George Goodheart: „Listen very carefully!“ Die Bedeutung der Anamnese aus struktureller Sicht...

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George Goodheart: „Listen very carefully!“ Die Bedeutung der Anamnese aus struktureller Sicht Dr. Ramšak Ivan splošni zdravnik, Arzt für Allgemeinmedizin, Sportmedizin, Neuraltherapie, Manuelle Medizin, Dozent für Applied Kinesiology D.I.B.A.K

Transcript of George Goodheart: „Listen very carefully!“ Die Bedeutung der Anamnese aus struktureller Sicht...

George Goodheart:

„Listen very carefully!“

Die Bedeutung der Anamnese aus struktureller Sicht

Dr. Ramšak Ivan

splošni zdravnik, Arzt für Allgemeinmedizin, Sportmedizin, Neuraltherapie, Manuelle Medizin,

Dozent für Applied Kinesiology D.I.B.A.K seit 2000

greeting

• The way and length of the handshake

Why are you coming?

• Ability to express the priority of problems

• Gesticulation and body language

Since when do you feel pain?

• Slowly beginning– Overstrain, overuse

– focus

– abrasion

– ...

• Suddenly beginning– accident

– operation

– birth

– ...

• Report of body work out:– Years of exercising

– Increase of exercise in one/last year

– Size of body work out last 4-6 weeks

– Intensity of body work out last 4-6 weeks

– Frequency of competitions last year

Slowly beginning - overuse

Slowly beginning - focus

• How are you during virus infection?

• How are you if you have stress?

• How are you on holidays?

• Are the problems changing from one to the other side of the body?

• Typically.: „All my problems are on the rigth/left side!“

• Sensitivity of temperature?• Is your pain different during the

seasons?• How do you feel when it`s

clammy?• ....

Slowly beginning - overuse

Suddenly beginning – accident

• Tell and show me how the accident happened!– Which muscles were contracted?

– Which muscles were stretched?

– Which ligament could be stretched?

– Skin proprioreceptors strained?

– ...

• Was it your first accident?

• Do you have many other problems?

• Are you afraid?–Sympatic reflex-dystrophie or

Morbus Suddeck

Suddenly beginning – accident

Suddenly beginning – operation

• What do you feel when do you remember the operation?

• Sensitivity of scar?

• Problems with metals used for implantation?

• Redondrain...?

• Did you ever have problems after narcose?

Suddenly beginning – birth

• Length of birth?

• Sitting, defecation, kohabitation... Since when after birth possible?

• Perineal tear?

What would cause more pain?

moving – structural pathologyresting - functional problems

When during day and night do you feel the

most pain?

When during the four seasons do you feel

most pain?

The common symptoms of depression

• neckstiffness

• Pain in knees and ellbows

• Deep lumbar pain

• Interscapulary pain

• „I feel pain everywhere!“

Show me the radiation of your pain !

In which position do you feel most pain?

SittingRunning, up-, downhill, WalkingLying

Pain during sitting

• Coccygis

• Cat II

• Tuber ischiadicum – rectum-pathologies, hamorrhoiden...

• Lig. iliolumbale, lig. sacro-tuberale , lig. sacrospinale

Pain during/after walking

• Dysfunction of the feet–Talus medial: gonarthralgia,

inguinalgia

–Talus lateral: trochanter major pain

–Pes valgus: lumbar pain, inguinalgia, ...

–..........

Pain during/after walking

pes valgus

Pain during lying

• Category I

• Ligamentpain – hyper-mobility – stress!!!

• Visceral pain

• ...

THANK YOU ! !