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I was training for a marathon when my right knee started hurting pretty bad. X-rays were negative, so I went to a physical therapist for help. She found the problem was in my hip, not my knee. Does this seem right to you?

Pain or other symptoms experienced at a site remote from the cause of the problem is called referred pain. It is a fairly common problem that physical therapists are trained to watch out for. For example, knee pain can occur as a result of low back, hip, sacroiliac, or ankle impairments. With any musculoskeletal problem, therapists conduct a thorough screening exam to make sure the problem has a musculoskeletal origin and is within the scope of their practice. To do this, they use a screening model that includes past medical history, risk factors, clinical presentation, and associated signs and symptoms. An understanding of the clinical presentation comes from a broad exam referred to as a regional interdependence exam. By expanding the exam to include a broad region (not just a single joint), problems like this can be identified quickly and treated appropriately. This helps prevent delays and the extra cost of treating the wrong thing.

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