Musculoskeletal Physiotherapy
Regional assessment and management
Musculoskeletal physiotherapy requires region-specific reasoning. For the lumbar spine, distinguish radicular from referred pain and screen for cauda equina. For the shoulder, differentiate rotator cuff tendinopathy, subacromial pain, adhesive capsulitis and instability. For the knee, know ACL, meniscal and patellofemoral presentations. For the hip, recognise osteoarthritis and gluteal tendinopathy.
Management follows a biopsychosocial model: education, load management, graded activity, and strengthening. Tendinopathy responds to progressive loading, not rest. Osteoarthritis responds to exercise and weight management. Acute soft-tissue injury follows protection, relative rest, ice, compression, elevation, and early controlled movement.
Traps
Items often test the difference between a special test's purpose and its interpretation. A positive Lachman supports ACL injury but does not measure laxity grade alone. Another trap is advising rest for tendinopathy when loading is indicated. Watch for questions where the correct answer is reassurance and education rather than a passive modality.
Worked example
A runner with lateral knee pain and a positive compression test. The reasoning: suspect meniscal or iliotibial band involvement; assess hip abductor strength and running load; manage with load modification and progressive strengthening. Rule of thumb: for persistent musculoskeletal pain, find the load problem and the capacity problem, then close the gap with graded exercise.