• Make sure you describe accurately any problem completing this section.
  • List 5 things you can not do ( or you are in pain when you do ) that you would like to do.
  • Rate the pain you are in when doing them including where.


To help decide which muscles may be involved with your pain

1) Can you lay on your back on the floor with your legs out straight without any back pain or any tight muscles? If no describe the tension or pain What relieves the tension or pain?
2) Take off your top and stand in front of a mirror Describe the angle of your collar bone ( using a clock face ). eg right hand side 15 minutes past 2, left hand side 45 past 10 For men Are your nipples level For women ( due to most women not having the same size breast ) NOT DONE HERE, I USE OTHER TECHNIQUES TO GET THE SAME INFORMATION. Mark the lowest rib in line with the nipples Are the marks level? Put your top on.
3) Place 2 towels on the floor so that you make a straight line. Lay face down with your knees placed equally apart from the center line lay down so that your nose touches the center line. This way you are straight, you may now turn your head. Place your feet together. Have someone check your leg length is the same. To make sure one of your ankles have not collapsed. Bend your legs to 90 degrees check the leg length at the knees. Are they still the same? Keeping one your leg at 90 degrees (not further ) the other straight. Can you very easily lift your knee off the floor more than 5 centimeters ( making sure you do not lift your hip off the floor)? Repeat the other leg.
4) Take at least 5 steps straight ahead. Describe the angle of your feet using a clock face.
5) Place your fist on the front of your hips. Are your fists parallel to your feet?
6) Stand next to a table. Can you stand on only the leg furthest from the table? If you have trouble balancing touch the table ( not lean ) with the hand on the same side as the leg you are standing on.
7) Go for a short walk to settle the body. Lay down on your back, relax and describe the angle of your feet using a clock face. Have your partner look down your body from above. Are you lying straight? If not have them realign you so that you are straight. Describe how you feel. Are your shoulders off the floor?
8) When standing in a relaxed position. Are your palms facing your hips or slightly behind you?
9) Place both hand above your head.
Can you hold this position while someone very gently tries to pull them apart?


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