Orthopaedic PTIntro

University of Scranton - Department of Physical Therapy
Edmund M. Kosmahl, PT, EdD
send e-mail to Dr. Kosmahl copyright 2000 Edmund M. Kosmahl

PT351 ORTHOPAEDIC PT PRINCIPLES OF ORTHOPAEDIC PHYSICAL THERAPY

PRINCIPLES

Evaluate

- screen for non-musculoskeletal causes
- identify musculoskeletal problems and causes
EVALUATION OUTLINE (you are here)

History

Observation

Quarter Screening Examination

Appropriate Examinations

Selective Tissue Tension Examination

(Spine - repeated motion, PIVMT, length/strength balance)

Special Tests

Reflexes and neurological

Accessory motions

Palpation

X-ray studies

Treat

- problems
- eliminate causes
Re-evaluate

- assess effect of treatment
- modify as needed

EVALUATE - ID PROBLEMS

Identify the tissue involved
Define the musculo-skeletal (mechanical) problem

Examples of Musculo-skeletal Problems

EVALUATE - ID CAUSES

Determine and eliminate the cause of the tissue irritation

Causes are treated to prevent re-occurrence
Examples of Causes of Tissue Irritation

PAIN - SPECIAL NOTES

Must reproduce "THE PAIN" to identify the musculoskeletal problem

Pain is often the chief complaint
Don't treat the pain - treat the problem

REPRODUCING THE PATIENT'S COMPLAINT

Selective tissue tension examination - stress all tissues possibly responsible

Repeated motion examination - move intervertebral disk

ROLE OF MEDICAL DIAGNOSIS

Rule out non-musculoskeletal cause for patient complaint
Developing a physical therapy program around a medical diagnosis (as opposed to a musculoskeletal problem) unwise

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