The importance of a good subjective

Hello all,

I am currently doing my musculo OP placement and have had a situation this week that made me realise how important it is to get a good subjective and that things are not always as they seem. Ok so here's the situation: I had a patient who came into the clinic who's main concern was tightness around the posterior neck and shoulders. I thought great..this seems simply enough, check her range, do some postrual correction and then we are good to go. But little did I know all was not as it seemed. As i continued my subjective she stated that she never really gets a good night's sleep (maybe only 4 hours) and on these days she feels very lethargic and it seems that her symptoms are worse. However if she gets a good nights sleep then she feels "like she's 20 again" and full of energy. So i asked her why she wakes up at night and it's becuase she has to void her bladder, up to 10x per night!! And with even further questioning she also told me that she was incontinent on one occassion. I asked her how long this has been happening and she said years but she has never done anythign about it. She asked me why i was asking her all these questions so i explained to her the importance of the pelvic floor muscles, where they were, their function (i even brought in the model of the pelvis!!). After my little women's health tut i suggested she should see a women's health physio. I explained the role of the women's health physio and how they could help her with her problem. She seemed very happy and relieved at the suggestion. So what i thought would be a nice, simple case of poor posture turned out to be a whole lot more!! So moral of the story is...it is important to get a thorough subjective or you can be missing out on important information.