Just want to get a diagnosis on my sports related knee pain.
Can Anyone Recommend a Reasonably Priced Physio in Melbourne for a One-off Appointment Re. My Knee
Covfish87 on 24/04/2018 - 17:41
Last edited 24/04/2018 - 18:51 by 1 other user
Last edited 24/04/2018 - 18:51 by 1 other user
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I had a crook knee paid $125 to see a sports physio. Half an hour of massaging etc to achieve zero result.
Made an appointment with an orthopedic specialist, took XRays and there was no major damage. Gave me a cortisone injection and now 100%
Physio's have there place, just not quite sure where it is.Until the cortisone injection wears off and you're left back at square one, with potential development of structural damage secondary to increased use of your now pain free leg. Even if no such damage has arisen, you're option is again to rely on cortisone injections (which are terrible for the health of your connective tissue) or to see a Physiotherapist in an attempt to fix the cause of the issue, not merely address the symptom.
The approach that was taken would be like having a car that keeps running low on coolant, and instead of spending the time to investigate the cause and eliminate it, you just keep topping up the coolant level and hope no damage is caused. Diagnostics of biomechanics will always take some time, and unfortunately 'wasted time' and 'time spent progressing towards success' can appear identical.
This isn't to say that receiving the cortisone injection was a bad thing, inherently. In face, some Physios will recommend it in order to facilitate rehabilitation. But you should always seek to eliminate the cause of any given symptom, no matter what health professional needs to be involved.
Ignorance is no excuse. Everyone injuries/pain is different and will be resolved or dealt with differently. Sometimes cortisone or basic NSAID will resolve an issue but often it won’t. Insinuating Physio’s don’t have a place because a needle fixed your issue is just moronic.
Not quite as moronic as your reponse
Nah sorry. You’re a muppet with no clue. Your solution does not fit everyone, or make Physio’s pointless. Keep your stupid advice to yourself so as not to mislead others.
Seeing a physio is pointless until you've had an MRI or similar done to assess any structural damage.
Not necessarily. Whilst imaging certainly helps for complex concerns, plenty of issues can easily be diagnosed without it. More complex situations call for specific tests to assess individual structures, which can also provide adequate diagnosis. I wouldn't recommend anyone spend the time and money involved with such imaging (not to mention increasing burden on the healthcare system) unless instructed to do so.
I wouldn't recommend anyone spend the time and money involved with such imaging unless instructed to do so.
I wouldn't recommend anyone spend the time and money involved with such physio treatment unless they've established it will be helpful.
plenty of issues can easily be diagnosed without it
Maybe if the OP is fat and a GP can tell them they need to drop a few kilos and their knee pain will be alleviated.
If there's a structural issue with the knee, a physio will be relying upon self-reporting from the patient(unreliable) and simple range-of-motion tests etc. Any "diagnosis" provided by the physio will be provisional and often ambiguous.
Getting appropriate scans eliminates these problems and provides a differential diagnosis, which is critical when patients could report similar symptoms with conditions as varied as patella tendonitis, torn meniscus, loose cartilage in the knee etc etc etc.
I wouldn't recommend anyone spend the time and money involved with such physio treatment unless they've established it will be helpful.
This is a false equivalency.
Physiotherapy alone is capable of providing diagnostics and treatment. Conversely, imaging is purely diagnostic which may assist with treatment. As such, it is possible (and far, far, from rare, as you seem to be suggesting) that a Physiotherapist can diagnose and treat, thus mitigating the need for any imaging. Whereas any imaging must necessarily be accompanied by additional treatment, so you are (at the very least) guaranteeing multiple visits in this process.If there's a structural issue with the knee, a physio will be relying upon self-reporting from the patient(unreliable) and simple range-of-motion tests etc. Any "diagnosis" provided by the physio will be provisional and often ambiguous.
This is simply false. Range of motion is certainly one facet of assessment, but that's about where the truth in your statement ends. For the specific example of the knee, there are a number of special tests with high inter-rater reliability to diagnose damage to various structures:
Anterior Draw, Lachman Test, Pivot-Shift Test: ACL
Posterior Draw, Posterior Sag Sign: PCL
Varus Stress Test: LCL
Valgus Stress Test: MCL
Ober's Test: IlioTibial Band
Joint Line Tenderness, McMurray's Test, Apley's Test, Thessaly's Test: Meniscus
Patellar Apprehension, Clarke's Sign: Patellofemoral painThe utilisation of these tests in conjunction with patient history can, and often does, provide accurate diagnosis.
