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Photo Credit:  Eric Evans, Orca in the Salish Sea near Port Angeles, WA

Subjective Versus Objective Measurements

When a person describes what they are feeling, such as pain or restrictions in movement in the body, this is considered subjective information.  By adding numbers to this pain we can turn it into a measurement.  Typically I like to use the pain rating scale of 0-10/10 with 0 being no pain and 10 is the worst pain imaginable or needing to go to an emergency department.  So if they say the pain is 10/10 it is a really bad pain. 
This describes the intensity of the pain subjectively.  It is also helpful for me to have the person give me the quality of pain such as dull, aching, sharp, stabbing.  I like them to describe any symptoms or complaints they are having at that time.  I also have them describe any other symptoms such as numbness or tingling and rate them on the 0-10/10 scale for me. 
By describing the intensity and quality of pain we can determine if anything changes with specific activities or treatments.  If something makes pain improve it is a good idea to keep doing that.  Conversely, if something makes the pain worse, it would be best to stop that activity or exercise.  There is one caveat to that statement.  Sometimes people can feel worse before they feel better.  The other thing I think about is that if a specific treatment makes a problem worse that can be a good sign in that we were able to change something.  So if something worsens, this can mean that it has the potential to improve. 
I have found that when one joint is unlocked, the next one will show that it needs attention and can be even more painful.  Sometimes it is a sequencing problem.  You might have to unlock one joint and then go to the next one but if it makes you worse to do this second treatment, it is a good idea to start with this one and end with the one that makes you feel the best.  
Another part of pre-test and post-test is that it is very important to compare exactly the same position or activity before and after a treatment.  If standing is painful before treatment, for a post-test you want to compare in standing.  I like to have patients test several different positions or movements so we get a good idea of anything that changes.  Frequently, I will ask how it feels to stand up from a chair, standing, walking, moving from standing to sitting, or in sitting.  This gives me a good idea of which joints are restricted and the specific pattern they are stuck into.  This helps me determine what treatment is necessary.

Objective Measurements

Objective measurements are those that a therapist can measure using a variety of tools.  For example, when standing we can compare the height of the shoulders or pelvic bones.  When lying down we can see the difference in length of the legs.  If one is shorter than the other is commonly indicates that the pelvis is out of place.  I like to measure a body parts range of motion, or the ability of the joint to move through different positions.  I use a goniometer or a 360-degree protractor to measure the range of motion in joints.  Taking your weight on a scale, measuring how far forward you can reach without falling, timing how fast you can do something, or measuring how big around the body part is a sample of objective findings.  

Combining Subjective and Objective Measurements

When I ask what the intensity of the pain level is while the person is bending forward from the hips, this is an example of combining subjective and objective measurements.  Another way to combine subjective and objective measurements is to ask how the person feels as they are walking (subjective) and observe how they are walking (objective).  For example, if they were limping prior to the treatment protocol and now they are no longer limping, this indicates a positive change which came about from the treatment you just performed.

Pre-Test & Post-Test Measurements

The important thing about doing these measurements is to make sure you repeat the test the same way after you establish baseline data or measurements taken before trying anything to manipulate the motion or ain levels.  Stepping on a scale before starting anything would be taking a baseline or pre-test measurement.  It is best to do this prior to starting a diet change or exercise.  


By changing one variable at a time you can determine any change using a specific variable.  With dieting if you remain at the same weight then your diet is not working.  If you add exercise at the same time you change your diet, you will not know if the diet or exercise made the most beneficial change.  By changing one variable at a time this will become more obvious.  While losing weight on a diet you know it is improving you, now add exercise and see how much more improvements you will make. 


After a car accident, I like to have people start with only one thing at a time.  People are often sent to start medications, chiropractor, massage therapist, and physical therapist all at the same time.  Once I see someone if they are already taking the medications-they have a good idea if this is improving their symptoms or not. 


If they want to see a chiropractor or massage therapist I will often have them wait to see me once they have determined how they respond to those techniques.  If everything is started at the same time, it is difficult to determine what treatments are making you better and what makes you worse.  I think once this has been established, then it is fine to jump on board and see if adding another new technique helps.   


When you have a medical issue, such as hypertension or high blood pressure.  Frequently the doctor will add one medication at a time but sometimes something might be going wrong so badly that they will try several changes at one time.  If there is a problem with one of them it usually becomes obvious and they stop that medication or change the dose or even the manufacturer.  


So in conclusion, also perform a pre-test to determine pain or discomfort in what specific position or movement.  Then try doing something, such as one of the highly specialized stretches I teach using Releasing Joint Restrictions.  The perform a post-test in that same position or movement.  If you are better than you were before that was a good, beneficial exercise to do.  If you feel worse, it may be likely that you feel that the pain has moved to a new location.  It might be very close to the last place, but this indicates that one joint has released and now it is time to try to unlock the next one.
Changing one variable at a time will help you determine what treatment protocol is making an improvement.  I will then often have people stop doing that protocol.  If their symptoms worsen again, it is definitely that treatment technique that improved them.  Be your own therapist and determine if something is improving you.  If so, keep doing that.  If not, consider not doing that particular treatment protocol. 

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