Yesterday, I shared with you the start of our case study series for the week. We met Matt, who is an avid golfer with pain that gets worse when sitting. When trying to get an understanding of what’s going on, we need to ask the right questions.
Today it is all about trying to get more information, but this is where we step into the movement exam.
First step is to establish a baseline. At rest, what is the pain? When sitting, what is the pain intensity, location, how long does it take for the pain to come on?
We also need to look at posture. Ideally, our posture should be symmetrical. Shoulders should be stacked over the hips; eyes and nose should be facing head on at whatever thing he’s looking at. There should be a gentle curve of the spine (when looking at the side), not too straight, not too arched or rounded. It turns out that he was slightly rotated to the right (due to his eyesight, he had to turn to the right to focus).
Next is to look at the range of motion. Any time there is pain that radiates down the leg, I look at the spine first. If we skip this part, a lot gets missed.
So we look at forward bending, side bending, rotation, and back bending. Are there any limitations? Do any of these motions actually change his pain?
It turned out that back bending, and turning to the left increased the length of time he was able to handle sitting before the pain came on. This is great news, we found a movement that can change his symptoms.
Establish a baseline. Take a look at yourself. How’s your posture? Notice any asymmetries? What if you moved in one direction, how does your pain behave? Make note of the activities/stretches that make your pain better and worse.
Stay tuned tomorrow as we discuss the next steps.