Why Your Physio Does All Those Things – Testing Your Movements
After the subjective examination, all the questions your physiotherapist asks you to find out what kind of problem you have, they will have a good idea of what kind of pain problem you have and what area to concentrate their examination on. One of the major ways of investigating what is going on in the body is to ask you to perform particular movements and record the reactions for interpretation later. The way your muscles, joints and discs respond to various movements gives valuable clues as to their health and normal functioning.
Initially the physio may look at your posture and once that has been recorded they will ask you about the location and level of your pain at that movement before they get you to move. When the movements are being performed the physio is looking to see what kind of reaction your anatomical structures are giving. If you have a primarily postural problem then this will ease when you are moved out of the typical stressful posture and worsen when you are placed in your typical poor posture for a while.
A dysfunction type of problem occurs when a joint or muscle or disc wall has a restriction of some kind which is painful when stressed but does not change greatly with repetition. Repetitive movements will bring on the typical pain each time the movement is repeated but the pain will not change greatly as the movements are performed. This tells the physio where the restriction is and that it is not irritable i.e. is not easily stirred up so that treatment can be reasonably vigorous without danger of aggravating the pain greatly.
A derangement type problem can occur is disc-related syndromes when the disc is liable to mechanical change when stresses in particular ways. In this case repeated movements will cause pain and as they are continued the pain alters in intensity, usually worsening significantly or changing in area. In back pain syndromes the pain in the back or buttocks may worsen and the pain may spread down the leg, indicating that dynamic changes are occurring in the disc. This kind of problem is more irritable than a dysfunction and needs the physio to handle it more carefully.
Postural problems respond well to postural correction, dysfunctions to steady stretching stresses and dysfunctions are best managed by avoiding aggravating postures and movements and performing repeated movements in a direction which reduced symptoms in area and intensity.
Author: Jonathan Blood-Smyth