What to expect at your initial consultation
01 — A conversation
A conversation between us where I write down your medical history, lifestyle and details about your current problem. It’s important to be thorough so I have as much clarity as possible about what’s happening in your body. If you have a list of your current medication, scan reports, or blood test results then these will be helpful but not essential in understanding your case
After I have taken your case history I will ask you to remove relevant pieces of clothing so that I can examine you properly. Don’t panic! You won’t be forced to do anything you’re not comfortable with. You can bring shorts/leggings/a vest top if these make you feel more comfortable.
02 — Clinical examination
Observation. We need to see your body move to gather more information about what might be going on. Physical assessment involves things like getting you to move your back/arms/legs in different directions so I can see how your muscles and joints move together.
Palpation (focused touch) of your muscles and tendons to assess where the pain is and where it might be coming from. We will always ask permission before palpation.
Clinical tests are aimed to challenge specific things (like knee ligaments or nerves) and to recreate the issue you’re experiencing. They help us to be as specific as possible in our diagnosis.
03 — Diagnosis
By combining all the information from the conversation and examination, I arrive at a ‘diagnosis’ (what I think the problem is at that moment in time).
It might be that the diagnosis involves expertise and skills which are outside of my professional remit, in which case I will direct you to the most suitable option for you. For example, if I’m concerned that your headache is due to high blood pressure, and not from a problem in your neck, I would refer you to a GP or cardiologist.
If I’m happy that the diagnosis is something I can safely treat we decide together what the treatment will involve based on my suggestions and what you’re comfortable with.
04 — Treatment
Treatments can involve a combination of any of the following:
Soft tissue techniques (stretching/moving/kneading the muscles)
Mobilisations (moving parts of your body around whilst you remain relaxed)
Manipulations (cracking/HVT/HVLAT - moving a joint through a very small range of motion very quickly)
Dry needling (medical acupuncture into tight areas or knots in the muscles)
After treatment you’ll get dressed. There will be time for your questions and I’ll go through any advice and exercises which are going to help you look after yourself.
Follow up
Follow up treatments involve the same 4 elements as an initial consultation but in different proportions. The conversation at the start will be shorter as we don’t need to repeat all of the questions. The examination will be shorter because we don’t need to repeat all the tests just the most relevant ones. The treatment will be longer. There will then be time for questions and review of your guidance/exercises.
Does it hurt?
Clinical tests are designed to provoke symptoms and recreate the problem. This may therefore hurt but we’ll keep it as brief as we possibly can. We use these tests to be as specific as possible with our diagnosis.
Patients may experience soreness for a short period after treatment. This is a normal response to treatment and we will advise patients how to manage this with self-care advice.
Please please always let us know if you’re experiencing pain during a treatment so we can adjust what we’re doing. ’No pain no gain’ does not apply here.