Case Studies

Please find here a selection of cases we have assessed and treated. We hope this gives you a little more detail and understanding of what we do and how we do it.

Rib pain, Covid 19 / Coronavirus

Rib pain is common following coughing fits. The huge amount of coughing some experience with Covid 19 can lead to rib joint dysfunctions and persistent pain. This patient was in her 40’s and had previously been fit and well, a regular Pilates class attendee and an occasional jogger. Covid 19 knocked her flat. For several weeks she was bedridden, coughing constantly and feeling dreadful. Slowly over 4 weeks, the symptoms reduced and…

Covid 19 Corona Recovery

Each of us will recover at different paces and involve different strategies. If you have spent time in bed or hospital you will be much weaker and less fit than you were. You typically start to lose fitness after a few days of no activity so this has to be taken into consideration. You will find everyday jobs tiring as you didn’t before. Simple things like stairs or just short walks will…

Finger fracture

A rugby player fractured his ring finger whilst making a tackle. The fracture was re-aligned at Accident and Emergency and was splinted for a few weeks. When the splint was removed, he had stiffness and swelling in the finger and was unable to use his hand. He was a self-employed plumber and therefore needed to have a good strong grip. On the assessment of his hand,  it was established that the fracture…

Distal radius fracture (wrist fracture)

A 40-year-old gentleman fell off a ladder backwards onto his right wrist and fractured his distal radius. He is right-handed and works as a carpenter. After a period of immobilisation in a cast, his wrist and hand were very stiff and weak. He was unable to do his job and was concerned as he was self-employed. He presented with very limited movement in his fingers, thumb and wrist and with persistent sub-acute…

Boutonniere deformity of ring finger

This patient was in his late 20’s and presented with a right ring finger stuck in a flexed posture. He had a rugby injury 6 months ago when his finger was caught in someone’s jersey. At the time he thought it was just a sprain so he did not seek medical advice. However, over time he was unable to straighten the finger and it developed a deformity of flexion at the PIPJ…

Thumb arthritis

A 65-year-old lady presented with chronic pain at the base of her right thumb which she described as a constant dull ache and loss of power in her hand. She loves gardening and cooking, however, the pain in her thumb was increasingly interfering with her ability to use her hands. She has tried a variety of pain medication which has not had much effect. She saw her GP and after investigations (x-ray),…

Coronavirus, Ribs and Breathing

Ribs and Breathing If you are recovering from illness or struggling with breathlessness, or even fear, anxiety or panic, learning some simple breathing techniques can really help. It is essential to keep good lung function and breathing patterns to ventilate all the lung to reduce infection by mobilising and clearing the whole of the lung of fluids. Your lungs sit within the protective cage of your ribs, with the diaphragm – the…

Foot Stress Fracture in a Runner

Running involves a lot of aches and pains and it is hard to work out what to be worried about and what not to be. However, the dreaded ache at rest, in a bony area, such as the foot is when alarm bells go off. This club runner, ‘Jess’, had been running well for a few months with nothing more than a bit of soreness on the inside of her left shin…

Shoulder surgery, a personal view

I am Mark Buckingham, one of the Physiotherapists at WPB, and on the 1st April 2019, I had surgery on my left shoulder. The shoulder had been troublesome for over a year, with pain on lifting and overhead work such as gym, throwing or hedge cutting. There was no incident or trauma, just a build-up. Like all of us, I initially ignored it, but then it became more painful, especially after gym…

Golfer’s back pain screening

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…

Persistent low back pain

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…

Low energy / RED-S

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…

Nutrition through injury

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 have 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…

Marathon Nutrition

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 his wife and pre-school children…

Osteoporosis & Fracture

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 a 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…

Bad back and sciatica

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…

Hernia in a footballer

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…

Runner’s Achilles Tendon

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…

Calf muscle tear

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…

Gymnast’s Hamstring

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, she suffered a fairly rapid onset of a deep ache and sharp pain that was made worse the more running/jumping she did. Her symptoms eased after…

Keyboard Wrist Pain

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…

Chronic Pain – Case Study

In this case study, a 23-year-old male developed Chronic Regional Pain Syndrome (CRPS) after an accident at work. (it can be called Complex regional Pain Syndrome as well.) It started as 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…

Heel Pain – Case Study

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…

Cycling – Fractured hip

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. An x-ray revealed that the Femoral head (ball) had…

Headache or Migraine

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…

Chest and throat pain

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.

Total Knee Replacement

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.

Tennis Elbow – Case Study

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…

Shoulder – Case Study

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…

Neck Pain / Whip-lash

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…

Low Back Pain – a nasty one

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…

Knee injury after skiing

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…

Hip Pain

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…

Hip Pain – lateral tendon

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 the 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…

Back, rib & shoulder pain

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…

Treating Arthritic Joints

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.

Ankle Sprain

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.