Impairments on level of structure and function we can find:
- Deformations of bones and their consequences: skoliosis, deformation after Spine fractures
- Degenerative processes: Arthrosis, disc hernias, osteoporosis....
- Hypermobilities and structural based instabilities: hyper mobile Cx or Lx
- Inflammatory / infectious processes: Rheumatism, M. Bechterew, Arthritis....
as seen in physically heavy working persons
Syndromes of arthro-muscular disorders: Lumbago, Facets syndrome, functional instabilities
In most of the cases the patient wants to see the (orthopaedic) physician because pain is limiting activities of daily life. Example: a patient is usually not going to see the doctor because the rotation of the thoracic spine is reduced but
Pains is an important treatment parameter: Usually patients are motivated and cooperative (as long as the pain is influenced positively by physical therapy). For the PT pain is also a good reference for the treatment success.
Limitations in daily life activity are a result of deficits in the senso-motor system (causal impairments). One of the most existing causal impairments is the reduced range of motion on the background of structural changes and/or pain.Other impairments :
- Strength and Endurance caused by lack of movements (inactivity atrophy) or by pain induced inhibition
- Proprioception (ligamental lesions, post OP,)
- Coordination (either as cause for Overuse syndromes or as consequence of pain processes)
- Balance (as consequence of lack of strength/endurance/coordination/ROM)
- Neuropsychological functions and symptoms: fear, lack of self-confidence,
- Every orthopaedic dysfunction is related to changes in the neuromuscular coordination:
- as cause for disorders
- as result (of nociception)