Case Studies

Shoulder & neck pain

Client: Musician

 

Problem:

The client complained of a nagging left shoulder pain and burning pain in the back of the neck which increased during and after playing the violin. The pain was so intense other job options were being considered.  Driving was also causing pain especially when reversing and having to turn the head.

 

Assessment:

After undertaking a visual examination of posture and joint mobility I observed the following:

  • elevated left shoulder

  • an imbalance in the neck and shoulder muscles

  • both shoulders were forward (rounded) 

  • on elevation of the left arm, movement was restricted with pain in the lower left shoulder (lower Trapizus muscle)  

  • on moving the head to the right side there was discomfort

  • on palpation scar tissue was found in the shoulder and neck muscles.

 

Treatment:

The effects on certain groups of muscles used and the posture held whilst playing the violin were discussed to provide the client with an understanding of why the pain was occurring.

The following course of treatment was then undertaken:

  • deep tissue massage was applied to the muscles of the shoulder and neck to release muscle tightness and remove adhesions.

  • gentle soft tissue mobilisation (massage) to the muscles of the shoulder.

  • the trigger points causing the pain were found and treated.

  • gentle stretching exercises were given to help mobilise and strengthen the shoulder.

 

Results:

After the 1st treatment the client reported initial discomfort in his shoulder and neck, but increased mobility.  Only upon rehearsing for a concert two days later did he experience burning in the back of the neck.

 

After the 2nd and 3rd treatments the client reported the same initial discomfort, but after a couple of days the pain had gone. He found the exercises given to help relieve the tension were working well.  He still felt a burning sensation in the back of his neck after playing the violin.

We agreed that treatment would be required more frequently to reduce the build up of scar tissue in the back of the neck.

 

The client now feels that the burning sensation is bearable, and he is able to continue with his musical career.

Shin Pain

Client: Amateur Marathon runner

 

Problem:

The client complained of pain in several areas: the left and right shins, across the lower back in the knees whilst training and weakness in the ankles and upper legs,

The pain would start during running and gradually worsen. The pain would remain for at least 24hrs after training.  The client wanted to continue his hobby, but increasingly felt the pain outweighed the enjoyment.

 

Assessment:

The effects of impact on the body whilst running were discussed and how to help relieve these problems. We looked at posture, especially feet to make sure there was no over-pronation.

After undertaking a visual examination I observed the following:

  • back – tension across the lower back and in the left buttock needed releasing.

  • hamstrings - the muscles in both legs showed tightness with small adhesions.

  • knees – some scar tissue on the ligaments around the Patella (knee cap).

  • shins/ankles  -  on palpation I felt the tight Achilles and calf muscles were causing the pain and discomfort  and scar tissue on the medial tibia inside of both legs at 4 -6” from the ankles.

 

Shin splints (Medial Tibial Stress Syndrome (MTSS).

The pain associated with shin splints is a result of fatigue and trauma to the muscle's tendons where they attach themselves to the tibia. In an effort to keep the foot, ankle and lower leg stable, the muscles exert a great force on the tibia. This excessive force can result in the tendons being partially torn away from the bone.

 

Treatment:

The following course of treatment was undertaken:

  • deep tissue massage was applied to the muscles to release muscle tightness and remove adhesions.

  • soft tissue massage was applied across the shins and knee ligaments to remove the adhesions.

  • sports massage was applied to the Hamstrings and Quadriceps.

 

Results:

A couple of days after the 1st treatment the client did a 6 mile run – there was no pain in his knee, his ankles felt stronger and he felt increased endurance in his legs. There was still in the lower back and some discomfort in the shins.

 

After 2nd and 3rd treatments, when training the only pain now experienced was in the lower back, but this was decreasing. The client was surprised to feel stronger and have improved endurance when running.

 

After 4th and 5th treatment, whilst training there was still discomfort in the lower back, but a distinct improvement in leg strength.

 

After running the Wilmslow half marathon the client required treatment.

He reported that during the first 3 miles his shins were hurting due to his initial starting speed but on slowing slightly this wore off. After completing the race he experienced some pain in his lower back.

 

On palpation of the shins there was pain and a build up of scar tissue; this was removed with massage. We discussed the continuing discomfort of the lower back following a run.

 

Massage has increased the strength and endurance of the clients running. He now receives fortnightly sports massage to help keep the muscles from re-injuring and to maintain his level of running.

Achillies rupture

Client: Craig

 

Problem:

Craig ruptured his Achilles tendon in his right leg whilst playing football.  He had an operation to re-stitch the tendon together.

 

Assessment:

After undertaking a visual examination and joint mobility I observed the following:

  • A large lump (scar tissue) over the repaired area. 

  • Muscle weakness in the calf muscle and tendon.

  • Restricted movement of the ankle.

  • Discomfort of the heel caused by the wearing of a cast.

  • Loss of feeling over the ankle area

 

Treatment:

The following course of treatment was then undertaken:

  • Tissue massage was applied to the scar tissue to remove and breakdown adhesion.

  • Deep massage to the calf muscles to release muscle tightness.

  • Gentle soft tissue mobilisation to the Achilles tendon

  • Acupressure massage to the heel to relieve soreness.

 

Results:

After the 1st treatment the client reported a slight increase of mobility in the ankle. 

 

After the 2nd and 3rd treatments the client reported a further range of flexibility, less discomfort in the heel.

 

On the 4th treatment the scar tissue had been broken down and he was given exercises for rehabilitation to increase flexibility and strength.

