Case Studies

A 55-year-old gentleman presented for a golf-specific screening to help his assess for any movement issues that could be addressed to help reduce the risk of injury. He explained to me that he played off a handicap of 15 and has experienced some ongoing lower back pain on the left-hand side. He was a right-handed golfer. The pain was intermittent and would come and go but he was more aware of it…

A 48-year-old gentleman presented to our clinic with a long history of low back pain. The pain started after lifting incident at work three years previously. Initially, he had very severe pain in his back and some pain into his right leg and he had to take time off work. He underwent a course of chiropractic and physiotherapy care, local to him, which made some small improvements however his pain remained and…

Elite middle distance runner – low energy availability and symptoms of RED-S by Cara Sloss Presentation: Female, 22 years, 1.65m, 47kg National level athlete – competing distances 1500m – 5km Moved to university in the past year Training load increased from 55miles – 70miles per week also started strength and conditioning twice a week. Has a supportive coach and this mileage increase was done gradually. Living in a shared house, previously living…

Example based on a female, 46 years, 1.70m, 62kg Club level runner, regularly competing in road, cross country and fell races (up to marathon distance) Trains with a club 2x per week and has weekly mileage of around 50 miles per week Has always thought she has a good knowledge of nutrition and fuelling for her longer races Has a chronic ankle injury which she now requires surgery on which will mean…

Disclaimer: Case study examples are highly specific to the individual, goals set may not be right for anyone else, even if the presentation sounds similar to you. Individualised nutrition assessment is key! Athlete preparing for Marathon by Cara Sloss Presentation: Male, 49yrs, 86kg, 1.86m Has ‘good for age’ place in London Marathon Works in an office and commutes 1hr each way to work Lives at home with wife and pre-school children Additional…

A 55- year old lady injured the middle of her back (thoracic spine) when she had lifted a heavy suitcase down from the garage roof to the floor. At the time she felt severe and very sharp pain in the middle of her thoracic spine. A few days later she came in for a physio assessment. She described “deep vice like constant pain” in the middle of the spine radiating around the…

This patient was late 30’s with a desk job but tried his best to keep fit with trips to the gym a couple of times a week. This was hard because of the kids and the increasing demands on his time. He knew that his back was tightening up for several months and simple things like putting his socks on were harder as he just didn’t bend well. The issue came just after…

This patient played Sunday league football and due to a limited training regime was perhaps not as conditioned as he might have been for the enthusiasm he brought to the game. It was during a sprint to try and stop the ball from going for a corner that he felt a pull in his lower tummy on the right. It was not more than a pull and he was able to finish the…

The main symptoms were Achilles pain in the morning, struggling to get to the bathroom which took about 30 minutes to settle down and loosen up. It could be sore after being on it for a period of time, However, it was running which was the biggest issue. Very stiff and sore to get going and took a good mile to free up. The patient was limping and was feeling aches in the…

The issue for this patient was not the dramatic sniper shot but a rather dull gradual build-up of tightness in the inside of the left calf muscle. This was related to playing badminton specifically but it had been troubling him whilst walking the dog as well over a few weeks. There was no specific sharp pain but a gradual weakness and ache in the calf as well as a feeling of not…

The history is of a 12-year-old female gymnast presented with a 4-week history of a painful right posterior thigh. The pain started on the run-up to a vault, towards the end of a 2-hour training session. The patient did not describe immediate pain but rather, once aggravated, a fairly rapid onset of a deep ache – sharp pain that was made worse the more running/jumping she did. Her symptoms eased after a…

History: The patient had been suffering for several years of hand, wrist and forearm pain on both sides and also some left sided shoulder pain. He is a 40-year-old professional console gamer and writer, both activities involve spending long hours either gaming or typing for various contracts. His pain had been so debilitating he had had to stop taking on new contracts for several months and decided to seek help after accepting…

In this case study, a 23-year-old male developed CRPS after an accident at work. It was a relatively simple strain of numerous tendons in the hand. As is typical with manual workers it is hard for them to take time off to rest the injury. Whilst most issues recover given time, some can develop into a chronic pain syndrome. This is a complex condition which presents in multiple ways. It can be a…

