Date: 09/11/ 2020

Hours: 3

Total hours: 22

This session was an online consultation with a 56-year-old male client who had complaints of pain in the proximal hamstring and some hip pain.  They described the pain as a dull ache at the centre of the hip bone and radiates around the thigh.

The client first experienced this pain in April after running and then sprinting up a hill and hearing a ‘snapping’ sound before falling to the ground and fainting. The client finds that going up stairs and quickly walking brings on pain. After moving to a slower running group, he has found that just under a mile the pain began to increase.

The client is extremely active and uses running as stress relief after work as a social worker. However, he now feels as though he does not have an opportunity to relieve any stress due to his injury and is becoming frustrating for him. He had previously been taking part in a yoga class which had helped with some stress and decreased some of the pain in this hamstring and thigh, however this class had been cancelled due to the recent COVID-19 pandemic and national lockdown, with pain increasing since not being able to attend these classes.

The client overall leads a very healthy lifestyle with a good diet and does not smoke or drink. He has always had a very active lifestyle with running being a large part of his daily lifestyle.

After a series of subjective questions, an objective assessment was carried out where the client’s ROM was assessed. The clients Lx was assessed with flexion, extension, side flexion, rotation and the combined movement of extension/side flexion all presented no pain. However, in Lx side flexion there was a slight tenderness in the right-hand side with a NRS of 2/10. The hip was then assessed with extension, internal rotation, external rotation, and abduction presenting no pain. However, there was some tenderness in the right side of the posterior hip during hip flexion and adduction. The knee was also assessed due to this being an insertion point for the hamstrings, however there was no pain in either flexion or extension of either knee.

Due to the nature of the injury and the location, a clinical impression was made of a hamstring tear in grades 1-3.

The client will be provided with some exercises to complete at home before a face-to-face session the following week. During this session, further assessment will be performed with PROM, RROM, neurological testing, functional tests and palpations will be completed due to the first session being online making these forms of assessment more difficult. The rest of this session will then be completed in the gym where the client will be provided with further exercises including hamstring curls, deadlifts, and squats. These are exercises which will aim to keep the client engaged during the session as they are eager to improve.