In my two previous blogs A Different Perspective On Your Physiotherapy Assessment and The Subjective Physiotherapy Assessment, I discussed the importance of getting that connection and really listening to get the patients story. Why are you here, what are your beliefs about treatment?
Now it’s time to go further, honing it down with specific questions about the problem.
Let’s use an example to help illustrate. Someone comes to me and they've had chronic pain in their foot for a very long time. I would be asking questions about the possibility of arthritis. Questions regarding the nervous system. Looking at the way that the body moves. Seeing if the pain is transmitting down from the spinal cord, because it could be a problem in the spine itself and not the foot at all. Having a look at the function of the foot, seeing if biomechanically the patient is walking in a strange way, and is that is making it worse?
How does it feel? How does the tissue feel? Is there any swelling? Are there problems with circulation? Is the sensation there? Are the nerves working properly? Is there an amplification of pain so that when I touch, the tissue is overly sensitive? What are the clues as to what's going on?
This is a very important start to this part of the assessment, which leads to the physical assessment.
To recap, the first part is establishing the connection and the story, the background, the beliefs, the values. The next part is to do with the Four Keys, to do with your immune system and your general health.
The next part is to hone it down into the particular problem today and how it's starting to manifest itself physically.
The final step is to go into the physical, which we can't do remotely by zoom. The physiotherapist has to get hands-on and assess physically, face to face.
In my next blog The Physical Assessment I will delve into the actual hands-on physical assessment. Many of you may have thought that this would be the first step in an assessment and that is the mistake that so many make, missing out on the vital steps of building connection and trust and gaining a deeper understanding of the all-important beliefs of the client. Make that mistake and you are destined to gain so much less.