Wednesday, March 2, 2011

Case Study: Shin Splints

I wanted to take a moment and discuss the re-hab work I done with a 22 year old gaelic football player with shin splints.

Patrick Ward put up some brilliant Case Studies on his blog a while back, so I decided that I liked his "style" so much that I what copied him!!

1st Session:

I used the SFMA:

Cervical Spine: DN
Upper Extremity Patterns DN

I also look at ALSR from the FMS, which was a 1 on both. So it was DN.

Maunal Treatment:

I performed Muscle Energy techniques to the Upper Traps, scalenes, sternocleidomastoid, and Levator Scaplua.

Corrective Exercise:

MSE x3:

Mobility: Muscle Energy Technique for Hip Flexors, and also hamstrings because of ASLR finding (Big Emphasis on Belly Breathing).
Static Stability:: Leg Lowering x8
Integrated Stability: 1 Leg Glute x8 (Very big focus on belly breathing, and short foot posture)
Pattern: 1 Arm 1 Leg KB SLDL x5

Client was asked to perform:

Hip Flexor AIS, Leg Lowering & 1 Leg Glute Bridge at home for MSE.

2nd Session:

Huge improvement in ASLR and MSE, and cervical spine had remained FN since first session.

Upper Extremites and MSR havent made any improvement so a corrective strategy was put together to address that.

MSR x3:

Mobility: Rib Roll x5 (with oral and facial drivers, and big focus on breathing)
Static Stabilty: Reach Roll Lift x5 (big focus on belly breathing at the end range)
Integrated Stability: 1 Arm 1 Leg KB SLDL x5 (Focus on packed shoulder.
Pattern: TRX Row x5 (Slow eccentric)

Client was now ask to also perfrom the following at home.

And Rib Roll, and Reach Roll Lift for MSR.

Session 3:

Cervical Spine: FN
Upper Extremity Patterns FN

ASLR and MSE had unreal improvements. ASLR was now a comfortable 3, and ASIS's easily were in front of the hips.

Upper Extremity patterns where now FN, and MSR was also FN.

Clients Over Squat was almost FN but arms were still a little too far forward. His over head squat had made a huge improvement though.

Unfortunelately I didnt get a chance to FMS before the client as he was in a rush, as was I. Sorry guys, I know!

As for his shin splints, the client was playing a lot of football at the time, and didnt remove this "negative" during his rehab. His said his shins were "way better", and were not bothering him as much anymore.

I told him to take a break from football for 3 weeks, and maintain his improvements with the corrective strategies that he had been doing at home. If his does this then all pain should be removed.

Stay Strong,



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  2. Robbie would you say that it is typical for such improvements in assessment scores to be made in such a short space of time? Do you feel this is due to major progress being made or the athlete learning the exercises / being more familiar with them?