Patient stories

Ladies European Tour golfer with pain in the front of both knees

This elite golfer was referred to me via a strength and conditioning colleague with a 3-month history of pain to the front of both knees having not suffered with knee pain previously. Unfortunately it was caused but an increase in weight lifting in the gym.

On our assessment, she had pain to both kneecaps on deep squatting tasks and struggled to control rotation in single-leg tasks at her hip and feet. Using taping strategies and adjusting the technique in her gym exercises as well as providing additional exercises to start controlling rotation at her hip and feet, we made early progress with her pain.

She’s not competing on tour without any pain.

18-year old England golfer with lead wrist pain

This elite-amateur golfer came to me with wrist pain having had a change in the volume of her practice sessions.

On assessing, she was weaker on her lead grip strength and wrist strength compared to the right and had pain on touching the big tendon on the outer part of her wrist.

We made changes to her practice, taped her wrist when hitting balls, spoke to her swing coach about some swing changes to offload the wrist, and started a strength program for her wrist and forearm alongside her strength coach.

It took a while but this patient is now playing at college in America pain-free after 3 months of on/off treatment.

Lead knee pain in a 39 year old 4-handicap male golfer

This golfer came to me having tweaked his technique with his coach which emphasised a lot more knee bend in his lead knee on impact. In my experience, a change in technique is one of the biggest risk factors for new injuries because it usually combines with an increase in practice volumes as well.

On assessing his knee movement and strength, I diagnosed a left patella tendon injury in this golfer’s knee which is unusual in golfers but did fit with the history of onset. We started a strength program in the gym which concentrated on stimulating change in the patella tendon, but also improving the force production in other areas of his body including the trunk and hips muscles.

In 2 months this golfer was hitting the ball pain-free and with more speed on his irons and driver but using the same swing technique.

63-year old 14-handicap club golfer with trail golfer’s elbow pain

1 year history of right inside elbow pain after a driving range session. Has managed it since, but increases with playing.

On assessment he had better than average grip strength interestingly but was weaker than expected around his shoulder, and stiff in his mid-back.

We put an exercise program in place for him to work on these areas as well as hands-on treatment to the forearm. He was pain-free playing golf in 3 months.

66-year old 1-handicap club golfer with lead outside hip pain

He felt sudden pain at impact when playing golf in Portugal on holiday. He saw a hip specialist who after an MRI diagnosed a gluteal tendon injury. On testing, the golfer was limited in their mid-spine rotation as well as external rotation of their lead hip by 15˚ . On strength testing he had a 10kg reduction in strength on his lead hip compared to his trail hip.

Based on these finding, we devised a strength and mobility exercise program that the patient did outside of our sessions. In session we did some hands-on treatment consisting of soft tissue massage as well as spinal mobilisations.

Within 2 more sessions, the patient was playing pain-free and back to his next golfing holiday!

68 year old female golfer with ‘tennis’ and ‘golfers’ elbow

A very common injury for golfers due to the wrist use throughout the swing. This is most commonly caused by golfers change their equipment, technique or increase their volume of golf played. This patient started to play a lot more golf, and her technique meant she had a lot of wrist movement leading to impact in her swing.

Pain started in the outside and inside of her lead elbow. It came on gradually and was fairly simple to diagnose after taking her history and doing some strength tests in our first session. She was quite weak in her grip strength testing too, and very stiff in her spine turn which meant she compensated with excessive wrist movements in her swing.

We put a strength and mobility exercise program in place to rectify the above deficits. We also used taping techniques which helped, and some hands-on treatment to release the soft tissue surrounding the area. I consulted her swing coach for help making some swing adjustments to take work away from her wrists.

After 3-4 weeks we started to have very nice pain reduction and by 6 weeks from the our initial appointment, she was pain-free playing golf and tennis.

45-year old 9-handicap club golfer with lead groin pain

He started playing golf in covid, and in his lessons the swing coach noticed a large amount of lead knee drifting inwards in his backswing. He started to feel left groin pain at impact which would build through his round. It would be very stiff in the morning.

On assessment, he lacked 20 degrees of rotation on his lead hip compared to his trail hip. He also lacked 10degrees of rotation through his with mid-spine on the lead side as well. He was painful on compression testing through the lead hip, and it was much harder on strength testing compared to his trail hip.

We started a strength and mobility exercise program to improve his movement in his lead hip and mid-spine as well as strength his hip to cope better with the forces of the golf swing

He was pain-free with golf withing 8 weeks of starting his program.

55-year old 1-handicap club golfer with right side bum pain

He had sudden pain 3 months previously on the 18th after 3 consecutive days of golf. Long walks and from downswing to impact were his biggest aggravators. His strength scores on testing were significantly lower on the right side compared to his left. This was possibly caused by a right-sided lower back injury 10 years previously. His hip mobility was very good.

We started a strengthening program which he completed 3x a week aiming to build his strength scores to be able to cope with the forces of the golf swing better.

Within 2 months he was playing pain-free and strength scores had returned to normal.

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.

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.

This patient recovered from her neck pain in 4-6 weeks of starting treatment.

27-year old male golfer (24 HCP), right-sided rib pain

4-month history of right rib pain. He was new to golf, and very commonly started to go to the driving range 4x a week as well as playing 18 holes and carrying his bag. All of which was brand new to his body. He had most pain using his longer and more powerful clubs, with coughing and sneezing, and rest made his symptoms better. He had limited rotation of his mid-spine on assessment which induced his pain. Pressing the attachment of his 6th and 7th rib to the mid-spine was the most painful.

We started a gradual mobility and strength program for his thoracic spine, trunk, hip and shoulder blade muscles, as well as some hands-on treatment to reduce his pain including joint mobilisations, soft tissue massage and taping. We spoke to his swing coach to look at anything in his swing that could be adding to compression or over-stretching in the area.

We managed to return him to playing pain-free in 8 weeks, which is a typical recovery time.

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.

76 year old male, following right knee replacement surgery

I’ve helped many patients after right knee replacement. It’s a common surgery and generally patients do really well afterwards.

This patient had been struggling with his right knee for 1 year. He was very limited with his day-day tasks and not really going out of his house. I assessed him for the first time 1 week after the operation and he was walking well with crutches. He was a little sore around the surgical site and restricted in his knee movement.

We started a movement and strength exercises for him to do at home, and in weekly sessions with did lots of hands-on treatment like joint mobilisations and massage.

Making the exercises harder over time, the patient is now 1 month after the operation and pain-free walking as well as back to his normal life at home with no restrictions.

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.

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.

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!

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.

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.

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.

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