A 44-year-old male office worker visited the clinic with pain in his left lower back. He explained that his hobby was weight training in the gym and that his back pain worsened after training and when in the sitting position. He had been living with the pain for the last five years, but in the last year the pain had intensified.
The client had received treatment based on the application of soft tissue techniques to the affected area as well as some core exercises which had temporarily eased the symptoms but not fully relieved the pain.
During our consultation and subjective history consultation, the patient told me he had suffered a bad ankle sprain seven years ago. Upon assessing his posture and his squat, I identified he had a limited range of motion in his ankle in dorsiflexion and that he had been needing to compensate the movement with his pelvis.
We applied manual therapy in the ankle, improved the foot and ankle proprioception and biomechanics and strengthened the lower leg and the result of this was the back slowly got less painful and stiff. The patient started to increase his gym routines without problems in his back.
To resolve the symptoms, using connect therapy, I needed to work firstly on the primary driver, which in this case was the ankle. Imbalance during these seven years caused the patient to compensate in the pelvis and lower back. When the ankle was getting better and the symptoms of the back were improving, I could introduce work on the secondary driver, which in this case was the pelvis and lower back, in order to help the patient to fully recover.
Of course we introduce therapeutic exercise to improve the stability and mobility of the pelvis and lumbar spine but taking into account the biomechanics of the foot at all times.