Ive been practicing counterstrain techniques for my upcoming OMM practical. Im 56 and 120 lbs. I have no problem if the patient is my size, or even a little bigger. My boyfriend however outweighs me by about 80 pounds. Ive been practicing on him, and its incredibly frustrating. There are aspects of techniques that are just not possible, such as some of the lifting, and even just reaching around him. Since its counterstrain, all the movements are supposed to be passive, and I feel like Im just trying unsuccessfully to lift dead weight.. Since I need one hand on the tenderpoint, half the time I cant even reach the next body part I need to sidebend or rotate. Ive practiced with other classmates that are smaller, and I have no problem, but Im concerned about getting paired up with someone on a practical thats much bigger than I am. I also dont want to be limited to practicing on people my size, and our OMM department streses that we should be comfortable performing techniques on people of all sizes. Has anyone else had this problem.. any advice?
-
New SDN Article! Health Professions Week
Yeah, we have some big people in class. You always pray that they don't stick you with them for the practicals, but if so, you better be able to synthesize landmarks quickly, and hope they don't check you.my alias said:
As far as not being able to reach, they always teach us alternate techniques for such a situation.
Yeah, you have to get imaginative. Just remember what you are trying to achieve (extension/flexion, rotation, sidebending) and do the best you can.
This might mean standing/sitting on a different side, changing your position, etc.
As long as you kow what you are trying to do and can explain it!
This might mean standing/sitting on a different side, changing your position, etc.
As long as you kow what you are trying to do and can explain it!
- Oct 2, 2002
- 4,679
- 1,585
- Status
- Attending Physician
Good luck on your practical this monday/tuesday
In terms of counterstrain on a larger (or heavier) person, there are tips and tricks that can help.
For AL1-5, try holding the legs around the thigh region instead of the lower limb. Also, try to have the legs as close to your body as possible. This way, you can monitor the point while getting some assistance from your leg muscles in holding up them legs
When you finish, instead of hovering their legs while slowly lowering it (all the while telling the patient to relax), flex their knees all the way. Then lower their feet onto the mat (it should be near their ischial tubes). Then translate the feet (now on the mat) until the legs are straight. This will prevent you from having to carry the burden of gently lowering the entire lower limb onto the mat BUT it also prevents the patients from tightning up their muscles (a natural reflex to prevent their legs from dropping like a brick) when you try to lower their legs.
There are other tips/tricks for other points on spine, ribs, etc. If you have time, find an instructor and ask him/her for tips/tricks.
GT
PCOM 2007
"Give me liberty or give me neuro"
In terms of counterstrain on a larger (or heavier) person, there are tips and tricks that can help.
For AL1-5, try holding the legs around the thigh region instead of the lower limb. Also, try to have the legs as close to your body as possible. This way, you can monitor the point while getting some assistance from your leg muscles in holding up them legs
When you finish, instead of hovering their legs while slowly lowering it (all the while telling the patient to relax), flex their knees all the way. Then lower their feet onto the mat (it should be near their ischial tubes). Then translate the feet (now on the mat) until the legs are straight. This will prevent you from having to carry the burden of gently lowering the entire lower limb onto the mat BUT it also prevents the patients from tightning up their muscles (a natural reflex to prevent their legs from dropping like a brick) when you try to lower their legs.
There are other tips/tricks for other points on spine, ribs, etc. If you have time, find an instructor and ask him/her for tips/tricks.
GT
PCOM 2007
"Give me liberty or give me neuro"
Is there a way to monitor the anterior tenderpoint on T3/T4? Judging by my handouts there is not but it seems that you could use the same position that is used with the anterior T5-T8 with just less flexion.
- Thread Starter
- #7
thanks everyone for your input. I think in real life I'd be able to negotiate ways around different positions that are harder. Unfortunately however, I'm studying for the practical, so I'm trying to get things by the book. But most of my problems involved lifting both legs at once, or reacing for a patient's right arm with my left arm when I'm monitoring the tenderpoint with my right hand, and can't reach his arm bc of some type of pretzel conformation I put him in. I guess the benefit of practicing on someone much bigger than you is that you get the techniques down really well, and it's much easier when you get paired with someone your own size. I just feel no mattter what techniques I use I'm hurting myself more than I could potentially help anyone. And I still say this is 3D twister.
Raptor, it does say in out handout that you can't monitor the anterior tenderpoint for T3/T4, but then going by alternate explanations posted on blackboard, it seems that you should in fact be monioring it, and adding a sidebending, rotating left component. But thats for a type 2 F SR, RR dysfunction, it' not really clear what our handout i treating for.
Raptor, it does say in out handout that you can't monitor the anterior tenderpoint for T3/T4, but then going by alternate explanations posted on blackboard, it seems that you should in fact be monioring it, and adding a sidebending, rotating left component. But thats for a type 2 F SR, RR dysfunction, it' not really clear what our handout i treating for.