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Observations made by a Musculoskeletal Physiotherapist

When training to be a Physiotherapist you learn generalist skills in how to assess and treat patients in many different realms of healthcare including: neurology, cardiology, medical, surgical, orthopaedics, paediatrics, intensive care and musculoskeletal. As we become Specialist in an area we develop the skills needed to hone your clinical skills.

Having good observation skills is absolutely mandatory as a Musculoskeletal Physiotherapist and a quick look at a patient can inform you of many things.

These are some of the things we look at and why:

  • How pleased they are or are not to see you- its not unusual for patient to slip below the covers in hospital when the physio approaches to get them up walking or to ask them to take a deep breath or cough. Or perhaps you have had a long wait to see the physio.

  • Posture and gait can lead us to think of potential pathologies a patient may have. Physiotherapists cannot stop themselves from observing gait patterns and having thoughts going through their head like- they need a new hip, I wonder if they had a stroke, if they run like that their Achilles will become sore…

  • How much pain a patient is in is evident often in their face and the postures they have adopted to protect themselves from further pain- this helps us to ensure we are screening out for other more serious pathologies, which make be less obvious and have not yet been investigated.

  • The distribution of weight in sitting and standing can indicate the anatomical structures that may be involved, the severity of pathology and there may be deformity as a result of muscle spasm.

  • Colour changes and swelling can indicate to us the types of structures that may be injured and how old an injury is. Bruising tends to track downwards away from the injured area.

  • Muscle wasting can indicated that there is nerve compression or that there is pain inhibited wasting meaning the problem has been there longer. An example of this being wasting of the thigh when you have a sore knee or hip.

  • Any obvious factors that may be leading to your problem such as poor feet biomechanics or having one leg shorter than another. There is no problem fixing a problem if we do not address the cause.

  • How good your balance and core strength? Injury can reduce our balance response rate and our core strength weakens with pain. The natural ageing process and growth spurts in children also affect balance and core strength.

All this can be gleaned from observation and it helps us to build on your diagnosis and treatment plan. Physiotherapists try and watch you when you walk in to see them. Amazingly we do this observation very quickly…….Call 0131 447 9990 to make an appointment with one of our Edinburgh Physiotherapists

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