Diagnostics aren't everything

I have been a physiotherapist for a while and have spent more time learning, unlearning, adjusting and shifting my thinking than I thought possible.

When I graduated I honestly thought I could cure all ailments and had “magic hands” but first I needed the correct diagnosis.

I needed to find the structure at the root of the issue – was it the medial collateral ligament or the medial meniscus, now do not get me wrong, this information is still helpful and can be important, but rarely.

Ok, before you shoot me down in flames let me explain. Unless it's broken or requires some kind of surgical intervention knowing the exact structure is rarely going to change the outcome.

For example, if your quadricep muscle is torn it will not function – right? But if it isn’t it can still be painful.

Pain is simply a signal from the brain indicating there is a threat to the system. I want you to take your index finger and bend it back, bend it back until you get a warning from your brain, telling you, this is pretty uncomfortable, and you should probably stop; the structure or tissue is not being damaged but simply under threat.

What does this mean for physiotherapy? Do I just guess and make it up? No, I have a pretty sound knowledge base in anatomy and I work on it regularly. What it does mean is that we have to look at the whole picture. Let's look at function – what can you not do, what is weak, what is tight, what movements do you like and lets take advantage.

Many of us rush to ask for x-rays, ultrasounds, MRI’s etc to try and explain the pain. Instead many end up feeling defeated and ignored and feeling like you are going crazy when we are told they are “fine” and “normal” . All that “normal” tests tell us is that there is nothing structurally wrong; it doesn't tell us a damn thing about your pain. This is why I rarely suggest them to patients – unless I really want to rule something else out.

Your pain is real, your pain is personal and it is completely unique to you which is why we have to look at it from a unique one on one perspective.

Find yourself a health practitioner with open ears and some time for you.

I only offer one to one treatments with an hour assessment and 30-45min assessments. You deserve better.

Nicola Robertson

Pelvic Floor Physiotherapist