Hawkes Physiotherapy Blog

I often find my patients asking me this question before I have even assessed them: “Do you think that I should get a scan?” My typical response is "no or certainly not yet." They say "but won’t it show exactly what is wrong with me?” The problem is that the scan will show all the issues that you have, but what is relevant or just incidental? You see what is normal? Patients presume that we are all perfect with no abnormalities so a scan will show the single abnormality causing our pain. This simple isn't true. Here are some great examples of this point: In the knee, Cyteval (2008) actually found meniscal (cartilage) tears on MRI scans in 1 in 3 middle aged and elderly people and these individuals had no symptoms or pain at all and would consider themselves normal. A similar finding was also found by Beattie et al (2005), they found that 60% of pain free 20-68 year olds showed abnormalities in at least three of the four regions

You wouldn't believe the amount of patients that I see, who come in and say:  “I've put my back out” or “I’m out of place or alignment” and then ask to be put “back in place”. Then again, maybe this is you? It depends on your experience of Physiotherapy, Osteopathy, Chiropractory. When I proceed to tell patients that these things don’t really happen in the human body, they will say “but such and such says it does and they cracked my back and I was back in place again and my pain went away”. Now I'm not saying that the treatment doesn't help. It does reduce pain & increases range of movement but it didn't crack you back into place for sure! I'm not saying things can't be out of normal anatomical alignment because they can but they generally don't move in and out quickly and sometimes they will never change. A persons alignment is down to lots of factors such as bone size and shape, joint surface contours, ligament shortening or laxit