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Finding the reason

Skrivet av Shirin Zarur

17 December, 2018

As a physiotherapist our work is to help people with their pain most often, but also to improve the function of the part of the body affected. In our field of work (musculo-skeletal pain) it usually is quite easy to narrow down and find the area that is responsible for the pain. But what a lot of my patients don’t think about, is the detective work we also need to do to find the reason for the problem. To do so, we need to take in the person as a whole – which means to know and understand what the person does during the day, how they are affected by their environment at work and socially, the posture of the person, the anatomy of the person and how they’re using their bodies (pattern of movement). To do so, we ask a lot of question – which many don’t have the answers to as they’ve never thought about them. When we finish our questioning, we start the examination.

And here’s where things sometimes get a bit strange. Especially if it’s the first time you visit a physiotherapist, a physiotherapy examination could seem a bit strange. I’ll use an example; someone having pain from the elbow area and all the symtoms and tests of the muscle show its a lateral epicondyalgia (tennis elbow – pain on the lateral side of the elbow). OK, easy you think, it’s just treating the insertion and the muscles themselves. But I actually need to see the person without the shirt on. Why? Because I also need to examine the position of the shoulder in it’s socket, the position of the shoulder blade, and how they work when testing their function. Is the shoulder blade stable and moving as it should? Is the upper arm in it’s right position in the shoulder socket? If not, then the load and the force is not transfered correctly down the arm, and the elbow could be overloaded. And no matter how much we treat the elbow, the pain just keeps coming back. Side note though, all overload of tendons take a long time to heal, as tendons have bad blood circulation. But you get the idea. If it keeps being overloaded it just won’t heal…

Same thing to the neck, lower back, hips, knees etc. So when we ask you to take your clothes off to see more of your body – there’s a reason 😉

Finding the reason is even more important than the treatment itself. And if you have an appointment booked with a physiotherapist, you might want to think of all the things that will help us finding what ails you such as: When do you feel the pain? When does it feel better? What movements helps and what movements increases the pain? What in your environment helps and what makes it worse? How did it start? What’s been going on in life before you had this problem? Etc.

And remember, stress always increases the tension of all the muscles in the body, and therefore affects levels of pain etc.

Take care of your selves!


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