Who:
28 year old male powerlifter (works as Bar Manager).
Reason for coming to Barefoot Physiotherapy:
Hurt hip competing in a strongman competition 8 months earlier which had settled with treatment. Then back and leg pain started 2 months after that. MRI findings of L5/S1 disc herniation. Had a cortisone injection 3 months prior to starting treatment, which did not make a noticeable improvement. Other physiotherapists had recommended surgery or further steroid injections.
Goal = bend down to tie shoes. Powerlifting training painfree.
Presented with:
Lower back and left leg pain
90% neural irritation in both legs
<10% back movements in all directions, bending forwards most restricted
60% hip range
10% hamstring range
Significant back muscle spasm
Pins and needles and numbness in left calf/foot
Pain with training at ~70% normal load.
Treatment:
Neural interface treatment in lower back
Lumbar disc release
Dry needling and trigger point release of glutes
Home program of neural interface treatment by partner (taught in clinic), self-releasing glutes, adductors, quads, triceps
Re-training posture and glute activation for powerlifting
Outcome (4x 60 min sessions and 2x 30min sessions, over 5 weeks):
No neural irritation
Full lower back range
Full hip range
Full hamstring flexibility
No back muscle spasm
Pain free return to powerlifting and equalling personal best lifts from over a year ago after a month back at training
Influences on the Result:
The client travelled from Toowoomba for treatment so time between sessions was longer than ideal, especially in the early phase. To account for this, he had 2×1 hour sessions the first day (with a few hours gap in between), then one hour sessions for the following 2 appointments (one week in between). The client and their partner were incredibly diligent with self-releases and nerve treatment and sometimes even came to sessions testing better than when they left the previous session due to consistent, quality self-treatment.
