Musculoskeletal assessment: why is it needed and what happens?

Written by:

Dr John Tanner

Sports medicine specialist

Published: 18/12/2020
Edited by: Laura Burgess


If you have persistent pain in one of your joints or muscles and nerves that is interfering with your daily activities, you may be referred to a specialist for a musculoskeletal assessment. We spoke to one of our experts in sports medicine Dr John Tanner about what happens during a clinical assessment and what possible conditions your doctor might be looking for.

 


Why might someone be referred for a musculoskeletal assessment?

You might be referred for a musculoskeletal assessment due to pain as the key symptom arising from a joint, muscle or nerve. You might experience pain on certain movements or in certain positions. Stiffness is the second common symptom and weakness or numbness, the third.

Such symptoms account for 25-30% of all problems for which a patient consults a doctor. Pain can be severe, even unbearable, and/or disabling and often worrying. Interference with sports, exercise, work and activities of daily living often prompt seeking help.
 

What would be examined and how?

We examine the affected region and the adjacent regions to assess the chain reaction or sequence of stresses and strains within the movement chain. Active and passive movements are observed, which may include gait, performing a squat, raising up one foot, and then the passive range of flexion and extension of the knee.

We palpate the affected part for swelling, tenderness and heat and note the muscle texture and also identify tense muscles and trigger points. We test the nerves by assessing the tendon reflexes, and we perform sensation testing and isometric strength testing, which checks out the neurological status.
 

Does the assessment differ between professional athletes and non-athletes?

Not really except with athletes more attention is given to the specific techniques that are used in throwing a ball or javelin, bowling, lifting technique for weights, forehand and backhand strokes, the spinal posture in the golf swing, for example.
 

What are the most commonly diagnosed problems?

The most commonly diagnosed problems during a musculoskeletal assessment are:
 

Disc protrusion Myofascial pain Osteoarthritis Tendinopathy Meniscal injuries of the knee Capsulitis Impingement syndrome of the shoulder.
 

What specialists might I be referred to after the assessment?

Most of your problems can be dealt with in house by physiotherapy, osteopathy, ultrasound or X-ray examination, dry needling, local or spinal injections. However, sometimes more specialised investigations are needed such as MRI or referral to an orthopaedic or spinal surgeon is required.



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