“Passing the BOC doesn't automatically prepare you for every real-world clinical situation.” What do you wish your clinical education had prepared you for better?

I’m interested to see everyone’s answers Had a patient come in yesterday with ankle issues. He was offensive lineman at a local college. Extremely swollen right ankle after three weeks of repetitive ankle, injuries and pain through it. Pain with passive inversion, pain and limitation with a passive PF. Weakness with big toe and 2nd through fifth toe extension, weakness in eversion, and 0 degrees of tibial IR. What are you doing to start?

I’m wondering if how I set up my current calendar of appointments and assessments is efficient. Right now, the patient has to book an assessment first (30min) so I can get an idea of what’s going on. Then they book a classic appointment (60min) where we actually do the rehab and treatment. Any thoughts on how to do this better? I am open to all suggestions.

If you could change something that would make you like your job more, what would it be? It can’t be money or time off.

Hey everyone, I’m currently in my first year working in the industrial setting for Amazon. I’m limited to “first aid” treatment (ice, heat, non rigid support, massage). I’m coming from 4 years of working in the secondary school setting, so the transition has been interesting. I was treating a package handler with lateral wrist/thumb pain, could classify as De Quervain's. Pain started at an 8/10 on day 1. Pain reproduced with thumb flexion, radial deviation, supination, wrist flexion, resisted thumb extension. She was limited to ~ 60* wrist flexion (posterior wrist tension). Treatment included STM/TPR of the thenar eminence and posterior/lateral forearm, muscle activation techniques targeted to the wrist and thumb extensors and opponents pollicis. Wrist flexion improved to 80-90*. Pain decreased to 1/10 - she described it more as irritation. She ultimately elected to see a physician since she remained in a 1-5/10 pain cycle depending on her work duties for the day. I feel that if I was free to prescribe exercises, her symptoms would’ve resolved with progressive loading of the wrist and thumb extensors. Are there any other manual therapy techniques that others would have tried? Other assessments that I missed.