January, 2001, Vol. 01, Issue 01 By Whitney Lowe, LMT
There is often significant misunderstanding about the definition and role of assessment. Many people confuse the concepts of assessment and diagnosis, and for that reason they shy away from learning about them. Assessment skills are a systematic method for gathering information to make informed decisions about treatments. Since assessment is really information gathering, you can’t really do any kind of massage without doing some level of assessment. When your hands feel a tight area in your client’s muscle tissue, you naturally focus your attention on reducing the tension in that area. You have performed assessment through palpation and then chosen a particular course of action as a result of your assessment of the client’s tissue state.
Diagnosis, on the other hand, is the assigning of a name or a label to a certain group of signs or symptoms. To arrive at a diagnosis, the practitioner (usually a physician) will perform some type of assessment, and based on the findings, will assign a name or a label to the problem. When you assign a name or label to the problem and state to the person they have “x” condition, you have given them a diagnosis. Gathering information about someone’s condition to determine if you should proceed with massage, is assessment, not diagnosis.
Assessment skills have become increasingly important for massage therapists. Numerous studies have indicated that people are increasingly using alternative medical approaches such as massage therapy to treat all kinds of problems. In many instances, these people are coming to massage therapists before seeing some other primary care provider, such as their physician. They may present a certain group of signs or symptoms and ask a massage therapist to help them, because they have heard massage therapy can be helpful for people with similar ailments. While this is a wonderful opportunity to demonstrate the healing power of massage, there is tremendous responsibility that comes along with that opportunity.
We must be able to determine if that person’s condition is something that we should work on. If it is, we must determine what type of soft tissue work will be most effective. In many instances, one type of massage may be beneficial, while another type may be harmful. It is not really accurate to make blanket statements such as “massage is good for this problem, but not for that one.” It may depend on what type of massage is used.
In this column we will focus on assessment of orthopedic problems those that decrease or limit a person’s ability to move their body properly. There are a variety of orthopedic assessment systems. Despite their differences, they all share several common components: a detailed client medical history, visual examination, palpation, and some form of movement evaluation, which may include any number of special testing procedures.
While learning new massage treatment methods has certainly improved my skills, nothing has made as much impact on my ability to treat pain and injury problems as studying orthopedic assessment. It is my hope to share some of the wonderful things I have learned, so that you may improve the quality and success of your practice.