 

On the 5th and 6th treatment the range of movement in the ankle was 90%. The strength was improving and we continued with deep tissue massage to the ankle and calf muscles.

Piriformis Syndrome

Client: Damien

 

Problem:

The client complained deep pain in his right buttock, a numbness in his lower leg and pain whilst walking.

 

Assessment:

After undertaking an examination I observed the following:

 

On palpation of the buttocks where the sciatic nerve crosses the piriformis muscle, the muscle was too tight and pain occurred.

Pain and discomfort occurred in the buttock area whilst placing the hip into an external hip rotation and abduction.

When raising the leg 25 degrees, the sacrotuberous ligament and piriformis muscle became taut because of its attachment to the ischial tuberosity and the hamstrings.

 

  • Back – tension across the lower back and in the left buttock needed releasing.

  • Hamstrings - the muscles in both legs showed tightness with small adhesions.

  • Knees – some scar tissue on the ligaments around the Patella (knee cap).

  • Shins/ankles  - on palpation I felt the tight Achilles and calf muscles were causing the pain and discomfort and scar tissue on the medial tibia inside of both legs at 4 -6” from the ankles.

 

Treatment:

The following course of treatment was undertaken:

  • Soft tissue pressure massage was applied to the Pririformis muscle.

  • Deep tissue massage was applied to the muscles to release muscle tightness and remove adhesions.

  • Soft tissue massage was applied across the shins and knee ligaments to remove the adhesions.

  • Sports massage was applied to the Hamstrings and Quadriceps.

 

Results:

After the 1st treatment the client felt he had more movement on walking with less pain.

 

After 2nd and 3rd treatments, the pain and discomfort in his buttock and back was hardly noticeable and the sensation in his lower leg was slowly improving.  His calf muscle needed a lot of deep tissue massage to release the tension and simple stretching exercises were given.

 

After 4th and 5th treatment, he had no pain or discomfort in his buttock on activity. His sensation in his lower leg was increasing with every visit. He was advised to try a short run.

 

On the 6th treatment, he reported the run went well, no pain in his buttock or back, the sensation in his leg is recovering slowly.  Continued stretching and exercises advised for prevention.

Sciatica

 

Client: Walker, hiker and office worker

 

 

Problem:

 

The Client complained of pain radiating from the lower back and pins and needles down the right side of the buttocks into the knee.  The pain varied from a mild ache to excruciating discomfort. Driving and sitting at a desk for long hours aggravated this and walking in the hills became more difficult due to pain in the buttocks and lower back. Eventually she reduced the hill walking to low level and then this became too painful.

 

Assessment:

 

On examination of the lower back and buttocks area the buttock muscles were (hyper tonic) over tight/tense. On deeper palpation of the buttocks I found the Piriformis muscle inflamed which was pressing on the sciatic nerve.

 

Treatment:

I applied deep tissue massage to relax the buttock muscles and pressure to the soft tissue on the piriformis muscle, which runs under the buttock muscles. This helps to relax the muscles, increases circulation, break up scar tissue and release the pressure on the nerve. I asked the client to regularly do buttock clenches between treatments to help relax the muscles.

 

 

Results:

After the first treatment there was reduced pain and discomfort, which lasted for a few days. Between each treatment this improved, the buttocks began to relax and tone.  After five weekly treatments the pins and needles had completely gone and just a small ache after sitting for long hours.  They felt relieved and happy they could now enjoy the activity of hill walking again. 

 

 

Groin pain

 

Client: Stephen S.   Fell runner

 

Problem:

Pain was occurring in the groin during training and the day after a running competition the groin muscles were tight and painful. Cramp and tightness occurred when stretching and severe pain when rotating the left leg to the left and flexing the left hip.

 

 

Assessment:

On resistive rotational movement and adduction of the hip, pain occurred in the adductor magnus muscle.  On palpation the adductor magnus and pectineus muscle was tender and scar tissue had formed.

 

Treatment:

Deep tissue massage and soft tissue treatment was applied to the thigh area to remove scar tissue. Resistive and static stretch was applied during massage to help strengthen and stretch the shortened adductor muscles.  Stretching exercises were advised between treatments.

After several weekly treatments there was only slight discomfort after a long run.

 

 

Results:

Range of movement had increased in the hip with a greater stretch of the adductor muscles. The pain and spasm had gone. The scar tissue in the adductor magnus and pectineus had reduced.  He was able to run without pain.

I advised regular massages and also stretching before and after running. 

Fibromyalgia

 

Client: Mrs Smith

 

Problem:

She came to me with a complaint with Fibromyalgia and was advised by the pain clinic to try massage to relieve the pain and spasms.

Fibromyalgia syndrome affects the muscle fiber and connective tissues causing chronic pain, muscle spasms and tendor spots.

Her main tendor spots are hips, buttocks, side of legs and neck .

 

Treatment:

For the first treatment I tried a gentle massage to the the areas of concern, which gave her some discomfort during the treatment.

 

Results:

The first treatment gave her a lot of relief, so we continued with the gentle massage.

She came for 5 weekly visits and the pain had reduced with less flare ups.

Web Design by Caroline Boulton

Holistic Life Sports Injury & Wellness Centre

12 The Paddock

Handforth

Wilmslow

SK9 3HQ

Tel: 07770 881876

  • Facebook Social Icon
  • Twitter Social Icon
  • Instagram Social Icon