General subjective:

● Start with:
○ Client details; usually filled out in a form.
→ Open Q; “what can I do to help you today?”
○ social history:
■ Occupational considerations and how this affects the patients symptoms.
● If relevant workers comp info.
■ Physical activity and exercise- consider if this meets the national
guidelines.
■ Sports:
● Number of training sessions etc.
● Next important comp.
■ Hobbies/ how day is spent (if relevant).
■ Family support (if relevant).
■ Living situation (fi relevant) e.g. stairs.
■ Lifestyle factors (smoking, alcohol)?
○ body diagram
■ Clear areas with tick.
■ Nature - sharp, shotting, ache, dull, burning.
■ Depth- referred pain is often deep.
■ Frequency- I/T vs constant
■ Severity- at best, average, worst
● Then:
○ History of presenting condition + any treatment.
■ When, how, why
■ Chronic- why attending now
■ Close ended Qs etc. Does it come on when you're stressed?
■ Progression- how has it changed since it started and you've seen me?
○ Past medical history
■ of similar episodes or related problems.
○ Aggravating Factors, Easing factors
■ Related to loading, sustained postures or repeated mvmts.
○ Functional restrictions
■ What are you not able to do because of the problem/ pain?
○ 24 hour pain behaviour
■ Night
■ Early in the morning
■ During the day
● Finally:
○ Imaging:
 ○ Meds for condition
○ General health and screening questions
■ Any medications or medical conditions that you think I should know
about.
■ Any recent surgeries.
○ Screening: if relevant
■ B or B disturbance, saddle anaesthesia or paraesthesia.
■ No gait disturbance.
■ No Hx diabetes; thyroid, heart or lung cancer, weight steady.
○ Patient beliefs, goals and expectations; medical opinions

General physical:
● Observation + palpation:
● Functional test (not appropriate if severe pain and/ or very irritable).
● AROM +/- OP (R2 or R2 with mild pain).
● PROM +/- OP
● Screening of other joints:
● PAMs (for peripheral).
○ NOT indicated if movement is pain limited or movement is within full range.
● Accessory + physiological motion palpation- I think you always do it.
● Muscle function:
○ Resisted isometric muscle tests.
○ Strength and endurance (MMT).
○ Muscle length tests.
● NTPTs:
○ If pain is distal to spine.
● PNS examination:
○ If; numbness, P&N’s, tingling, paraesthesia or weakness in limb +/- distal referred
limb pain.
● CNS examination:
○ If; gait disturbance, loss of balance or coordination, increased tone, bilat/
quadrillat pain, numbness, P&Ns, weakness, loss of fine motor control.