Praktikast Benficas

Ei ole nüüd mitu päeva kirjutanud, sest esiteks pole viitsimist olnud ja teiseks pole ma peale praktika ja trenni suurt midagi teinud.

Avastasin, et palju mõnusam on minna Benfica staadionile jala. Missiis, et sinna on ligi 6 kilomeetrit ja et mu metroo kuupilet niisama tolmu kogub. Kuna mu praktika algab iga päev kell 16. 00, siis hakkan minema kuskil 14. 45 (väike varu igaksjuhuks, kui peaksin tahtma nt. poest juua vms osta). Praktika lõppeb kuskil 20. 30 paiku, tulen sama teed pidi tagasi ka. Õhtud on olnud mõnusad soojad - lausa lust on kodu poole jalutada. Meil on siin ikka õhtuti kuskil 20 kraadi, päeval päikese käes oli kohati juba päris palav. Eks ikka juhtub jahedamaid päevi ka sekka, aga üldjoontes on väga ilus kevad.

Nüüd nädalavahetusel ka peale trenni, filmide vaatamise ja FT-alase info lugemise netist midagi muud teinud pole. Ilus ilm on küll, mõtlesin linna minna, aga ei viitsi kuidagi.


Praktika algas mul kolmapäeval (21. 03) Benfica kliinikus. Kuna tegemist on S.L. Benfica üldkliinikuga, siis on seal igasuguseid sportlasi nagu jalgpallurid, korvpallurid, ujujad, võimlejad, rugby-mängijad jne. Palju on noorsportlasi, kellest mõned on väga noored ja vigastuse tõttu opereeritud. See ei ole normaalne, et üks 15-aastane noor on käinud juba põlveoperatsioonil. Viga on vales treeningmetoodikas - liiga palju tehnikale keskendumist, liiga vähe üldfüüsilist trenni. Kui quadriceps ikka nõrk on ning MCL ja LCL põlve korralikult ei stabiliseeri, siis on vigastused kerged tulema. Ma usun, et valesti treenimise viga on ka eesti noorsportlaste seas üsna levinud, ainult et neil puudub kvaliteetse füsioteraapia teenus.

Mis me nende vigastatud sportlastega siis teeme? Väga suur rõhk on elektri- ning ultraheliravil, samuti lihast tugevdavatel ning stabiliseerivatel harjutustel. Elektriravi teeme mitme eesmärgiga - valu vähendamiseks, turse alandamiseks ning lihaste tugavdamiseks. Tihti tehakse turse alandamiseks elektriravi kombinatsioonis jääga.
Need aparaadid on hoopis teistmoodi, kui meil koolis oli. Ja nad on portugali keeles. Alguses ma ei saanud mitte midagi aru, nüüd läheb juba päris hästi nendega töötamine.

Panen siia oma praktikapäeviku 21. 03 - 23. 03, mis on inglise keeles (peame selle lõpuks kõik kokku köitma - üks osa, millest moodustub meie hinne), kes viitsib lugeda, see viitsib, aga üldiselt on see füsioteraapiast kaugetele inimestele võib-olla väheke ebahuvitav. Aa, ja vigu võib ka sees olla, sest ei ole viitsinud seda veel läbi lugeda.



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I started my internship in S. L. Benfica Clinic on 21th March. The first impression of the clinic was very good because of the various training/rehabilitation equipment and electrical/ultrasound therapy devices.
There are 4 electrical therapy devices. 3 of them are form different producers. 3 of them have ultrasound therapy possibility, one of them doesn’t but it is a large device and has 4 channels, the others are a bit smaller with 2 channels each. The clinic also has several portable TENS devices. The electrodes are self-adhesive and come in 3 different sizes: the smallest are round, the medium square and the largest are rectangular.

21. 03. 2012

1. A girl, basketball player. Has a meniscus surgery on 19th March. The exact mechanism of the injury is unknown because the knee problems begun already 6 months ago. Several treatments were applied but with no result. The surgery was the only option.
She practices knee extension (ball under her knee, then extends her knee). Also electrical therapy – Russian electrical stimulation – was applied, with frequency of 50 Hz, impulse-pause 1:1, intrval 10 ms. The electrodes were placed on her quadriceps for 20 minutes. After that, another electrical treatment – high voltage stimulation – for reducing the oedema, was applied for 20 minutes with the combination of ice. Frequency was 100 Hz, current intensity 55-60 V. The electrodes were placed bilaterally on the knee.

2. In the clinic, there are a lot of patients, who have knee injuries. Most of them are basketball players, but as my instructor said, there knee injuries occur also in other sports like athletics, rugby, football, futsal. A lot of young athletes have had a knee surgery, other suffer form knee overuse and inflammatory processes. The rehabilitation process with knee injury patients consists generally of electrical and ultrasound treatment and of various exercises to strengthen the thigh muscles. There are also exercises for the knee stabilization. They use different equipment like trampoline, bosu ball, stability and balance trainers, Power Plate.

22. 03. 2012.

1. The same patients as yesterday – the basketball player with the meniscus surgery. Treatments were also the same as the day before.

2. A girl, swimmer. Has a strain and inflammation in one of her adductors, near the insertion. When palpating, the groin is painful, during walking not. TENS treatment with frequency of 100 Hz for 20 minutes was applied. The current intensity was 13, 5 mA. Also some passive adductor stretches were applied.

3. Also a lot of patients with several knee injuries. E. g. A girl with lateral collateral ligament (LCL) sprain. She recieves electrical therapy in combination with ice to reduce the inflammatory process. The both electrodes were placed on the lateral side of the knee.
Has pain, when flexing the knee.

23. 03. 2012.

During the two previous days, I was mainly observing the work of my instructor and could do only a few electrical therapy sessions myself, but on the third day of my internship, I had the opportunity to do a lot more. I also realized that my lack of portuguese language won’t do me any good and complicates the communication with the patients, since a lot of them don’t know any English.

1. The basketball player from the previous days. Some passive mobilizing was done; also some knee extension. The quadriceps stimulation with Russian electrical stimulation for 15 minutes, frequency 50 Hz, 17,4 mA. To the knee extension an ankle weight was added, to make the exercise more effective. Also the high voltage treatment for reducing the oedema was applied – the parameters were the same as in previous days.

2. A boy, table tennis player. Has an overuse of the shoulder, tendinitis. Interferential current in continuous mode, frequency 80/150 Hz, current intensity 22 mA for 20 minutes with 2 electrodes was applied, placing the electrodes on the m. deltoideus anterior and m. biceps brachii.

3. A boy, volleyball player. Has a thumb thrauma. It was his last treatment session. Participated already in training – no pain. The 10 sessions have been successful.
TENS was applied, the electrodes were placed on the thumb bilaterally. The duration was 20 minutes.

4. A girl, volleyball player. Suffers from shoulder overuse. Before electrical therapy did some strengthening exercises for the muscles surrounding the shoulder joint.
Interferential current, 2 electrodes, with frequency of 80/150, current intensity 28 mA for 20 minutes was applied. The electrodes were placed on the m. deltoideus anterior and m. biceps brachii.

5. A girl, the swimmer from the day before. Has an adductor strain. TENS was applied, with frequency of 100 Hz, current intensity 13, 5 mA for 20 minutes. Also some passive stretches for adductors were applied.