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Assess, Don’t Guess

Updated: Dec 3, 2020

Key Points

  • A thorough assessment is critical for an effective recovery plan

  • Assessing and re-assessing should be constant through a plan of care

  • Assessments for recovery should cover more than just physical ability



“Assess, don’t guess.” I can’t tell you how many times I heard this in PT school. Honestly, it could be north of a million. A thorough assessment is the backbone to an effective and efficient treatment plan. Without a detailed assessment, you are effectively playing darts blind folded - sometimes you may get lucky but most of the time you will be way off target.


What’s covered in a thorough assessment?


At the very least, a good assessment should cover the 4 main ingredients needed for a succesful recovery from an injury. In the context of assessment, this would include a detailed physical exam (including medical and subjective history), basic nutrition, sleep quality/habits, and mental preparedness for change.


Physical Exam


The goals of the physical exam are as follows:

  • Rule out any medical conditions that would require referral

  • Develop an understanding of the patterns of movements that aggravate and alleviate pain

If your PT understands which movements repeatedly cause pain, they can modify/change/avoid those movements until the body is able to tolerate loading those patterns. Additionally, if they know what movement patterns cause pain, they can build interventions to target the pain while helping to develop exercise plans that allow the client to improve strength, stability, and overall health in non-painful patterns.


Nutritional assessment


In a physical therapy setting the nutritional assessment doesn’t need to be super detailed. The goal is to gain an understanding of the foods someone eats, how they eat them, and why they eat them. Whether or not your PT is capable of helping to address a client’s nutritional needs is irrelevant - they should still be doing a basic assessment. If a PT doesn’t feel comfortable helping with nutrition, they should refer you to someone in their network who can!



Sleep assessment


Sleep is when you heal. A quick assessment such as the Pittsburgh Sleep Quality Index can give useful information about sleep quality and duration. If a PT can help improve someone’s sleep even a little bit when they are recovering from an injury, it will significantly increase the benefits of the rest of their plan of care.


Mental preparedness for change


This can be simple. In my own practice I like to use the following as an assessment of mental preparedness:


On a scale of 0-10, 0 being least and 10 being the most, how committed are you to solving this problem right now?

For my clients who fall closer to the 0 end of the scale, I know how important mental and emotional support is going to be through their rehab.



Best of luck on your recovery journey! If you would like to learn more about working with Blue Iron Physio, click here, to set up a call with Dr. David Schwartz.


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