There’s a reason I’ve started my Biomechanics webpage with “Biomeh…what?”

Here’s a recent case study to help you understand what the power of unlocking your biomechanics can do to improve performance at any level or just day to day function. Also, how a little commitment and determination to see change can have a huge effect very quickly. It’s all quite simple really…..

There he is....look how happy he is...!

There he is….look how happy he is after just 3 weeks…!

This is Nathan….he had to pull out of his tennis league in October due to back pain above his left hip which wouldn’t go away, he was waking up in the night with the pain and activities such as driving and playing tennis were making it worse and worse. Nathan also has a physical job as a handyman doing decorating indoors, landscape gardening and large scale home improvements so this was affecting everything he needed to do day to day. He rested it tried some stretching and yoga, and got some physio to help strengthen it. After 5 months, Nathan returned to tennis still feeling a little discomfort but much improved for the rest, and was able to run 8km no problem. On returning to tennis, the pain also came back and his lovely Coach Karen recommended he came and saw me to try to get to the root cause.

SI Joint, a small amount of movement should occur between the sacrum and iliac crest of the pelvis

SI Joint, a small amount of movement should occur between the sacrum and iliac crest of the pelvis

On the first assessment, we found that the joint where his sacrum and pelvis sit together had become jammed up and wasn’t moving, in order to lift his knee (to walk, run, climb stairs) he had to hitch his left hip up rather than the subtle rotating motion allowed at a fully functional SI joint. Watch this illustration to see how the pelvis rotates through gait.

This could have been putting extra workload on the muscles used to hitch the hip up. Look at where it says DS, this is a test for movement at the SacroIlliac Joint, there was also overactivity of his hip flexors on the opposite side and some asymmetry in glute and piriformis activity. The muscles marked as QL (Quadratus Lumborum) were both overactive causing a breaking system on both sides of his spine, this meant that when he leant over to the side, all the movement came from his upper back and none from his lower back…this is a common response, when muscles are over worked, they can spasm or hold in a shortened position to restrict movement at a joint to “protect it.”

Initial Assessment Results From 15/3/2016- Green circles highlight areas of joint or nerve dysfunction

Initial Assessment Results From 15/3/2016- Green circles highlight areas of joint or nerve dysfunction

I set Nathan his homework of 3 release exercises around his pelvis and one for his lower back which he did religiously for 9 days (apart from couple of days travelling to and from Cardiff where he took a cricket ball and rolled on that instead!) Because of his practical job, he found it hard to sit and do them throughout the day so took a little extra time at breakfast and to unwind at the end of the day doing them at home. Ignore the markings higher up, we come back to these later on, just like with your car, it makes more sense to level your axels than to keep replacing a balding tyre.

The results were impressive, the day I assessed him and went through one set of the exercises, he went to tennis training that evening and said he already felt a freer in movement. But here are the results of assessment number 2…just 9 days on, he had unlocked the SIJ on the left side with a few muscles on the left still restricting hip rotation and extension.

Assessment 2 on 23/3/2016- released SIJ on left hand side

I adapted his exercises to continue the focus on releasing the right hand side and gave him some conditioning work to get his glutes firing up again, restricted muscles need to be reawakened so he used a resistance band at home and some bodyweight exercises just 2-3 times a week. I also added in some mobility exercises to focus on releasing his back-I also gave him a little “helping hand” with some massage work to assist the right hand side!  This time, I rebooked him for 2 weeks, to give him a chance to get into a routine of doing the conditioning work and because he was managing to stay motivated doing them!

So here’s the impressive part…and all credit to Nathan for sticking to his exercises day in day out for the 2 weeks…..

His lower back had completely freed up and there was now movement down the whole length of his spine. The green circle here indicates some asymmetry in rotation, he is restricted twisting one way…so we have introduced some mobility exercises for his upper back and given him all the previous ones as maintenance to do on a regular basis and as part of preparing for and recovering after playing tennis, running or a heavy day at work. I’ve also set him the release work for the shoulders which can influence rotation, lung capacity, how much power he can get in a shot and once the spine is moving freely, we will check and rebuild core strength to help him maintain his alignment. Working the core hard when there is asymmetry can “pattern in” these dysfunctions and leave you prone to injury, it can also create compensatory movements and in the end, strains and pulls to the muscles that are overworked.

Assessment 3 8/4/16

Assessment 3 on  8/4/2016

So that’s the biomechanics process explained; screen everything (make no assumptions as to where the pain could be coming from) release everything, then protect your new symmetry by building strength in the right places, learn to move properly again and add in the functional movements relevant to your sport. It’s not an overnight fix, it’s a journey of discovery, an investment of time, money and effort, but the results last far longer and benefit everyone from the bodybuilder trying to achieve symmetry and activate their sleepy glutes to the Dad or Grandad who needs to get down on the floor to play Lego.

 

Massage therapy alone can be fantastic for fascial release but pinpointing the place to treat all comes down to sound biomechanical screening so get in touch! Nathan has been out running and back on the tennis court, what do you need to get back to doing?