Online assessments and treatments during lockdown….
Firstly, I’ll never take the assessment process for granted again!
One of the cardinal rules to learning to assess and diagnose a patient, is that one takes a thorough and detailed subjective assessment.
Questions about how it started. This could be idiopathic, i.e. no idea; overuse; injury; compensation; intrinsic pathology, i.e. originating or due to causes or factors within the body; poor biomechanics…
We ask what exactly is felt where and when…
and also what exacerbates and what alleviates…
At the end of this subjective examination I should be able to assess SIN factors; Severity (pain scale out of 10), Irritability (how long it takes to aggravate/how long it takes to settle) and Nature (what is causing it) of the issue.
For face-to-face treatments or video appointments, the subjective is easy, no real problem here.
After the subjective assessment, I have a mental list of possible diagnoses, ranked in order of likelihood given the subjective information.
We then begin an objective (physical) assessment looking to prove or disprove the subjective theories.
Objective tests together with a knowledge of anatomy, pathology, physiology and patterns of injury allow a diagnosis and subsequent treatment regime.
For our video appointments, we must be a bit more inventive on the objective assessment. I’ve asked patients to poke and pull and even borrowed family members to help massage or stretch!
What sort of problems can you help with video appointments?
Not everything for sure! Some things defeat us, BUT most issues I can give advice and move the problem towards resolution.
For example, I have been helping a patient treat her neck. Having assessed which movements are limited and which vertebrae are sore, I have shown her how to self-mobilise and together we have progressed through the treatment grades and she is now pain-free with full range of movement.
A few patients are self-isolating and unable to get out to exercise. We have tailored exercise programmes for them, around their physical needs, paying attention to deep breathing exercises for those with chest issues. There is a huge range of ages and intensity of exercises to adapt. Even I’m getting fitter!
Ongoing progressive exercise regimes for those post-op, assessing wounds, swelling and strength. We have knee and shoulder post-op patients all progressing well.
I have assessed biomechanics, ordered insoles, given exercises and taught management of plantar fasciitis, Achilles tendonitis and tibialis posterior syndrome.
The shoulder too has been the problem joint for a few patients, with massage, strengthening and muscle balance exercises alleviating pain here.
On reflection, remote treatments are more successful than I’d anticipated, and patients are improving and reassured! If you think we can help, give us a ring! or book online!