Reading Time: 3 minutes

Each week in clinic I have several conversations with clients that start something like this ……..

‘I have been on google and think I have got ‘X’.

The Dr Google issue !!

Where ‘x’ is a specific diagnosis that the client has arrived at themselves often after trawling the internet researching their symptoms. Sometimes this may be in the ball-park but often the client has ended up down a diagnostic rabbit hole and arrived at an erroneous diagnosis. Often times this then leads to discussion unpicking perceptions and belief systems that in some cases have been fairly well ingrained.

The internet is a groundbreaking development which has changed all of our lives remarkably by providing instant access to information. But can be both a blessing and a curse!

The 2 largest contributors toward errored diagnoses are firstly the fact that google has no quality filter. And by this I mean that anyone (irrespective of experience or qualification) can upload information and/or video to google and often this information can be either inaccurate or non-evidence based.

And secondly the client researching this information is not a clinician (most of the time) and therefore the context of this information is often mis-interpreted.  When we assess clients in clinic, we use expert clinical reasoning to put the symptoms reported in context and use evidence informed assessment procedures together to arrive at a specific diagnosis. One of the most important aspects of this is how the information is interpreted and then used by the clinician to administer treatment and guide self-management.

The positive of researching symptoms online would be that you are beginning to understand some aspects of your condition and this may be valuable if you are looking in the correct area.

So, an analogy I often use in clinic would be that of using a plumber to fix my boiler. If my boiler fails or has issues I don’t go on to the web or you-tube in an attempt to try and fix it myself. There are a couple of strong reasons for doing this. Firstly, if things go wrong then I will put myself and my household in a compromised position.  Also,  if the work isn’t completed by an accredited professional then my home or boiler insurance may be invalid. And lastly I am wayyyyyyy more likely to get things wrong as my knowledge and skill base is novice level compared to my local plumber who is an expert in his field. But when we put this in the context of a client self-diagnosing and treating themselves, I often observe that many are willing to take a chance on getting things wrong, attempt self-treatment and this often results in prolonged symptom duration and poor treatment outcomes.

One of the key aims is to gain an accurate idea of the exact nature of your condition from which everything else flows and great outcomes are achieved! 45 minutes with us (or any expert clinician) is well spent getting a really clear idea of your diagnosis, treatment and timescales to recover. We will outline our recommended treatment if appropriate and/or provide exercises and self-management advice. Many clients do need ‘hands on’ treatment but not all!

There are some great sources of information on the internet and in another article, I’ll be highlighting several portals you can access with confidence knowing that they provide accurate, evidence-based information that have been screened for quality by me personally. You (and others) can then access this information to find out more about your condition and/or others as they may arise.

Education is such an important part of understanding your condition and place a premium on this at Active Therapy. But equally this information needs to be accurate and specific to you and your specific condition and requirements. What may be suitable treatment and management for 1 client may not be correct for another even if they present with the same condition. And this attention to detail is again another area we place a premium on when we assess, manage and treat clients.

So, you can see that initially it might seem like a great idea to surf the internet, attempt to self-diagnose and treat themselves. And this can give some acceptable results with regard to reducing pain. But there is progression to treatment which achieves the best results and using pain as a guide to success is flawed as we often observe clients with recurrent issues or persistent weakness because their treatment is incomplete, or they attempted self-management with sub-optimal results.

We prefer to get things right from the get-go, keep treatment to appropriate amounts and then most importantly empower YOU to understand and effectively manage your condition and reduce the risk of ongoing issues.

I regularly say to my clients at discharge ‘In the nicest way I hope not to see you again with the same problem!’ which is meant with the greatest respect and sincerity if we have got things right and the client continues to follow the advice provided.

I hope you have found this information useful but please also contact me at admin@active-therapy.com or 07970110526 and I’d be happy to help further

Look forward to meeting you soon and helping on your journey toward a pain free, active lifestyle

Andrew Caldwell

Consultant Physiotherapist

Clinical Director

Reading Time: 4 minutes

Many clients when they first attend physiotherapy sessions remark ‘I’ve never had physio before and I’m a little unsure what to expect!’. So, I thought you would find it useful for me to outline a physiotherapy assessment and treatment session to provide further clarity and answer any questions you might have.

The process of treatment actually begins with very thorough assessment which allows us to develop and treatment plan and subsequently deliver very targeted, effective treatment. After welcoming you to our clean, spacious and private clinic area we begin the assessment by discussing your presenting problem – the main issue that is causing you problems and has resulted in you picking up the phone or sending us an email to address that troublesome pain or injury!

