George Goodheart: „Listen very carefully!“ Die Bedeutung der Anamnese aus struktureller Sicht Dr. Ramšak Ivan splošni zdravnik, Arzt für Allgemeinmedizin,

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 ! !