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....

Overuse syndromes: 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)