasn’t convinced and whilst talking about the pt during my mid placement I presented all the facts once again to prove my point and then the supervisor finally came around…

The moral of the story I think is, DON’T forget about all your musculo and cardio and anything that you can use to help problem solve through some tricky cases. Because a lot of the time many of these patients will have pre morbid postures and habits that you will be unaware of and a lot of the time the patient will be unaware that they were doing it also, and if they are not able to be solved with a neuro brain maybe a musculo side to it might help.