My client was a forty two year old lady who had a long history of Plantar Fasciopathy (Plantar Fasciitis as it is often referred to) and was referred to the clinic by her GP. The Plantar facia consists of layers of tough connective tissue that spans the underside of the foot from the toes to the heel and blends with the tendons on the underside of the foot. It contributes to supporting…

This is a case study of a 50 year old male who was knocked off his bike and fractured his acetabulum (the socket part of the hip). He was training for a triathlon when a car clipped his rear wheel and sent him up in the air. He landed on the pavement with the outside of the hip taking the full force of the impact. X-ray revealed that the Femoral head (ball) had…

Postural related headache or migraine in the forehead/frontal lobe of the head. A 22 year old female presented with a two month history of Migraines that come on mid-afternoon and then stay with her until she goes to sleep that same night. She had been to see her GP and was prescribed Topamax which is used to help prevent migraines in sufferers. She found this useful, but the dose that was required…

A patient came to see me complaining of chest pain when cycling. He is a 38 year old I.T. Consultant who is a very keen cyclist, particularly time trials. His usual very high level of fitness had been diminished over the previous 6 months and he described a feeling of chronic fatigue.

A 54-year-old recently retired fire fighter attended for treatment, assessment and advice regarding his long standing knee pain. In the past he had undergone multiple knee joint injections and arthroscopic (Key hole) surgery to repair torn menisci (cartilage) in both knees.

This is a case history of a 49 year old lady with a classical tennis elbow. This is a typical presentation at the practice and shows how it is important not to just look at the painful spot. There are often a number of additional problems that have to be dealt with to get a good result. Subjective Pain on the outside of the right elbow with referral to top of shoulder…

A 43 year old police officer presented in the clinic with a one week history of right shoulder pain. It is important to undertake a thorough assessment involving questions and physical tests to determine the best way to treat a problem. The patient explained that his pain started when he woke up one morning.  He had also noticed, “a strange feeling” in his middle two fingers that came and went with no…

This patient was involved in a road traffic incident in June 2012. The car hit her from behind and she was in the driver’s seat with her seat belt on. As she went to get out of the car, she pushed the door open and noticed a pain in her right shoulder. That night she had pain on undressing and could not put her hand up behind her back. Then after two…

This is the case study of a 38- year old fit and healthy gentleman, who presented with an acute onset of severe lower back pain, an extremely common injury that will affect approximately 90% of us at one stage or another in our lives. What follows is a basic account of my management, which demonstrates the importance of a thorough assessment and a close working relationship with local Specialist Surgeons to enable…

A 47-year-old lady fell whilst skiing, experiencing severe knee pain and swelling and was initially taken to a hospital.  Her knee was x-rayed and she was advised that she had not broken any bones.   On her return, she was seen by an Orthopaedic Consultant and she had an MRI scan to get a more detailed assessment of her injury.  She was found to have ruptured her anterior cruciate ligament (ACL) with a smaller injury to her medial…

History Two months ago this patient slipped whilst at work on a plastic bag. He landed on his left side and twisted his hip at the same time. This was very painful and a lot of bruising came out over the next few days. He could not put any weight on the leg, so he went to have an X-ray at A&E. They reported no fracture around the hip or pelvis. But…

Pain on the side of the hip (lateral hip pain) Gluteus medius/minimus tendinopathy A 47-year-old woman presented with right side hip pain (on outside of the hip). She got the pain with running, walking up hills, lying on the side of pain and crossing her Legs. She stated she had the pain for the last two months. She also stated that she started work in the gym four months ago with the…

This case study involves a 28 year old lady (Ms P) who had a 7 year history of right sided pain half way up her back and under the right shoulder blade.  The pain was not becoming worse or improving but she recently realised that she was fed up with it and wanted to see if anything could be done. She described 2 pains: Pain 1 was a diffuse ache, present most…

Arthritic Joints – “a bit of wear and tear” Pain from stiff and degenerative, “worn” joints, can be quite debilitating and interfere massively with your activities of daily living.

An England under 21 Basketball player sprained his left ankle in March 2012, after landing on an opponent’s foot after a jump shot. His ankle went over and it was very painful.