“If you’re not assessing, you’re just guessing.”
Why the assessment is so important
Physiotherapists always need some form of assessment in order to design an appropriate, individualized treatment program. The assessment and re-assessment are critical elements in determining the correct physiotherapy treatment. They also determine whether a client requires further medical evaluation from a physician (e.g. for a non-musculoskeletal problem or for a musculoskeletal problem that requires immediate medical attention).
There are a number of reasons for performing an initial physiotherapy assessment, including:
- Medical Screening
- Accuracy: When possible, we determine the accurate cause of the problem/complaint. In some cases, this involves determining the anatomical structure that is causing pain. In other cases, this is not possible, but determining all the possible contributing factors to the pain is important.
- Causes: We determine the factors that led to the injury and/or complaint. This step is critical in determining the appropriate treatment plan.
The assessment may include both structural and functional aspects. For acute, traumatic injuries, an assessment with a strong structural approach is usually more appropriate. For chronic and/or gradual onset injuries, an assessment with a strong functional approach is usually more appropriate.
Many conditions are complex, which requires the ability to analyze all the relevant information (client history, signs and symptoms, aggravating factors, client goals, past medical history, clinical assessment/examination findings, diagnostic imaging, etc). Although we are dealing with complex conditions, with complex factors, the treatment doesn’t need to be complex – but it does need to be appropriate. This is why clinical expertise is so important.
Our clinical expertise allows us to analyze key principles of musculoskeletal health, including tissue tolerance, tissue capacity, tissue homeostasis, and regional interdependence.
See the ‘Our Approach’ section for further information.
At the end of the assessment, the following information should be identified:
- The client goals
- A problem list (pain, difficulty with activities, etc).
- A clinical diagnosis as well as possible differential diagnoses
- Contributing factors to the problem. This would include:
- Internal factors: motor control, mobility (including flexibility) , stability (including strength)
- External factors: Training regimen, footwear, equipment, surface, etc