Case Study: Sarah Lister

Sarah presented with posterior shoulder pain symptoms and nerve impingement brought on by her working posture, and pressure from carrying a rucksack loading over tight sensitive neuromuscular structures.

She was experiencing pain into the front of the right hip due to tightness imbalance of the right psoas muscle (deep hip flexor) and inner range gluteal weakness – the muscles that control and support the hip and pelvis when the hip moves into extension.

Sarah is also a runner and has increased her distance to Ultra Level. She started to experience pain over the lateral left hip and thigh into the knee, and occasional anterior shin pain with occasional pain into the first and second toe. 

On examination, I discovered a movement dysfunction of the lumbar spine at L4/5, which was evident in combined movements into flexion with left rotation and extension with right side flexion. As a likely compensation of this, there was significant tightness over the left paraspinal muscles along with over-activity through the left piriformis muscle.

These tight muscular structures through the left side were likely causing some compression to the sensitive nerve root structures of the L4 nerve root.

I needed to optimise mobility at the lumbar spine to stop the muscles to the side of the spine and into the posterior hip from compensating.

This required hands-on soft tissue release, acupuncture (to assist in release of tight soft tissues), and strength and conditioning to optimise full strength and flexibility over all the muscles through the lower back, pelvis and hips.

After persistently following an exercise plan, Sarah has seen a real improvement. Whilst she still experiences some symptoms when running, the pain is no longer going into her toes or lower leg. This is an indication that things are heading in the right direction. Ongoing reassessment and treatment will ensure that Sarah's issues will be resolved.

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