WAYS TO MEASURE IMPROVEMENT
When a patient presents to our office with a complaint, it usually pertains to a change in their ability to function normally without pain.  Pain is a multifaceted complaint that can be very complicated to manage.  After a thorough history, physical examination and review of any pertinent imaging findings, our doctors are mandated to determine a working diagnosis.  With that diagnosis comes a proposed plan of management that will require the patient to take an active role in their health care.  The responsibility is a shared one between doctor and patient, and it is very important for the patient to follow through with their role during this plan of management, so that both doctor and patient are doing their part to create an optimal outcome for the patient.
Having appropriate expectations from the outset is very important and this is no more true than when talking about expectations of pain reduction or management.  At both Elite Sport Performance and the Knee Clinic, our intake forms include what is known as a Visual Analog Scale for pain, allowing the patient to rate their subjective symptoms before the onset of treatment on a scale of 1 through 10.  We also look at patient-reported outcome measures.  This well validated approach looks at a person’s opinion of their pain and functionality and can include many different potential surveys.  In our Private Knee Clinic, we utilize one such patient-reported outcome measure known as the Knee Injury and Osteoarthritis Outcome score (KOOS).  Administering this survey, both before the onset of treatment and again at the conclusion of our clinical trial, allows us to get a better idea of the patient’s opinion of their own progress.  There is often a disconnect, especially in the early phases of care, between subjective improvement and objective improvement.  On each visit, our doctors or therapists will go through a series of objective tests and will compare the results of those tests to the previous treatment, as well as to the results from the initial assessment.  Often, these findings will not match perfectly with the patient’s subjective experience of pain.  This discrepancy lends itself to an important conversation about ways to measure improvement.
There are indeed many ways to measure improvement.  Not only is the amount of pain important but so too is the length of time it takes for the patient’s painful symptoms to onset, the  duration of symptoms, the activity level that they are able to maintain with an acceptable level of pain, and even how long it takes for them to recover after an activity.
The sport specialist nature of Elite Sport Performance is such that our mandate is to help patients continue participating in the sports or activities that they are passionate about.  These patients typically understand that their pain symptoms may not go away completely during these activities but that being able to continue doing the activities even with a mild to moderate amount of discomfort is a victory unto itself.  Other ways to measure improvement include a patient’s ability to sleep through the night, thereby allowing their body’s own restorative processes to help them heal further, or a patient’s ability to functionally perform their day to day tasks (such as brushing their hair) without significant pain.
Our ultimate objective is, of course, to have the patient’s pain go away and to have their function improve to the point that they are no longer thinking of or are even aware of their original presenting complaint.  As the law of diminishing return suggests, the largest improvements are often made early on in the course of therapy.  As time and treatment progresses, it is important for the patient to maintain consistency, both with their treatment as well as with their prescribed exercises and any changes or modifications to offending activities.  With persistence and attention to these details, optimal therapeutic improvement can be reached.
Lastly, it is imperative for the patient to pay attention to what symptoms they experience from day-to-day and with different activities so that they can relay this back to the doctor or therapist.  Let our  doctors or therapists know of any pain medications that you may be taking because these can often mask the patient’s true symptoms.
Our brand promises at Elite Sport Performance are ‘Results, Clarity, and Collaboration’.  If you have a musculoskeletal ailment and would like our expert input, please do not hesitate to contact us at (403) 689-9889 or by emailing us at reception@elitesportperformance.com.