Enhancing Palpation Skills Through the Use of Stereognosis Drills

Abstract

Context: Musculoskeletal palpation is taught in our athletic training programs as part of the injury evaluation process. However, as palpation skills are taught, the focus is oftentimes on accuracy of surface-anatomy landmarks instead of the ability to discriminate qualitative information such as tissue tone, spasm, or pain response from the soft tissue. Because palpation is foundational for evaluation and intervention, a need exists for further development of this skill. Objective: Provide educators with instructional techniques to enhance palpation skills. Background: Manual medicine techniques are increasingly common in athletic training and require superb palpation and soft tissue discrimination skills. The ability to detect large and small differences in tissue qualities during orthopaedic evaluation can lead to a more accurate assessment as well as enhance manual medicine intervention techniques. Description: We describe 4 activities to enhance palpation skills (coin discrimination, sheet tension, vacuum-immobilizer assembly, and spring-scale compression). Each activity is presented with progressions to improve the foundation of a student's palpation skills and provide advanced training to better refine palpation skills. Clinical Advantage(s): Integrating tasks to improve palpation skills throughout the athletic training curriculum may help improve student confidence, accuracy, and precision while performing patient evaluation and manual medicine interventions. Improved ability to detect and discriminate musculoskeletal pathology can lead to more accurate assessment and efficient intervention techniques. Conclusion(s): Palpation is an essential skill in musculoskeletal evaluation and intervention. With consistent and progressive instruction, this skill can be practiced and refined, improving student confidence and skill application.