About Your First Appointment

My first question when you come for assessment is usually "Did you find me ok?" which could possibly have you wondering if I've got all my cogs in alignment, but really I'm not daft I'm just doing the British thing of stating the bleedin' obvious.

The first part of the assessment is to find out about you and your injury. This takes about 10 minutes. I want to know what you do in life (work and hobbies) and about your health and medical background. This is because I need to make sure it's safe for me to do my treatments. At some point I'll ask you to sign a consent statement.

Within this bit of the assessment I want to find out all about your pain. When it gets worse, when it feels better, if it wakes you up, how you'd score it out of 10, not in a Tom Daley diving sense, but in terms of how bad it gets. A 10 is the worst pain you've ever experienced (kidney stones, giving birth or not moving your thumb out of the way of the hammer), some people hate putting a number to the pain and if you're one of those you might want to find a way of grading it..."It's like a small dog is licking my toes" right up to "an elephant is sitting on me". In any case it's important we have a measure, however subjective, because we can look back at this measure and see how it's changed over the course of your treatment.

I want to get an idea of how your problem started, was it a "ping" moment, for example, running for a bus and a muscle goes suddenly and instantly (this is what we call an Acute Injury), or did it creep up on you, starting with a bit of stiffness and occasional niggling, but gradually becoming bad enough to stop you doing what you like doing (this is an Overuse Injury).

I also really want to know what your expectations are. It matters to me whether it's a case of you wanting to complete an ironman distance triathlon, or to continue playing bowls, to be able to put your clothes on without being in agony from that shoulder or to climb the stairs without your knee giving way...all of those things are equally important because all of them are what you want to achieve.

Once I have all of this information, I will move on to looking at you. This part takes about 15 minutes. I want to see how your posture is when standing and sitting, I will also possibly want to look at your walking posture and some functional movements. It will be useful to have you undressed so I can see your muscles and body position more clearly. Some of my clients wear shorts (and vest top for women) and some are happy to be assessed in underwear. I'm happy either way, I want you to feel comfortable. I will do a visual assessment of your posture and I will palpate some bony landmarks to check whether you are level on the right and left side of your body. This gives me a good idea as to what structures might be tight or weak and which joints might be strained or stiff. I'll also look at some specific movements, based on where your pain is, this may mean testing one joint or several joints. For example, If you have shoulder pain, I will also check your neck movements.

Throughout the assessment I am trying to track down the cause of your pain. This means I am looking to reproduce the pain either on palpation (pushing on the structure) or by moving the guilty muscle, joint or ligament. I may well ask you "Does this feel the same as the pain you get?" or "Does this feel like your pain?".

Once I've tracked down the source of your pain, I will spend about 20 minutes treating it, so part of your initial assessment includes treatment time. I will also show you pictures of the muscle or joint causing you problems, and give you some advice and a couple of exercises to help you with the pain when you are at home and work.

This is the end of your Initial Assessment, it should take 45 minutes to an hour. I will then suggest that we either catch up by phone in a couple of days to see how the treatment has affected you, or I will suggest a follow up appointment, which we will book in there and then. The follow up is shorter, 30 minutes, but is mostly treatment with just a quick assessment to see how you are.

I hope this gives you a good idea of what to expect from your initial assessment with me.