Written by: Jan Earl de Chavez BSc-Kin. CAT(C)
Before an athletic therapist begins physically testing joints and muscles, they need to ask the patient questions about what they are coming in for. These questions cover topics such as general health, occupation, sports or fitness, injury specifics, and pain sensations. By receiving answers to these questions, the athletic therapist better understands why their patient is here.
There are two parts to observation, standing and walking. Standing observation is where the AT observes the alignment of various structures of your body from the front, sides and behind. The walking observation is how the AT determines whether movement is being affected, or just how the patient walks in general. These two are important in giving the AT insight on how the body is compensating due to the injury or condition.
Joint Rule-Out and Functional Test
The joint rule-out quickly tests the joint above and below the affected area to ensure that there are no issues with them. The functional test is a simple movement test to determine whether daily tasks are affected by the injury.
Range of Motion Testing
Also called isometric resisted testing as there is no movement occurring in the joint but the muscles are contracting. Different than the active range of motion, muscle testing is conducted with the AT holding the joint at an angle that stresses a muscle group while the patient performs a muscle contraction. Different resistances are performed to test all the muscles groups that act on the joint. The AT determine the strength level of the contraction and compares between affected and unaffected parts.
These are unique tests for a specific joint that confirms or eliminates the presence of an injury or condition. The shoulder is a great example as it has numerous tests for ligamentous sprains, impingements, joint laxity and capsule issues, muscle strains or tightness, and nerve compression. To narrow down which tests to perform, the AT uses all the informed gained from all the previous components of the assessment, especially the history.
Palpation can also be done after the observation is conducted, or it can be used to conclude the assessment. This is where the AT feels for palpable bones, ligaments, muscles and tendons to confirm which structures they believe are affected by the injury or condition. They can also feel for swelling, or determine sensory changes of the area.
Once the orthopaedic physical assessment concludes, the AT presents their differential diagnosis where they present what they think is injured or affected and why. After this, the AT will educate the patient on the rehabilitation program they will undergo and the appointment moves on to the treatment. The assessment usually takes about 25-minutes which leaves plenty of time in the appointment for any manual treatment and rehabilitative exercises.
Now that you know what to expect on your initial assessment, come visit me at Insahyu Training + Therapy located at 250 Saulteaux Crescent, or you can visit our website at www.insahyu.com and book online.
Team Insahyu: Certified Athletic Therapists and Certified Personal Trainers.