Health Blog

In the light of the recent news concerning Sir Chris Hoy and his terminal prostate cancer diagnosis, I am certain that I was not the only therapist who immediately thought “Would I have spotted this in my case history?”   

Sadly, in Chris Hoy’s case, by the time he had the symptoms of shoulder and rib pain it would probably have been irrelevant whether the diagnosis was made this week or in two weeks’ time.  Early diagnosis of a pathology can often be critical as no one ever wants to be treating the wrong thing.

For Osteopaths and physical therapists at Springbank Clinic, the case history is the most important part of a consultation.   We often have patients calling to book an appointment and asking, “Will I be treated at the first consultation?”  Of course this is always the aim, but treatment depends on the case history and in my opinion the symptoms and the onset are crucial.

In Chris Hoy’s case he said he felt discomfort in his shoulder and assumed it was from a gym session. Hearing this ‘assumption’ from the patient is when, as a practitioner, I should always be asking more questions … “Did you feel something specific happen?” “Was there a reason – for example did you increase weights, do more reps, try something new?”  “When did the symptoms start in relation to the gym session?” “Have you had this before and was it really exactly the same?”

The next thing is to ascertain if there are any patterns to the pain – are there specific movements or activities that aggravate or relieve the pain?  Sir Chris assumed he had simply aggravated his rotator cuff.  Unfortunately, pathologies do not always follow what a textbook describes and can present as similar to a simple mechanical issue.  So by the end of a case history we expect to have narrowed down our potential diagnosis.   We know our limitations so it is important to always ask ourselves “Does this make sense?”

Patients sometimes get frustrated at what they perceive as wasted treatment time during a case history, particularly where they consider their symptoms to be a repeat of a previous similar episode.  However, the practitioner does need peace of mind that they are treating something they can help rather than risking making things worse.  So please bear in mind – the case history is a very good investment of time!

Fortunately, at Springbank Clinic our practitioners have a wealth of experience from many years of practice.   We are confident in our ability to take our time and listen to our own instincts.  We can’t guarantee we will be spot on every time, but we will ALWAYS endeavour to establish a clear diagnosis and review at every visit as things can change and can become clearer.  

Having said all this, PATHOLOGIES ARE NOT COMMON and we do have the training to spot them.