Your First Visit

At the first appointment, most of the time is devoted to the Initial Evaluation. The evaluation has two components -- a subjective and an objective component.

Throughout the evaluation, the therapist considers what we in the Physical Therapy world call SIN:

Severity of the symptoms –- the intensity of the pain on a scale between 0 and 10.

Irritability of the symptoms –- how much movement does it takes to make the symptoms worse and how quickly do you get relief from the symptoms? For example, there is considerable difference between pain that is very strong after a few arm movements and lasts an hour and pain that becomes evident when the arm is moved in a specific direction, but goes away immediately upon returning to the resting position.

Nature of the symptoms –- what causes of the pain. The therapist has to have a very clear idea that the nature of the pain is mechanical prior to applying treatments. Problems like cancer and other diseases can create pain in joints and muscles, but, of course, these conditions are not treated by physical therapy.

During the Subjective Evaluation you and the therapist will discuss the history of your current problem, past problems, as well as any positions and activities that aggravate or ease the symptoms, and so on. During the Objective Evaluation the therapist will ask you to perform some movements in order to evaluate/observe the affected area and any connected areas-- for example, the neck area is commonly associated with shoulder pain. This will allow the therapist to create a baseline so that any improvement can be measured accurately. This evaluation also includes a general assessment of muscle strength and soft tissue mobility.

The therapist will then discuss his or her findings with you and discuss treatment options, as well as answer any questions you may have.