Date: 21/04/2021

Hours: 6

Total hours: 52

This session was an online appointment for a 34-year-old male with a complaint of pain in the back of the right leg at the hamstring. Upon assessment, the client described the pain of being at the muscle belly of the right mid hamstring muscle. The client injured the hamstring after sprinting during a training session for his local football club and describes the pain as a dull ache and a weakness in the muscle. They have been resting the injury for the last 2 weeks however they have not found any improvements. They have found that the pain increases when certain movements such as twisting or crouching. There was no swelling or bruising present at the injury site or at the knee.

During the subjective assessment, the client was assessed on social and family history and was asked about their diet and drinking habits where they described their diet and sleeping pattern as good and consumed alcohol 2-3 times a week however only have 1 glass of wine or a few beers. The client is currently a university student in sports coaching, meaning that they are frequently moving and doing a variety of different sports. This could also mean that they have been seated for long periods for online lectures and studying. There may also be some stress factors to consider with this.

For their objective assessment, the client was asked to move the camera so that the lower extremity could be assessed. From here, the lumbar active flexion and extension were assessed however there was no pain present. Functional movements were also assessed, this involved lunges where there was no pain in the left or right leg after 3-4 reps. The lumbar flexion towards the toes was also tested where there was no pain and full ROM.

The clinical impression of this client’s injury was a grade 1a hamstring strain. The client was then offered a face-to-face session the next week.

The treatment provided was a glute bridge, heel slides, RDL’s and the Asklings hamstring protocol including the diver, extender, and slider exercises for 8-12 reps, 3 sets.

The plan for the next weeks session is to be gym based after completing an objective assessment of the injury including AROM, PROM, palpations, functional testing and neurological examination. The exercises planned were as follows:

Warm up:

Treadmill- walking to a jog – 10 mins.

 

Prone hamstring curls – banded – 8-12 reps, 3 sets.

Lateral band walks – 8-12 reps, 2-3 sets.

Lunges – weighted – 8-12 reps, 2-3 sets.

RDL’s – weighted – 8-12 reps, 2-3 sets.

Deadlift – Weighted/single leg – 8-12 reps, 2-3 sets.

Askling’s protocol – 8-12 reps, 2-3 sets.

 

Proprioception:

Single leg stance – Diver – Utilise flat and unstable surface.

Kneeling on Bosu Ball.

 

Cool down:

Hamstring/quad stretching

Core stabilisation:

Bird dog