Why do physiotherapists examine your skin?

Physiotherapists examine the skin to help identify areas of weakness and tension. We then use a treatment plan that is most appropriate for you. (You're welcome.)

Let’s break down the skin and its purpose.

Believe it or not, your skin is the largest organ in the body and can provide a lot of information about the overall health of an individual. How you may ask? The skin is constantly working to maintain its balance. So, when something is not right, chances are your skin will become tense and painful. It’s your own personal warning system for us to examine.

The other obvious thing that we all know (hopefully) is that your skin is a protective barrier. Think of it as your own Ironman suit. It helps to protect the body from infection and injury. Therefore it’s quite important to keep your skin free of cuts, bruises, or other injuries that could harm you or just cause you discomfort. But we will get into more of that later. 

What about an example?

As physiotherapists, our primary focus will always be movement and the variables that go with it. Now people tend to forget that skin can control quite a bit of it. If you want an example, look how you go from “normal walking” to rusted robotics when you have a sunburn. Your skin is sensitive, inflamed, and far too tense to move. 

What are some of the health signs we can pick up from the skin? 

Your skin has a language of its own and could be filled with easter-eggs about your health. One of the most obvious issues we can discover just by looking at someone's skin is infection and or allergic reactions. Quite often the skin is sensitive, itchy and visually quite red, possibly even a bit yellow, just like a rash (or exactly that). 

The same goes for ‌infections in your joint, such as septic arthritis. The way we spot this clue is by making sure there is no discolouration around any of your joints (And obviously, you know, if you have pain we will know something is wrong). 

In general, skin changes can tell us a lot about general health and the area around the injury that may need onwards referral or specific management techniques! It could be the first step in a journey to help heal various issues your skin might guide us to, such as a reduction in blood flow, thyroid disorders and even gout or psoriasis. Psoarisis just as an example is often part of a picture of psoriatic arthritis which causes joint pain. This is why a full review of “the systems” is required by a physiotherapist!  

What about moles?

While your skin can tell us a lot about you, one of the things we examine your skin for (besides all of the above) are moles and to detect any possible cancer or cancerous changes. Some of the red flags we tend to look for on a mole are a sign of a scab, bleeding, growth, inflammation and even a specific shape (one of these could be a volcano/crater shape that dips or sinks towards the middle). 

Let’s just include a casual disclaimer. Google tells everyone they have cancer. So please; close the tab you just opened.

The ABCDE Rule

Yes, all doctors need to learn their ABC’s again. But this time, it’s a bit different. ABCDE stands for asymmetry, border, color, diameter and evolving. These are the characteristics of skin damage that we look for when diagnosing and classifying melanomas. It’s the most effective at identifying superficial spreading melanomas early. 

It is a good idea to check your moles once a month, especially if you have lots of moles or freckles (particularly if some are large), have fair hair or skin, use sunbeds or have a family history of skin cancer.

It’s always recommended to book in with a doctor if you have any changes to your moles or freckles or if you suspect any of them may be concerning, but if you want to have a look at yourself, you can use this diagram:

More on the skin, mobility and more of its magic

As mentioned earlier, your skin helps protect against microorganisms, ultraviolet light, and mechanical damage, but did you know that it also prevents dehydration and controls the temperature of your body? Since your skin is the first physical barrier to the outside world, it is your defensive system and regulator. The sensation of pain, temperature, touch, and deep pressure starts with the skin. 

Regarding mobility, as obvious as it is, your skin ensures that all of your movement is smooth as can be. With the help of your skin, hair follicles, nails and (even) sweat, your body can move without friction by feeding information to the rest of your body, for example: Damn, that water is cold! - Let’s get out, please. 

Congratulations, you saved yourself from hypothermia. 

Moving Forward 

On a more philosophical note (yet logical), it is only natural to evaluate the whole body. We are complicated beings with numerous systems and cycles, so in order to address a bodily issue, it only makes sense to look at you in your completeness.

It is worthwhile to take proper care of your skin. Wear protective clothes and equipment for physical work and sport, put on sunblock and avoid excessive UV exposure (they invented shirts for a reason). Additionally, make sure to check your moles regularly to avoid or detect cancerous changes.

If you have any concerns about your skin, be sure to consult with a physician or dermatologist. We will always be happy to help. As medical professionals, it's our responsibility to help detect and refer. 

Greetings, your friendly neighborhood physio.