Musculoskeletal screening

[Coxy]

As someone who's suffered quite a few niggling injuries over the past couple of years, I've seen this service being offered by my physiotherapy clinic:
http://www.lifecare.com.au/src/lchNewsDetail.cfm

Would the experts here have an opinion as whether this sort of service would provide any meaningful feedback? I'm really only interested in the postural and active musculature assessment, since most of my problems (shoulder impingement, groin pain, achilles tendinitis etc) seem to be related to those sort of areas rather than specific acute trauma.

[injuryupdate]

It is controversial as to whether screening gives value for money for athletes. Certainly chiropractors get scoffed at a bit for taking back X-rays of most people they screen, finding abnormalities in all of them and then prescribing long-term treatment to fix the abnormalities (temporarily of course until the next visit).

There hasn't been a groundbreaking study yet suggesting that across the board screening can help a patient with no particular presenting complaint.

Nevertheless:

AC Milan are getting rave reviews for doing highly detailed biomechanical and physiological screening of their players on a regular (weekly/monthly) basis. They claim that this has decreased their injury rates.

The Sydney Swans medical and fitness staff claimed something similar in an article in The Australian published just before their AFL Grand Final win.

At the institutes of sport around the country, most athletes get a medical and physio screen once a year. This is usually to check on existing injuries though rather than to help find potential ones that the athlete didn't know existed.

Screening is a modality of the future. Whether it is value for money in the present for the average person on the street is doubtful. Maybe it is getting there for highly-paid elite athletes, but even this is doubtful at the moment.

[hhh]

The next big thing in sport is going to be psychoneuroimmunology and prospective screeening assessments - much more so than musculoskeletal screening. Psychoneuroimmunology has already been lined to things like acquired training intollerance which is associated with increased viral/respiratory disroders and biomechanical overuse injuries - ie decreased performance. Musculoskeletal screening is also an important part of managing elite athletes, however not under its yes sir, 3 bags full sir format. If anyone offers x-rays as a screening modality walk out of the office.

[tuono]

Sports Massage Therapy in the UK for about 8 years so I know a bit more than 'average' :)

"Screening is a modality of the future. Whether it is value for money in the present for the average person on the street is doubtful. Maybe it is getting there for highly-paid elite athletes, but even this is doubtful at the moment."


If I were looking at a UK website I would not be at all suprised with these comments however on an Australian one I must admit to be totally suprised! I've always thought (and expressed to others) that is the field of sports science Australia was far ahead of anyone else (inc. the US). However can you not see the value of screening BEFORE an injury occurs? 'Prevention better than a cure' and all that.
For example;
How long does it take to assesss med/ lat rotation of shoulder joint but how much extra stress and ADAPTIVE COMPENSATION will occur if this movement is deficient. Why wait until the athlete complains of neck / shoulder / back pain or injures their rotator cuff before you even look at it ?
An analogy I use in teaching is You have a car and you want it to go as fast as you can do you FIRSTLY
a. Put a bigger and bigger engine into it (ie: train harder)
or
b. Make sure the wheels (feet / knees) are pointing in the correct direction and the brakes are not binding (antagonistic muscles are not short / tight restricting intrinsic ROM)

Which car will 'blow up' first

rant over :)

[Coxy]

Interesting. Again, pardon my ignorance, but what (roughly) does this screening process entail? What do they actually do?

One thing I'm getting at is will they request expensive scans like MRIs or things for things that _might_ be a problem but most likely aren't?

[tuono]

Sorry but I haven't a clue what 'they' would do
All I am advocating is that 'anyone' would benefit from at least a basic musculoskeletal screening process (ROM, basic 'functional' tests) prior to embarking upon any exercise / new activity.
Being just a Sport Massage Therapist I can only rely upon what my hands, eyes and ears 'tell' me, MRI's and the such would play no part unless we 'were too late' and the client were already suffering from an injury. However even then, the 'power' of 'non electrical modalities' should not (IMHO) be underestimated

[webdoc]

As a practising chiro I am always fascinated when non chiros tell the world what chiros do.
Taking Xrays to find spinal abnormalties and treating them for the rest of life, where did you get that one from.

[webdoc]

Chiros use XRays to exclude patholgy that may contraindicate therapy, we use use them to confirm physical findings (decreased ROM), and evaluate posture abnormalities as a source of musculo-skeletal injury etiology.

[darrenc]

Just started to read about screening and had to laugh at a chiripractor trying to defend the frequent use of xrays. Maybe Ozzie chiropractors are different, but come to the UK and see how many of my patients were xrayed routinely by chiropractors told the level of degeneration which shows they need long term treatment. As a physio i have things i wish my profession didn't do so maybe your one of the good guys but don't stick your head in the sand about your colleagues antics.

[darrenc]

P.S

Can you explain how an xray tells you anything about range of movement?