A 37-year-old female presented in clinic in early September, she was complaining of 1-week history of lower back pain, she had no mechanism of injury, 7/10 pain, constant, and was having some referral of symptoms onto left lateral hip. She denied any pins and needles, or numbness and she was screened for serious causes. She was finding it very difficult to walk and change position. Initially she was very worried about movement and hurting her back further. Her goal at this stage was for a miracle cure.

Assessment

On assessment she was very limited on the range of motion of her lower back especially bending foreword. Reporting pain 7/10 with this movement. She was very fearful of doing this. Her left facet joint was reproducing her symptoms on palpation. When trying to palpate this, the patient was guarding and fearful. The rest of the joints were clear of symptoms. When you irritate the joint in your back it can sometimes refer pain to other places. This is called somatic referred pain.

Treatment

This lady was given some treatment, education and advice about how to manage her symptoms. She was given some exercises to help restore the loss of range of movement and desensitise the pain in her back. She was reviewed twice where the treatment was continued, and exercises reviewed also.

Outcome

One month later she was 90% Symptom free and returned to previous level of function.

28yr old Semi-Professional football player. Presented to clinic 20th October 2020. One week ago, he was playing football in a match, he was sprinting and had a sudden onset of cramping and pain in his right hamstring muscle. Usually, Marcus is very active, playing football several times per week and cycling. His goal was to be able to reduce the risk of injury and return to play.

Initial assessment

Assessment of Hip + Knee, to ensure no damage had been sustained to any of the joints above and below. Palpation of the muscle was painful; some loss of muscle bulk was noted. Hamstrings were aching on resistance and stretch, indicating a diagnosis of hamstring strain grade 1. Marcus was given some treatment to aid and symptom resolution and given some hamstring loading exercises to help to heal and build strength. When the hamstring muscles get injured, it is essential to strengthen as when you have pain; this can cause inhibition of the muscle and cause an immediate loss in strength.

Outcome

As this was a mild strain, Marcus did very well with rehab and was able to return to play 3-4 weeks after his initial assessment. His rehab was being carried out in the gym, but we had to adapt this due to lockdown, and his exercise program was changed to home-based strengthening.

Symptoms and Assessment

A keen runner who was preparing for the marathon attended the clinic complaining of knee pain following increasing his running distance. On examination, the source of the pain was found to be under the kneecap. A weakness of the thigh muscles and poor leg control were also identified as possible contributing factors.

Treatment and Outcome

During the appointment, the client was treated with soft tissue release and stretches. He was given home exercises to help improve his leg control while running. He was also advised on how much running load he could undertake on the following days and how he could optimise his training in preparation for the event. Taking everything on board, he completed the marathon he was scheduled for and was planning to continue his stretches and home exercises to prevent a recurrence.