Utilizing Medical AND Movement Diagnoses
We’re all pretty familiar with the concept of a medical diagnosis.
For the sake of simplicity, a medical diagnosis serves to identify a disease, condition or injury based on certain signs and symptoms.
With regards to musculoskeletal injuries, medical diagnoses are specific to the tissues involved (muscles, tendons, ligaments, bones, discs, fascia, joints, etc).
A few examples of medical diagnoses include things like a “Grade 2 Hamstring Strain”, “Moderate Right Paracentral Disc Protrusion at L4/L5” or “Non-displaced Fracture of the Proximal Radius”.
As you can see, specificity in diagnosis is important so that treatment can also be specific.
When it comes to a movement-based approach to healthcare we value accurate and specific medical diagnoses as well as movement diagnoses.
What is a movement diagnosis?
A movement diagnosis (popularized by Shirley Sahrmann) serves to identify an observed compensation pattern or “deviation” from normal movement that is associated with the development of various musculoskeletal injuries.
Just as medical diagnoses are specific to the type of tissue involved and the severity of the injury, movement diagnoses are specific to the involved anatomy and their movement deficiencies.
For example, we often see patients who come to us with shoulder pain and have been given a medical diagnosis of “rotator cuff tendinopathy” that may range in severity depending upon the case.
This medical diagnosis provides us with the specific anatomical structures involved in the injury.
We’ll then perform a movement screen in order to identify the presence of any dysfunctional movements.
To be more specific, we observe patients as they move their shoulder through various ranges of motion to see how they utilize the structures involved (scapula and humerus) and to assess the overall quality of their movement.
Examples of movement diagnoses associated with shoulder pain (that often lead to tendinopathy) include “Inefficient Scapular Upward Rotation” and “Humeral Anterior Glide”.
As you can see, movement diagnoses must be specific to the structure and specific motion that are deficient.
Why do we combine medical and movement diagnoses?
Musculoskeletal injuries are typically “dynamic” in nature, meaning that they can be defined by both structural changes and by their movement characteristics.
Let’s dive into that.
Using the same example as above, rotator cuff tendinopathy can be identified by looking at the changes that have occurred within the structure of the tendon itself.
In addition, we can look at the way that someone moves their scapula and humerus (arm) when reaching overhead to see if the way they perform that movement places the tendon in a compromised position.
This type of movement assessment provides us with context for why structural changes may have occurred within the tendon, thus providing more context to the injury and the medical diagnosis.
If we find that a patient has inefficient scapular upward rotation and humeral anterior glide (head of the humerus moves forward in the socket), which place the tendon in a compromised position, then correcting these movement patterns will prevent further injury to that tendon.
We can use manual therapy techniques with corrective exercises to improve both range of motion and the quality of movement.
A movement-based approach not only helps to relieve pain, but also aids in proper healing of injuries and can provide patients with the tools they need to prevent future injury.
If you have any questions or if you’re interested in seeking care for a current injury, schedule an appointment with one of the Momenta Doctors for an examination and movement screen to figure out the best plan of action for you.
Follow our booking link here to schedule your appointment online now!
