Case Studies
54 year old sailing instructor - back
and knee pain
02-February-2010
Mr H came to me some months ago with a list of problems. He is very
active playing many sports as well as running his own Watersports Company.
The worst of the pain was in his lower back. I started my investigation
by checking his spine. This was tight in the lumber area, getting slightly
better the further up the spine. Whilst watching Mr H doing his basic
bending positions it was evident that the whole of the lower back was
tight. Also tight were the hamstrings.
I started work on the muscles in the lower back; these were thick and
tight and were full of contracture. I worked on these and then began
to go up the back following the spine. I carried out a lumber role to
begin with; this was very slow as Mr H’s body did not want to
role. I carried out this procedure 2 more times and then things began
to relax. An L5 role was carried out next, again slow work but with
patience achievable.
Mr H returned for his 2nd visit 1 week later, his lower back had been
tender for a couple of days after the treatment but that had passed.
The pain had been reduced by 65 – 70%. I carried out a repeat
of the first treatment. The lumber and L5 role were a lot easier this
time. At this point I showed Mr H some stretches for him to do at home
for himself.
Mr H returned for a 3rd visit the next week, again slightly tender for
a day after the treatment, but once gone the back pain was 95% gone.
Again worked on the muscle in the lumber area followed by the rotations.
The following visit the back pain was 100% gone! Now for the right Knee..........
Mr H’s hamstrings were very tight; the calf muscle also had contracture.
The right knee gives pain after Mr H has been sailing for 1 –
2 hours. The sailing position is crouched down so not a good position
to be in for hours. I worked on the calf and hamstring; both had contracture
and were very painful. I carried out a hamstring stretch and PNF on
both legs. The leg angle was only around 70 degrees.
Mr H returned the next week, the knee pain had gone for about 3-4 days,
and then returned. I carried out calf and hamstring muscle stripping.
This time I also worked into the IT band which felt tight. Once again
stretching the hamstring and IT band, there was a slight improvement
in the angle of the hamstring stretch. A L5 lumber role was also carried
out to make sure the lower back was still free.
When Mr H returned one week later things had not changed, the pain had
g
one for 3-4 days but then returned. Time for a re think! I checked for
tight quad muscles but did not find anything; I checked hip rotation
and again no real problem, carried out a Piriformis check but again
not a bad result. I then checked the Psoas muscle, the left leg was
a lot looser, Mr H’s foot was only 1 inch from the floor were
as the right leg was 2-3 inches from the floor.
I carried out a PNF Psoas muscle stretch on the right leg 3 times. Then
a hamstring stretch again and as before a L5 lumber role. Mr H returned
the next week he had been sailing and was still not in any pain!! The
problem had been a tight Psoas muscle all the time.
