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Physical therapy evaluation - what to expect!

Updated: Sep 2, 2020

So it’s your first visit to get physical therapy? Do you know what to expect or what to look for? No? Well, I’m here to help! Be it nerve pain or nerve impingement, joint pain (back, knee, elbow, neck, hip, knee, ankle, etc), muscle pain, or need for osteoporosis treatment, there are things to look for and ask about.

Evaluation time has come and you have determined you like this person and could feel comfortable with them. Great! Your history will be taken and questioned. Good questions that should have established answers are: 1) when/how did the pain start?, 2) any activity changes or atypical activity that occurred just before the pain began?, 3) reviewing with you to make sure they acknowledge your medical history i.e. high blood pressure, osteoporosis, diabetes, etc., 4) nerve symptoms/odd weaknesses addressed, 5) what are your (the patient’s) goals/expectation?

Now, we are into the nitty-gritty of physical assessment. During this part, you should be asked to move areas above, at, and below where you pain is occurring. Meaning, if you have low back pain, looking how the mid-back and the hip joints move can help determine all influencing factors as to why your low back could hurt. While your PT is looking at how much you do or do not move, your PT should be able to look at the quality of your motion and see if you’re deviating to one side or if you’re “cheating” somewhere because another body part isn’t moving. Whether your back hurts on one side or not should not limit your therapist from looking at both sides of your body. Special tests will be mixed in where your therapist will find out if they trigger your pain — this is where they may ask you “does that make it worse or better?” or “does doing this make your pain occur?”. Most importantly, your therapist should assess your joints; meaning, they should put their hands on and around the area of pain to find how well (or not well) the joints move. For instance, when I do a back evaluation, I will push/pull at the hip joints to find out their mobility and I will also push on each back level to see how well it springs as well as the symmetry of their resting position.

Always expect your physical therapist to do “hands-on” or manual therapy interventions. True physical therapy is most definitely more than being directed through exercises. Your pain developed from more than just weak muscles that got tight. A well-rounded treatment will involve pushing on trigger points of muscle (for release), working on joints (of the back, hips, neck, etc.), stretching, strengthening, and how to help educate you to adapt your lifestyle to provide an environment to heal.



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