Why Your Physio Does All Those Things – Prodding Your Joints and Muscles
Once the physio has seen the effects of repeated movements on your pain picture and tested the neurological status of your affected body part they will have a more detailed idea of which structures need more detailed examination to clarify the exact nature of the problem. It is time for the individual muscles, joints and ligaments to be stressed to assess their reaction and add to the understanding of what is going on. The physio may just feel and grip the area firmly first to get an idea of the state of the tissues. Are they very sensitive? Is there muscle spasm or thickened tissues?
Take your knee as an example. Once the general state of the tissues has been checked the physio will compress the area round the knee to find out if there is any swelling in the knee, known as an effusion. They will feel firmly around the line of the joint, over the main ligaments and where the tendons insert, around the patella and over the muscles nearby, looking for any tenderness, pain or thickening. Next the physiotherapist will test the ligaments which are tough fibrous structures which stabilise the joints and prevent them from going into unsuitable positions.
By using your thigh and shin as levers the physiotherapist can put significant stresses through the knee, stretching the knee ligaments which will react with pain or looseness if they are abnormal. The joints will then be put into positions which either stretches them of the muscles which pass across them to examine the integrity of the muscles and joints. In the spinal joints there are a number of specialised examinations which can be performed to try and narrow down the list of suspects. The physiotherapist will check the accessory movements of the individual spinal joints, the small gliding and sliding movements which occur inside joints as they move back and forth.
To examine these movements the physio will often put you on your side and move your spine backwards and forwards as they feel the movement occurring between the individual spinal levels. After this you may be placed on your front as the physiotherapist palpates (prods and pokes) your spinal levels with varying degrees of force but often quite firmly to see if any particular level reacts by bringing on the pain you normally complain of. All these tests go together to allow the physio to make a diagnostic theory.
Author: Jonathan Blood-Smyth