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.
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.
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.