Physical Therapy Evaluation
The purpose of the physical therapist’s assessment as detailed below is three fold:
1. To provide the physical therapist an opportunity to examine you to see how your condition has affected the range of motion of your spine and joints, your muscle strength and even possibly your balance.
2. To instruct you in home exercises that you can do to improve these conditions and reduce your pain. For those patients engaged in Accurate Clinic’s chronic pain management programs, these services by the physical therapist are free as part of the pain management program.
3. To evaluate your muscles for the presence of painful areas called “ trigger points.” Trigger points are areas in muscle that can be severely painful, triggering pain when touched or pressed, triggering pain when the affected muscle is stretched, contracted or otherwise moved. Also, the trigger point can refer pain to other locations so that while the pain may originate in a trigger point in the lower back, the pain can be perceived in the buttocks or thigh area. Trigger points frequently develop as a consequence to a spine or disc injury and can often be the actual source of pain inaccurately diagnosed as disc or sciatic pain. Diagnostic errors of this type have not uncommonly led to unneccesary and unsuccessful spine or disc surgery. If the physical therapist identifies the presence of trigger points, a safe and effective treatment plan can be advised and initiated as part of our chronic pain management program.
Please schedule an appointment with the physical therapist at your earliest convenience. The time needed for the assessment is usually 30 minuts or less.
What the Physical Therapist Assesses
Individual muscles are tested when the therapist puts the patient’s body in specific positions that isolate a specific muscle. The patient has to push against the resistance provided by the therapist, and the amount of force a patient can generate is given a grade between 1 & 5.
Neck, low back, and limb movements are all measured using a tool called a goniometer. This tells the therapist and physician where the patient has movement limitations.
Combined Movement Testing:
These are movement patterns that the therapist puts the patient through based on where the patient’s injury is. The therapist analyses the movements and looks for abnormal movement patterns and painful arcs of motion.
Accessory Joint Mobility Testing:
This is when the therapist moves the patient’s joints without any help from the patient to test the glide of each joint. This allows an assessment of what problems each joint may have.
The therapist feels the patient’s muscles for spasm, tenderness to touch, tightness and trigger points.
Myofascial Pain Assessment:
Pain derived from muscle and surrounding tissues including the presence of trigger points. Trigger points are areas in muscle that are sources of significant local and referred pain.
When the physical therapist’s assessment is completed, the therapist applies the findings to create a plan regarding what tissues and structures are involved in the pain. This provides the therapist with the means to guide and instruct the patient in aspects of body mechanics that will give the patient insights and methods to reduce their pain. These methods may include alternative ways of performing certain activities as well as specific stretching and strengthening exercises tailored to meet the individual needs of the patient.
Treatment options advised may also include Trigger Point Therapy directed at reducing the pain associated with trigger points and muscle. The therapist discusses these results with the patient at the end of the assessment and a full report is sent to the patient’s physician. The assessment session allows the patient to gain an understanding of the overall condition of their musculoskeletal system. It is also an excellent opportunity for the patient to ask questions regarding the physical management of their pain. This includes questions about sleeping positions and pillow placement, lifting, carrying and maneuvering in one’s home.