Assessment
Assessment evaluates a person for treatment. There are a number of elements to the assessment. The process can be divided into subjective + objective examination.
Subjective Examination
This is what the person says about the problem + how it is affecting them. This may include:
● What exactly are the symptoms (pain / stiffness etc)
● Where in / on the body are the symptoms felt
● What is the nature of the symptoms (sharp / Dull etc)
● What Aggravates or eases the symptoms
● When do the symptoms occur (am/pm/night)
● How did it start
● Has it progressed
● Are there any other issues
● Are there any other medical conditions
● Is there any (daily) pattern to the symptoms
● How do work, leisure + home activities affect the symptoms
● How does rest affect the symptoms
Objective Examination
The objective examination is the actual physical examination + testing of the patient. Testing may include:
● Posture
● Active range of movements of the joints
● Passive range of movement of the joints
● Muscle strength
● Ligament stress testing
Both the amount and the quality of movement is assessed + recorded. Work or sport specific movements may be tested too.
Neurological testing may include:
● Reflexes
● Neural tension / mobility
● Sensation - (light touch, heat, cold)
● Proprioception / joint sense
● Balance / Co-ordination
● Hand or foot - eye co-ordination
● Assessment of Gait - pattern, quality, symmetry
Diagnosis
Reaching a medical diagnosis is the process of identification of the nature and cause of a condition. It uses knowledge, logic, analytics, and experience to determine which disease or condition is causing a person's signs + symptoms.
The foundation of diagnosis is always the information from the history and the physical examination, but often one or more diagnostic procedures, such as x ray or MRI, may also be used to assist in making or to confirm the diagnosis.
Diagnosis is often challenging because the signs and symptoms can be nonspecific and atypical for a particular condition. Thus a differential diagnosis, where several possible explanations are considered, is used to determine the most likely correct answer.
Diagnostic opinion can take many forms - naming the disease, lesion, dysfunction or disability or may indicate the degree of abnormality on a continuum or a kind of abnormality within a classification. It is generally subject to constant review based on response to treatment provided
Prognosis
Prognosis is an opinion of the likely outcome of a medical condition based on professional experience, In effect it is a forecast of the likely progression of a condition based on the information to hand. In some cases it can be very accurate and expressed with confidence whereas in others it may be less certain especially where there is a multitude of factors which can impact on the outcome.
These factors include the condition itself, the availability of the most appropriate or best treatments and the environment it can be provided in, and patient factors including their compliance with treatment, their health status etc.
A complete prognosis includes the expected duration, the function, and a description of the course of the disease, such as progressive decline, intermittent crisis, or sudden, unpredictable crisis.
Treatment Modalities
A Physiotherapist can provide a variety of treatments such as
1. Manipulation,
2. Massage,
3. Electrotherapy,
4. Functional Rehabilitation exercises,
5. Advice on
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The cause of your problem
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Return to your normal activities
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Prevention of pain returning in the future.
Exercise is the most important way that you can:
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ease stiffness and pain
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build up muscle strength and stamina
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improve your flexibility and general fitness.
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improve co-ordination
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address muscle imbalance issues
Benefits of treatment continue for some weeks after the pain and symptoms subside so it is advisable to persist with the exercises for a period after the pain has gone.
Consult Ennis Physiotherapy Clinic if you need an assessment, treatment or advice about your condition especially if it has not settled within a few days.
Immediate Treatment
Immediate treatment after an acute injury should follow the ‘P.R.I.C.E.R’ Protocol for self treatment
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Protect – the injured area
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Rest – the damaged area to avoid further injury.
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Ice – for 5-10min initially + 20-30min during the first 5 days
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Compress – the injured area to minimise swelling and aid recovery
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Elevate – the injured area to prevent the accumulation of fluid
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Rehabilitate - return the injured tissue to normal functional levels of activity.. Consult a Chartered Physiotherapist to ensure a successful return to daily activity or to sport
Ice or cold therapy can be applied in a number of ways. Ice wrapped in a thin cloth (pillowcase, tea towel) is most effective. Crushed or chipped ice is best to use around an even area such as around an ankle. Gel packs are convenient to use + less messy but less effective. Similarly holding the part under running cold water / in a stream / sea can also be effective. Immediately post injury the ice should be applied for 10-15 minutes along with compression if possible and subsequent applications for between 20-30minutes. Submersion in an ice bath may be appropriate for large body area but should follow a recognised protocol.
Sport Related Injury + Recovery
Common causes of sports injuries are:
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Inadequate and/or inappropriate fitness and preparation for sport
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No Warm-up exercises done.
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Proper post-exercise cooling down is skipped.
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Inappropriate training - doing too much and repeating the same activities
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Pain during or after exercise being ignored.
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Improper equipment – wearing the wrong type of sports shoes.
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Incorrect technique and posture
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Collision, notably in contact sports such as rugby
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Insufficient rehabilitation and returning to sport too soon following an injury
Post Exercise Recovery Strategies
Intense training can induce some microscopic injury to muscles and other tissues. To aid recovery some of the following may be considered:
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Keep walking after you finish your race for 5-10 minutes to help prevent joint stiffness and muscle tightness
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Ensure you change into a warm set of clothes as soon as possible
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Eat a high carbohydrate + protein snack within 30 minutes after completing your race. Eat a balanced meal within 2 hours after your race and rehydrate adequately
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Spend 10-20 minutes doing static stretches to prevent the onset of muscle soreness over the following days
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Soak your body in a cold bath (ice bath), lake or ocean within a few hours of your race. This aids in decreasing inflammation in the working muscles, thereby aiding recovery
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Foam Rolling can be used to self-release tight muscles post race
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A massage in the week following your race will aid your recovery and reduce muscle tightness.
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Allow time for your body to recover before returning to training.
Consult Ennis Physiotherapy Clinic if you have pain or niggles that do not settle within a few days. Post injury.