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Follow HIP MNRS with every patient encounter – History, Inspection, Palpation – Motion, Neurovascular, Referred, Special Tests
Make sure you have a detailed anatomy understanding and can create a list of potential pain generators (muscle, bone, joint, ligament, cartilage, blood vessels, nerves, viscera & lymphatics) – any competent practitioner should be able to give a detailed list of the anatomy below their hand and the tissues they are stretching, compressing or activating
Clinicians performing regional exams must realize that no one sign is of absolute significance in isolation, each individual finding should be evaluated only in the context of other findings & the patient as a whole; this is particularly important with diagnostic procedures that may result in “soft” signs, which are difficult to reproduce & may have a large subjective bias in their interpretation.
When recording test results it is not enough to write “test-X positive.” Record any findings associated with the test (reproduction of symptoms, pain, muscle guarding, numbness & tingling, decreased flexibility, clicking, etc) – more information results in a more accurate assessment & better treatment. Remember assessment is therapeutic!