Musculoskeletal Assessments and Conditions Overview

Question 1

Musculoskeletal Conditions

Answer 1

Injuries or conditions that affect movement or musculoskeletal system (muscles, tendons, ligaments, nerves, bones, joints, and connective tissues).
Common general injuries include sprains, strains, fractures, arthritis, nerve injuries, tendinosis, bursitis, osteopenia, osteoporosis, and chronic pain syndromes.

Question 2

Musculoskeletal Assessments

Answer 2

Focus on systemic body posture and mechanics as well as acute injury if necessary.
Use functional assessments, strength assessments and questionnaires.
-posture, gait, functional mobility and balance, functional strength (ie. 30s STS; 1-10 RM).
Refer to specific RTW/RTP guideline assessments if necessary.

Question 3

Patient history and interview questions

Answer 3

MOI and DOI
previous injuries
current or past injuries
signs and symptoms (ssx)
chronic or acute ssx (new or old)
sudden and gradual onset of ssx
aggravators and easers
difficulty for certain activities or ADLs
pain description (type, location, radiation, pain level)

Question 4

Red Flags during Assessments

Answer 4

If a red flag (or multiple) comes up, we want the client to go get it check out by doctor.
Fever, chills, infection or systemic feeling of being unwell.
Night pain or pain at rest (relative as chronic pain clients will always have pain)
-use judgement
Neurological ssx such as…
-bowel or bladder dysfunction (send them straight to ER)
-loss of sensation in saddle area (torso and pelvic girdle)
-double vision
Loss of consciousness
Continued dizziness
Slowed or slurred speech (indication of stroke).
Difficulty swallowing (indication of stroke).
Unexplained weight loss (indication of cancer).
History of cancer (in conjunction with other red flag or if something can’t be explained then want them to get checked out).

Question 5

Order of Assessments

Answer 5

From least invasive to most invasive.
Observations (ie. posture, gait)
Palpations (ie. tenderness, swelling, etc.)
ROM (AROM, RROM, PROM)
Manual muscle testing
Special testing

Question 6

Positive test

Answer 6

Normally indicated by increase in pain or symptoms.
-occasionally indicated by decrease in symptoms depending on the test.
Means the test has found what it is looking for, so the injury tested for is present.
-ie. positive empty can test means there is rotator cuff tear possible present.
Just because there is a positive test does not mean we diagnose (out of scope of practice).
-other diagnostic criteria may need to be done such as imaging.

Question 7

Negative test

Answer 7

Means we can rule out that injury.

Question 8

How can all joint injuries and conditions be assessed?

Answer 8

Pain levels
Dermatome changes
Posture
ROM
Manual muscle tests
Other functional tests (ie. grip strength, lower and upper body strength tests).