How often have you visited a physiotherapist, clear in your mind what your issue is in terms of the symptoms you are experiencing, only to find yourself ‘filtering’ your descriptions in the assessment room, either because you don’t think some of it is relevant, or you are wary of coming across as a ‘moaner’? You may be surprised to hear that you are not alone!

A large part of our assessment and re-assessment during a patient’s appointment is spent asking questions related to their symptoms.  

The physiotherapist must be very clear to highlight to the patient the purpose of this part of the examination, as, while it is the foundation on which we build the physical examination and subsequent treatment plan, patients often try to keep their explanation of their symptoms shorter than necessary.  

Physiotherapists are ‘interpreters' in the treatment room, using knowledge of anatomy, biology and neurophysiology to interpret the wealth of information from the patient’s body's condition.

The phrase “I don’t know why but I keep…” are often heard in the treatment room, with various endings given, such as:

• The patient is finding themselves arching backwards in a rhythmical fashion - this may indicate certain types of lower back pain.
• They are finding they are more comfortable resting their arm in the air with the forearm resting on their head - this may indicate a problem with one of the nerves coming out of a joint in the middle of the neck.  
• The patient has found that, by applying strong pressure to a certain part of their body, the pain is relieved, despite being painful in itself, which may indicate a tension point within a muscle.

Ongoing dialogue between the physiotherapist and the patient continues to inform each and every session.

Caroline Hennigan, one of our core team of physiotherapists, recently saw a patient who couldn’t explain why her ankle pain improved when she moved it in a very specific way.

Caroline explains why this information was so important to her assessment: 

"Using this – the body’s capacity to inform – I could analyse the movement and work towards making sense of it.  I asked the patient to demonstrate what she had found helpful.  The key points were that in a position of weight bearing, she loaded the ankle, and then applied a force through her shin, before lunging forward to flex the ankle.  

"Assessing the biomechanics, I was able to explain how this fitted within the clinical picture and hypothesis within which we were working.  I could then take elements of the movement and incorporate them into my treatments. 

"We had already begun to introduce compression through the joint (as occurs in a weight-bearing position), and could progress this further to begin to treat the ankle in standing. 

“I was also able to apply techniques to enhance the movement preference the body was telling me it felt relief from.”

This article clearly highlights the fact that each and every time you visit a physiotherapist, don’t hold back with describing your symptoms and everything related to the condition you are suffering with. The more information our experts have, the easier it is for them to assess and diagnose the issue, meaning you are are treated more quickly as a result!