57 year old male businessman and marathon runner (usually runs 30-40km/week).

Reason for coming to Barefoot Physiotherapy:

Pain in the right hip with walking. Feeling of “tightness” and “grabbing” on the outer right hip, like it is going to go into spasm.
Was out for a 10km run one week prior when his hip tightened up and pain was experienced in his hip, and referring down his leg. Gait was significantly affected and he limped home. Pain and hip “spasm” did not subside. History of other hip and knee injuries in the past which have been treated with little lasting success.
Goal= Run a half marathon in 6 months time.

Presented with:

60% neural irritation
Poor balance (5%): Unable to stand on the right leg for more than 5 seconds without loss of balance
50% range of motion of hip and lumbar spine
Tight muscles and protective guarding throughout the trunk, and entire right leg
Significantly decreased glute activation – both right and left glute activation poor
Unstable/poor functional motor control – As demonstrated through a one-legged hop and jump. Very unstable take-off and landing on the right leg. Unstable/poor control at the hip, knees and ankle


Neural interface treatment
Needling of rectus femoris, glute medius and tensor fascia latae (TFL)
Home exercise program consisting of: Glute activation exercises, self-releases of tight muscles around the hip and knees and dynamic motor control and balance work
Education regarding the effects overloading the body with exercise and little rest
Emphasis placed on importance of self-maintenance
Graded running exercise program

Outcome (6 sessions in 3 weeks):

No neural irritation
Full range of motion at the hips and lumbar spine
Returned to running multiple times/week following a modified program
No pain with walking or running
Improved balance, glute activation and functional motor control
Significantly decreased muscle tightness around the hip

Influence on the Result:

Fully committed to process and completed all homework. Client prioritised his physio appointments even with a very busy work schedule. Client took time off running to let his body recover.