196 case-presentation-msk

UCP/AL/11/196

Name- (male)

Age- 30

Occupation- Cricket player

Present complaints- Back pain while playing

Pain

location – lower lumbar area duration- 3 years

onset - gradual type - dull pain

Aggravating factors- Prolonged Standing, vigorous activities

Easing factors- Rest

Past medical history- has had back pain before and undergone physiotherapy treatment in Hong Kong. No referred pain

Family history- No

OBSERVATIONAnterior Bony contours –normalSoft tissue contours-normalASIS levels-normal

Lateral spinal curves –increased lumbar lordorsis

PosteriorBony contours –normalSoft tissue contours-normal

Symmetry- normalPSIS levels -normal

Gait -normal

PALPATION

Tender points –present at lower back area

Tight muscles- increased tone at lower back muscles (erector spinae , quadratus lumborum )

TESTS

Forward bending test : curve is remained.

Leg length test – negative

Schober’s test –lumbar ROM normal

Pelvis: Compression test Distraction test}negative

nerve tests - negative

Muscle strength – lower back area and buttock area : normal (grade 5 )

* Lumbar Spondylosis

*lower back muscle spasm

1)Infrared therapy :20 minutes,3 times a week, for 3-4 weekssuperficial heat can reduce muscle spasm and increase

the circulation which brings nutrition to the lower lumbar area and removes metabolites

2) maintain muscle strength : back strengthening and core strengthening exercises

he is a cricketer . Muscle strength and flexibility is good . Need to maintain the strength.

Back exercises- Dart exerciseCat stretch ( 3 sets 10 rep )hug knees to chest

swimming

core exercises -Gym ball exercisesswimming

Education of posture –Correct sitting position - Sit up with your back straight and your shoulders

back.

Your buttocks should touch the back of your chair.

Correct lifting position- To pick up an object that is lower than the level of your waist, keep your back straight and bend at your knees and hips. Do not bend forward at the waist with your knees straight.

best position for sleeping and lying down - Try to sleep in a position which helps you maintain the curve in your back (such as on your back with a pillow under your knees or a lumbar roll under your lower back; or on your side with your knees slightly bent). Do not sleep on your side with your knees drawn up to your chest. You may want to avoid sleeping on your stomach, especially on a saggy mattress, since this can cause back strain and can be uncomfortable for your neck.

*Lower back area muscle spasm reduced

*back pain reduced

Thank You