Editor’s note: This article is part of the Health and Fitness page’s weekly series about sports injuries based on information from the physical therapists of Cyclone Sports Medicine. This week, Lea Herdman, Wiedener University graduate student and physical therapy intern, will spotlight the evaluation process.

How a physical therapist decides on a particular treatment is based on many factors, said Lea Herdman, intern at Cyclone Sports Medicine.

“A physical therapy evaluation is a composite of several features,” Herdman said. “Evaluations begin with having baseline knowledge of functional anatomy and are complimented by a thorough subjective history, observation and physical examination.”

Diagnosing a patient’s problem requires a physical therapist to fully understand the patient’s perspective as well as the clinician’s perspective, she said.

“The entire process is started by going to the Student Health [Center] and being evaluated by one of the health-care practitioners,” she said. “If your injury would benefit from physical therapy services, a referral is written, and then it’s off to Cyclone Sports Medicine and Physical Therapy.”

Once an appointment is made with a physical therapist, it is his or her turn to do an evaluation, Herdman said.

“An evaluation allows a clinician to arrive at a diagnosis and treatment by gathering information in several ways,” Herdman said. “The subjective portion of an evaluation contains everything that the patient tells the therapist, also referred to as patient history.”

Herdman said a patient history is comprised of several components, including a patient’s past and present medical history, emphasizing information that is most relevant to the current condition or the history of the present illness.

“The majority of time in the subjective portion is spent on such questions as chief complaint, mechanism of injury or onset of symptoms and the location, behavior and duration of symptoms,” she said. “A thorough history should include surgeries, medications, reports of previous testing, effects of previous treatments, allergies, social and family histories and lifestyle behaviors.”

The second part of an evaluation is the objective portion that covers all tests and measures that a clinician performs on the patient, Herdman said.

“During observation, the physical therapist visually inspects the patient for visible defects, functional deficits and abnormalities of alignment or posture,” she said. “After observing the patient, a clinician may then ask a patient to actively move a joint or extremity throughout an active range of motion.”

Herdman said if limitations in motion are found, the physical therapist will move the joint or extremity passively through the patient’s available range or passive range of motion.

Then manual muscle testing is performed by asking the patient to place his or her joint into a specific position and hold it there while the physical therapist gives resistance, she said.

By instructing the patient to fight the resistance from the therapist, the strength of muscle groups can be tested, Herdman said. A therapist will then test for tenderness within a problem area before moving on to more advanced tests, such as neurological testing.

“Neurological testing should be completed to help identify the involved structure,” she said. “Tests may examine cranial nerves, reflexes and sensation. Special tests may be performed that specifically look at disorders or injuries of orthopedic origin. Special tests might include those that examine the integrity of the knee ligaments or shoulder capsule.”

During an assessment, therapists will use all of the information gathered from the subjective and objective portions to come to a diagnosis, Herdman said. From there, the clinician will plan a course of treatment for the patient to follow.

“Although they vary according to individuals and diagnoses,” she said, “treatments may include stretching and strengthening exercises, electrical stimulation to address pain, swelling or muscle atrophy, manual techniques and heat and/or ice.”

For more information, call Cyclone Sports Medicine at 294-2626.