SPORTS MASSAGE SCENARIO

SCENARIO: A 34 year old male, elite race walker attends clinic complaining of pain in his left knee just below the kneecap.

BACKGROUND: He had been training for an upcoming major competition (50km walk) and had just completed a particularly heavy training week involving mileage of around 90 miles on the open roads. This was then followed immediately by a 20km track race, which he com- pleted but stated that he felt “poor” from the start. He was fine after the race but noticed that the next day his knee had a “tweak- ing” pain on full extension and had a rubbing sensation on the out- side of his knee.

He attended a therapist (qualifications unknown) associated with his athletics club for a month, receiving treatment once a week that consisted of electrotherapy but no soft tissue work. This eased the symptoms somewhat, and he was able to walk at a slower pace than normal for up to half an hour. He was able to maintain fitness by running, swimming and cycling, which caused him no pain.

GENERAL HEALTH: Excellent, very fit, no known allergies, no history of recurrent injuries.

PAST MEDICAL HISTORY: None

MEDICATION: None

ASSESSMENT: Observation and movement Stiff left base of his lumbar spine in right side flexion. A hyperextending left knee, not on right. Decreased medi- al rotation of his left hip. Restricted/tight left rectus femoris, hip flexors and ITB.

OVER TO YOU.... 1. What are the sport specific problems associated with this activity? 2. Are there any contra-indications to treatment? 3. What would be your suggested treatment plan? 4. Are there any other considerations?

Palpation Tension around the left base of his lumbar spine and piriformis, congested quadriceps and ITB.

IN THE NEXT ISSUE....

We will pitch the same questions at a our multidisciplinary scenario panel which includes medics, osteopaths, physiotherapists, sports rehabilitators, strength and conditioning coaches, biomechanics specialists, physiologists and psychologists. Their comments will be published in issue 9 as well as on www.sportex.net along with....

Contributions from readers With your approval we will also print the best of your suggestions in the next issue, so jump online at www.sportex.net and fill out the form for this scenario which will be page 2 of the online PDF version of this article or email editor@sportex.net with your sug- gestions making sure to include the words ‘Race Walker Scenario - Iss 8’ in the subject line. You can also submit this form as CPD

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evidence. The contributor of the best comment, pearl of wisdom, treatment approach or most valid point as judged by the editor and two members of the scenario panel, will win a copy of Primal Pictures’ 3D Interactive Skeleton or a £10 discount to attend a future sportEX CPD workshop.

If you would like to submit a case scenario, please email this to editor@sportex.net making sure to include an outline of the sce- nario, background of the situation, details about general health, past medical history, medication and your assessment including observation, movement and palpation. Contributor’s of published scenarios will win a Primal Pictures’ 3D Anatomy: Sports Injuries of The Knee (worth £150).

www.sportex.net