Leading Hunter Physiotherapy since 1971

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Case Studies

The following case studies outline the different ways in which Mitchell Physiotherapy can assist you.  Some of the details in these case studies have been changed to protect the person’s identity.

 3 Year History of pelvic pain , one of our best achievements in 2014

Premenopausal female presented with pain in the ‘bladder,’ pain in the lower abdomen and pain in the area of the labia . Her pain was a disability and reported as 8/10

The pain was increased with micturition to the point that she was reducing her fluid intake and avoiding emptying her bladder. She had numerous investigations all negative, this patient was sent to us by Dr Ahmed (urology)

The end results that her pain has been completely alleviated with dry needling trigger points in Adductor Longus, Adductor Magnus, Abdominal Obliques, retraining her breathing pattern and trigger point pressure therapy on the pelvic floor. We are now training her gluteal muscles and her core. The cause if this drama for this lady was an old SIJ problem that she was trying to stabilise with her adductors and pelvic floor. This ladies life has been restored and she has returned to things she has previously given up on due to he pain.

Forearm Pain Case Study

Mrs Y, 35 year old female – Medical Receptionist

Mrs Y presented to our practice with severe pain in the right forearm. She also had pins and needles in her fingers all the time. Mrs Y could not do some of her work duties, she found it difficult to do filing and use a mouse at work.

After a thorough examination of Mrs Y’s  right upper limb, some interesting things came to light. Mrs Y, had almost completely lost the grip on the right side, she also had a problem that physiotherapists call neural tension. We also found reduced  movement, and extensive muscle tightness and muscle weakness. The muscle trigger points were associated with some of these muscles.

Mrs Y attended our practice for a total of eight treatments. Treatment included appropriate muscle strengthening, muscle stretching, neural gliding and upper back strengthening. Mrs Y was given a combination of treatment in the clinic and a home exercise program. On her last visit Mrs Y had complete resolution and was completely pain free. She was able to do all her duties at work without pain and had returned to their chosen sport of rowing.

If you would like more information on this or other case studies send an enquiry via this site.


Upper Back Pain Case Study

Miss E – Professional Horse Rider

Miss E presented to our practice with right side pain over the top of the shoulder, after training several horses.  This pain was burning and quite disabling.  Miss E was looked after by Caroline Cooper, our equestrian Physiotherapist.

Miss E was analysed using out motion capture lab and mock horse called Anky.  It was discovered that during riding Miss E was unbalanced in her riding seat, and leaned to one side. This lean caused her to overuse her upper trapezius muscle which then cramped and was painful.  This lean was caused by tightness in hip adductor muscles on one side and weakness in gluteal muscles (buttock) on one side. There was also incorrect usage of Miss E’s deep neck flexors with over use of the sternocleidomastoid as a stabilizer (not what it is supposed to do).

With exercises designed to correct the weaknesses and poor recruitment patterns Miss E was able to ride all day pain free. On re-test with our motion analysis system Miss E was straight and more well balanced.


Incontinence Case Study

Mrs M, 56 year old female – Retail Assistant

Mrs M presented to our practice with slight incontinence (leakage of urine) and urgency (leaking when you think you need to go to the toilet) particularly when she finished work.  Mrs M found she always had to rush to the bathroom and sometimes didn’t make it in time.

After assessment we found that Mrs M had an over active bladder which was not able to hold normal amounts of fluid (a fixable problem).  She also had weak pelvic floor muscles and used her abdominal muscles too much when she was trying to hold on to make it to the toilet.  Mrs M was also not drinking the right type and amounts of fluids which was aggravating the problem.

Mrs M attended our practice for 5 treatments. Treatment included lots of education about fluid and dietary requirements, pelvic floor muscle exercises, deferring techniques and pad types. She was given a home exercise program which could be completed at work also.  On her last visit Mrs M was very impressed with her bladder control and continence. She was no longer rushing to the toilet at the end of the day and no longer suffered the embarrassing problem of leakage.


Shoulder Pain Case Study

Mrs X

Mrs X presented with right shoulder pain after falling off a step a few weeks earlier.  She landed onto her outstretched hand and felt pain in her shoulder.

On examining Mrs X, it was clear that she did not have full movement of the shoulder.  She had difficulty with overhead movements, carrying objects in her hand and with dressing herself.  Her right shoulder was noticeably positioned too far to the front of the body.

Mrs X attended four physiotherapy treatment sessions.  Treatment included mobilization of the shoulder joint, taping to hold the shoulder in the correct position, strengthening exercises for the rotator cuff muscles (shoulder stabilizers) and soft tissue massage.

Mrs X had complete relief of her pain, following a combination of both hands-on treatment and home exercises.  She was now able to dress herself and perform her daily activities as normal.

