Case Studies

57 year old lawyer -

23-November-2007

57 year old lawyer with no significant medical history. Very irritable and highly strung, probably because he is extremely busy. Very good physical condition with excellent muscle tone. Treated him 18months ago for mild neck and shoulder problems - 2 sessions needed.

Carried suitcase for long period whilst on business in London—sudden sharp pain donw from left pelvic area lateral, down into quadriceps. Caused severe limp, loss of sleep, difficulty rising from a chair and constant pain.

The great temptation was to consider this to be an obvious case of disc bulge, stimulated by carrying a heavy weight for long period. I immediately suggested an MRI scan but we had had three treatments by the time this took place. The 3 treatments to a very stiff spine, with L5 nearly totally immobile, had no effect. –except that he became very bad tempered and even more irritable with me!! The MRI was clear!!—no spinal problem. So I examined—again—the hip joints to find both stiffer than I had at first thought—but then found the real cause of the pain. The left gluteus medius and minimus were both in contracture. I worked deep into the muscles and this pressure produced the symptoms he had been experiencing. The next session was easier as he was in much less pain and more amenable. I then started hip joint mobilisation of both hips and continued with the deep muscle work until all the contracture was gone.

Gluteus medius is a common problem especially for runners which he did reveal during our sessions that he did each day after work. This is probably the origin of the contracture. He is a heavy man and has tight hips along with short adductors. The adductors are muscles in opposition to the gluteus medius especially—and they are a great deal stronger and thus , it is my belief, if they become contractured as they do on most runners then the gluts will have to work too hard to overcome the resistance of the adductors. So this patient has been ordered to do splits to counter the adductor shortening—he wont do anything else!!