And this is where we stand out from the crowd… And whilst it might sound simple this aspect of assessment is SO important …. WE LISTEN!!!

Yes, believe it or not one of the main frustrations that clients report to us is that no-one has taken the time to allow them to tell THEIR story and thus describe THEIR main problem of concern …. Clients often describe being rushed in and out with inadequate time or that the clinician they consulted didn’t actually listen to their primary complaint or they felt ‘fobbed off’ …. This part of an assessment called the ‘subjective assessment’ and lasts around 15 mins.  This part of the assessment is the patients’ story and at Active Therapy we let you tell this story, guiding you through with specific questions which allow you to fully detail your issues.  We do this without putting words into your mouth nor do we use confusing, medical terminology you won’t understand (but if you are medically literate then of course we will!). This is a very important part of the assessment process as it provides very important information which we then use to help arrive at our clear diagnosis of your complaint and subsequently deliver the most appropriate treatment in conjunction with your own preferences of the options available. By listening to your story, offering you the treatment options available and delivering targeted treatment we achieve outstanding results and get you out of pain and functioning optimally ASAP ….

So, once we have had a good chat about your main issues and you are much clearer about the potential reasons for your pain, injury or sports performance deficit we move into the ‘objective assessment’.  This part of the assessment is the clinical examination can be quite varied dependent upon your condition and the information we have gained from the previous ‘subjective assessment’.  We use research based, very detailed assessment procedures that provide clear information from which we can arrive at a diagnosis.  This part of the assessment often involves being partially undressed as we need to see all appropriate body parts during the assessment to provide the optimal level of information. But don’t worry often shorts (and strappy top if you are a female patient) is sufficient. We always provide professional and private conditions for assessment, and we can always modify the assessment if you feel in anyway uncomfortable. We often find that patients have been assessed whilst fully clothed and since the pandemic maybe just over the telephone.  Both these examples would significantly compromise the accuracy of assessment and most probably lead to misdiagnosis and thus mis-directed treatment and sub-optimal outcomes.

**Please note that all patients under the age of 18 must be accompanied by a parent or guardian during the assessment process.

Once we have completed the physical part of the assessment (around 15 mins duration) we use the information from both the subjective and objective parts of the assessment, along with the results of any tests to date to arrive at the diagnosis of your condition.  This might be problem with a specific tissue (such as a ligament tear) or maybe cumulative overload resulting in pain (too much work in the garden or training overload in the gym for example).  This expert analysis of all the clinical information allows us to form a ‘clinical impression’.  Our lead clinician is an expert in their field with over 20 years’ experience working exclusively in Musculo-skeletal, orthoapedic and sports physiotherapy environments.  We do this expert work, day in, day out and as such we aren’t ‘general’ practitioners. This is in no way dis-respectful to your GP who deal with a whole array of conditions and often don’t have the extended depth of assessments skills or adequate time to accurately assess you and therefore arrive at an accurate diagnosis.  So, for a typical patient with low back pain, you are better placed to see an experienced physiotherapist as your first contact as in the overwhelming majority of cases this will result in an accurate diagnosis and most importantly this is the evidence-based form of treatment required in the vast majority of cases.  If your physiotherapist has any concerns that your condition might need medical assessment, they will refer you to your GP.  The correct pathway has been followed – happy patient and happy GP – huge WIN WIN for all concerned!

But the key thing to understand regarding this is that we EDUCATE you about the diagnosis so that you clearly understand this information, how this effects your treatment plan and what we expect you to do as part of your treatment such as home of gym-based exercise plans.  As part of this process, we can provide timescales for treatment and return to activities of daily living and sport that are of particular importance to you.  We aim that no client under our care leaves our clinic room after that first session with questions and you have a clear understanding of your condition and treatment.  But just in case you do have any queries then you can drop us an email 24/7 and we’ll come back to you ASAP to clarify any specific questions you might have.

Education and understanding are really important factors in clients achieving outstanding outcomes!

And here at Active Therapy we place a premium on high quality, detailed education in language our patients understand.  And for those of you who are visual learners that learn best through images we have a large screen monitor in the clinic room so we can pull up helpful images as part of this process.

So, as you can see the process of physiotherapy assessment and treatment is detailed and targeted and at Active Therapy, we are experts in arriving at accurate diagnoses, providing laser focused treatment which achieves outstanding outcomes!

I hope you have found this information useful but please also contact me at admin@active-therapy.com or 07970110526 and I’d be happy to help further

Look forward to meeting you soon and helping on your journey toward a pain free, active lifestyle

 

Andrew Caldwell BSc (Hons) MSc MCSP

Consultant Physiotherapist

Clinical Director