Getting appropriate scans eliminates these problems and provides a differential diagnosis, which is critical when patients could report similar symptoms with conditions as varied as patella tendonitis, torn meniscus, loose cartilage in the knee etc etc etc.
There is grave irony in this block of text. Firstly, Tendonitis is an old term implying an inflammatory process in the pathology of this condition when this is not the case (thus it is known as Tendinopathy). Furthermore, imaging will not accurately diagnose tendinopathy; accurate diagnosis is yielded from, you guessed it, accurate history taking (pain behaviour in the morning, onset relative to sudden increase in tendon loading, onset relative to de-loading/loading mismatch, etc).
As for torn meniscus, the special tests above can provide adequate diagnosis.
For loose cartilage, this will not necessarily be inherently symptomatic. Rather, it would be the trauma that resulted in the loose cartilage that would require investigation. Regardless, I cannot imagine the thought process of "my knee is sore, so I better get imaging to check for loose cartilage"; it's utterly absurd.tl;dr - Please educate yourself on any given topic when providing criticism so as to avoid kerfuffles such as this.
i am a physio myself but have left the clinical side so i can give a somewhat unbiased opinion and can tell you that most of what you are saying is wrong. Your understanding of physio testing and diagnosis and incorrect and your reliance on scans is often not needed, a waste of money both personally and to the health system and can lead to self fulfilling prophecies and catastrophisations
perhaps i should do an AMA Physiotherapist post and people can ask open questions about the profession etc
This is a false equivalency.
Physiotherapy alone is capable of providing diagnostics and treatment. Conversely, imaging is purely diagnostic which may assist with treatment. As such, it is possible (and far, far, from rare, as you seem to be suggesting) that a Physiotherapist can diagnose and treat, thus mitigating the need for any imaging. Whereas any imaging must necessarily be accompanied by additional treatment, so you are (at the very least) guaranteeing multiple visits in this process.
Don't use terms you don't understand, there is no appearance of equivalency, I'm using the same format to highlight the incorrectness of your statement.
There is grave irony in this block of text. Firstly, Tendonitis is an old term implying an inflammatory process in the pathology of this condition when this is not the case (thus it is known as Tendinopathy).
Glad to see you're not being pedantic over minor differences in terminology when the meaning is clear. Oh wait…
As for torn meniscus, the special tests above can provide adequate diagnosis.
This is simply false. These physio tests can show the size and orientation of a meniscus tear(critical in treatment and prognosis)? Really? Really? When you start making outlandish claims like this I can't take you seriously.
For loose cartilage, this will not necessarily be inherently symptomatic.
So if it's asymptomatic, why would they be seeking treatment? Completely asinine statement.
Rather, it would be the trauma that resulted in the loose cartilage that would require investigation.
Do some basic research and you'll find many, many instances of loose bodies in a joint causing issues and requiring investigation and corresponding intervention, be it surgical or otherwise.
TL:DR - Your arguments are lacklustre and your debate style is intellectually dishonest. I'd tell you to educate yourself, but you're clearly resistant to the idea.
Terrible advice. Ignore this misleading stupidity.
See a doctor first to find out the underlying cause then look into a Physio if they think that is the right way to go. The physio I go to is at the top end of Collins St. They do a lot of work with dancers.
Wow the armchair experts are out in force above with shit advice as usual.
Physio’s have their place especially for diagnosis of tendon and soft tissue issues. They are also very good at finding the root cause not just identifying/treating the issue. Often an MRI is a waste of time as imaging can be inconclusive and a skilled Physio or Osteo can diagnose many injuries without imaging. That said there is a pace for imaging obviously as well but that is not step one. That’s shit advice.
OP do you have private health extras? If yes then seeing one of their preferred providers is usually cheapest. If not, you’ll find most Physio’s are in the same ballpark cost wise. Find one in a convient location as they are friggen everywhere and see how you go.
Talk about armchair experts - you are hanging yourself with such inane comments and criticism
Sorry I used big words too difficult for you to understand. Try again.
skramit you make some good points however i would tend to steer clear of preferred providers. health funds only pay very low amounts so a good physio can charge more as they are more experienced and better at it. you tend to find the less skilled or less experienced ones being the preferred providers
skramit you make some good points however i would tend to steer clear of preferred providers. health funds only pay very low amounts so a good physio can charge more as they are more experienced and better at it. you tend to find the less skilled or less experienced ones being the preferred providers
Most injuries require more than one visit. Many will require imaging, and most imaging requires a doctor's referral.