If you would like more information on this or other case studies send an enquiry via this site.


Shoulder Pain Case Study

Mr D

Mr D presented to our practice with a sharp pain in his right shoulder when he lifted anything away from his body, and he had a dull ache while he rested.  He didn’t remember any specific injury to his shoulder.  He stated it gradually became worse over 3 weeks.  He works in a local mine as a fitter and stated it was getting more difficult to work without pain.

On examination Mr D had restricted movement in his shoulder and was unable to resist a gentle pressure against the arm.  Further testing highlighted an injury involving some muscles of the rotator cuff.

Mr D attended the practice a total of 10 times. Through treatment Mr. D received specific rotator cuff exercises focusing on returning correct movement in the shoulder as well as reducing his pain.  Mr. D was able to return to work with no pain and full function of the shoulder and was able to return to cricket trials as a fast-bowler.


Knee Pain Case Study

Miss L, 35 year old female

Miss L presented with pain at the front of her knee, which meant she couldn’t walk properly.  She also had reduced range of movement and swelling around her knee. This affected her ability to work at her job in childcare.

She was seen a few times and we corrected her joint pain and muscle control with a combination of McConnell taping, ultrasound, frictions, release of tight muscles, joint mobilisation, stretching and strengthening.  We used a number of different techniques including Mulligan therapy, McKenzie therapy and trigger point therapy.  Miss L was encouraged to exercise and was able to do this in our gym under supervision.

She has left our care with no pain and complete resolution of her pain. Miss L was able to do all her activities with no pain and all her work duties including crawling, running, jumping and hopping in her role with small children.


Knee Replacement Surgery Case Study

Mr T

Mr T attended our practice 1 week after receiving left knee replacement surgery.  He was using a pick up frame to walk with and had quite a bit of swelling in his knee. He wanted help returning his knee to normal and was curious which exercises he should do after surgery.

Examination revealed that Mr T had very limited  knee range of motion and that he was weak in all his leg muscles. His knee was very painful for some months before the surgery so his muscles got very weak during this period.  He still had a bandage on his knee and was seeing his surgeon again next week.

Mr T attended our practice 8 times. Treatment consisted of knee range of motion exercises, stretching of the appropriate muscles, strengthening and education about his knee operation, swelling and rehabilitation progression.  Mr T had a home exercise program that he conducted independently every day.  Once his wound healed and he had permission from his surgeon, we took Mr T to our hydrotherapy pool and demonstrated some easy exercises for strengthening his knee and improving his gait.  Mr T now continues hydrotherapy independently and has returned to walking his grandchildren to school without the use of an aid.


Lower Back Pain Case Study

Mr J

Mr J attended our practice with severe lower back pain with shooting pain down his right leg.  He mentioned that all he did was bend down to pat the dog and the pain shot across his back and down his leg.  He was not able to go to work that day due to the discomfort.  He stated that he had back pain in the past but not as bad as this.

After examination of Mr J’s back we discovered that the pain down his leg was due to his lower back.  He had some pins and needles in his foot that increased with certain movements of his back.  Mr J had weakness in his right leg due to his pain and was very limited in bending forward.

Mr J attended our practice for a total of 6 treatments.  Treatment included mobilization of the spine, traction, strengthening of the core and education regarding proper posture.  A home exercise program was provided which included simple strengthening and movement exercise. Mr J was able to feel the difference in his back and was 80% better by his third treatment session.  He was able to return to work in 3 days and is currently a participant in our fit to function class that focuses on core control and strengthening.


Ankle Sprain Case Study

Miss H

Miss H attended our practice after she had rolled her left ankle at her basketball semi-final the day before. She stated she jumped for the ball and landed on her team-mate’s foot causing her ankle to roll sharply.  Miss H has done an injury like this before and knows to ice it, however it was a lot more swollen compared to last time.

After examination, we discovered that she had sprained 2 ligaments in her ankle with no signs of a fracture.  She had a large bruise along her foot and severe swelling around her ankle.  She had limited range in her ankle and was finding it difficult to walk.  Her calf strength was limited due to her pain.

Treatment consisted of range of motion exercises and swelling reduction with ice, elevation, ultrasound and compression.  Miss H purchased a set of crutches to rest her foot for a couple of days.  After 48 hours we commenced Miss H on a strengthening and balance exercise program.  We used  stretchy Thera-Band for these exercises.  Her swelling reduced in a week and she had only limited discomfort when walking within 2 weeks.  After 6 weeks, Miss H was strong enough to return to her new indoor basketball competition.  She was taught special taping techniques and ankle exercises to help keep her ankles strong as she continued to dominate her opposition.

If you are a patient or a physiotherapist and would like further information about any of these case studies please make an enquiry via our enquiry box on this website.