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Case studies

Patient stories

Golf Physiotherapy

29 year old Ladies European Tour and Ladies PGA Tour player with neck pain

This multiple winning tour player came to see me for help with on-going right sided neck and shoulder blade pain. It had been on and off for the last year but well managed with exercise. Unfortunately she’d had an acute flare of her symptoms playing in Cape Town the week before having slept on a different bed. It started to give her pain at the impact part of the swing.

On assessment, she was limited due to pain through neck rotation to the left mainly, and was subsequently stiffer on measuring her mid-back rotation to the left. Strength measurements of her shoulder showed a reduction on the right hand side compared to the left, potentially contributing to more demand through the neck on turning.

On palpation, she was very sore into the right side of her upper and lower neck joints as well as shoulder blade musculature. We did some hands-on treatment and taping to these areas which gave relief on re-testing. We started a tailored exercise routine working on shoulder, shoulder blade and neck strength. We discussed further input from swing and strength and conditioning colleagues to cement these physiological changes for long-term resolution of her pain.

So far, this patient has reported a significant reduction in her symptoms.

Physiotherapy

13 year old footballer / hockey player and cricketer with Osgood-Schlatter to both knees

This patient’s front knee pain started with basketball 2 months before our first session. He’d seen a knee specialist and MRI had confirmed Osgood-Schlatter to both of his knees with significant inflammation to the growth plate of his upper shin bone.

It’s a very common injury in sporty adolescents who are still growing and going through puberty. We established a balance between how much/ type of sports he played as well as volume/ frequency and how his pain reacted. This is very important to gauge this balance, otherwise the pain doesn’t improve.
We started a strengthening program around his ankles, hips and knees specific to his sporting demands, which the patient did consistently. Taping his knees helped a lot to manage his pain levels day-day and during sport. We also did soft tissue release techniques to help reduce the tone of the big muscles groups around his hip, knee and ankle.

Recovery can take months with this injury, but does always improve as long as it’s managed appropriately.

We were able to build up this patient’s strength levels to cope with sporting movements, and he was back to all sports pain-free in 4 months.

Golf Physiotherapy

28-year old male professional golfer on DP world tour, thumb and wrist pain

Left thumb and wrist pain for over a year having hit more off matts whilst practicing in the Winter. He’d only had injection therapy leading up to our first appointment.

We tested his wrist and grip strength using hand-held dynamometry to give us objective numbers to work towards. He was 20-30% weaker on his injured wrist and thumb. Having liaised with his swing coach/ S&C coach and the medical team on the DP World Tour, we made a plan as a team and started a thorough rehabilitation program for him as well as using taping, dry needling and manual therapy to accelerate his progress.

He was back in Q-school hitting balls pain-free within 3 months of us beginning treatment.

Golf Physiotherapy

34-year old female golfer (11 HCP), elbow fracture

Left forearm bone fracture. I saw her 2 weeks after the fracture whilst she was still in the sling. We started very basic movement and strength exercises initially to accelerate the tissue healing alongside hands-on treatment. Once the 6-week bone healing process had finished, we were able to plan and progress her movement and strengthening targets with day-day demands and eventually the golf swing in mind. We progressed her rehabilitation using strength measurements to check her tolerance.

She returned to golf in 3 months and is still playing pain-free!

Physiotherapy

38-year old runner with knee pain

2 weeks history of swelling and pain to the front of her left knee having increased her running frequency over the last 2 months. The patient was limping into the appointment. She had obvious swelling around her knee cap and pain with squatting on assessment. She was under-powered on assessment through her calf, knee and hip muscles on testing. We started with taping and hands-on treatment to settle her acute pain which had immediate effect. We tailored a graded exercise program for her to do at home 2-3x per week. We met weekly for 4 weeks progressing the difficulty of the exercise and building back to running tolerance.

She was back running with no pain in 4 weeks.

Golf Physiotherapy

62-year old male golfer (17 HCP), lower back pain

3-month history of lower back pain. Had had a lower back operation 3 years ago with sciatica. Main pain playing golf with pain into his lower back and left bum cheek. After a taking a thorough history of his injury, and assessing his movement and strength capabilities in our first appointment, it was obvious this golfer had some spinal and hip movement restrictions due to pain as well as strength deficits around his hips and pelvis. I corresponded with his swing coach who sent me videos of his swing. We made some swing adjustments together to offset the demand through the lower back. This immediately helped his pain so he could return to a modified amount of golf initially. We constructed a strength and movement rehabilitation exercise program which he did diligently a few times a week. Alongside this, we used hands-on treatment techniques in session to reduce his pain.

He would return to full golf with no pain in 2-months.

Physiotherapy

68-year old tennis player with shoulder pain

3-month history of right shoulder pain whilst playing tennis, particularly with serving and his backhands. The cause was likely due to a slight change in grip on his racquet placing more demand on his shoulder to produce force. We changed his grip back, and adjusted the volume/ type of shots he could play whilst still allowing some aspect of tennis. We identified strength deficits in the shoulder using handheld dynamometry and built an exercise program based on these deficits. We used hands-on treatment in session to improve movement restrictions. For clarity of diagnosis we organised an Ultrasound scan with a colleague and discussed injection therapy as an option to accelerate his progress.

SIn the end he didn’t need this and managed ot get back to tennis pain-free in 4-months.