Karen came to the clinic suffering from long-standing back pain and stiffness in both her hips and thighs. Here, our Sports Therapist Hannah talks us through her case…

4-5 minute read

The Patient

Karen, a 65-year-old retired nurse, came to the clinic with lower back pain and stiffness which had been causing her problems for over a year. She had been looking forward to her retirement but now…

• She was struggling to walk her dog

• The pain was affecting her quality time with her friends and family

• She couldn’t comfortably carry out daily tasks like cooking and cleaning

• She was beginning to get depressed, worried that things might never improve 

Karen had been seeing another practitioner for around 12 months and felt she was making no progress. 

Our one-hour assessment really allowed me to drill down into Karen’s problem. In many cases, especially with older clients, the answer can be to do less, not more. Karen told us that:

• She had 15 different exercises to do from her previous practitioner

• She was never asked for progress reports 

• She’d had scans done on her spine which had worried her

There was a lot of tenderness in the muscles and joints around her lower back and hips too.

We managed to rule out any serious causes of lower back pain with our assessment, so it looked as though the source of Karen’s pain was simply stiff and achy joints and muscles. But why had it persisted for so long? We discussed the imaging report with Karen and reassured her that the changes on her scan were normal for her age - and in many cases people have these changes with no pain whatsoever.

Once we had reassured Karen that moving her arthritic spine would not lead to more damage, we took a closer look at her rehab programme.

Starting Treatment with Arthritis

Our job is very simple in some ways; treating almost every complaint can be broken down into the same two stages: calming it down and building it up. 

Phase 1: Calm It Down

I suspected Karen’s existing exercise programme was too strenuous, so the first thing I did was to reduce her exercise programme by two-thirds. I gave her just 5 exercises instead of 15. This means:

• We can focus on quality rather than quantity

• If the pain is indeed being worsened by overtraining, this reduction will help

Karen came back weekly for a few weeks - this allowed me to check in with her, use some massage and stretching techniques to keep everything supple, and tweak her exercises if necessary. After just one week, she’d seen improvement - the first in over a year. By week 3, she was ready for the next stage…

Phase 2: Build It Up

By now, Karen had grown confident in performing her rehab. Crucially, she had seen enough sustained improvement that she started to believe she’d get better! Now it was time to build up her back and hips so she could really start to enjoy moving again.

Knowing when to progress exercises can sometimes be tricky, but Karen made it easy. She told me that she didn’t feel like they were doing much any more! The increases were gradual, and at Karen’s own pace, but those small increments soon added up. 8 weeks might sound like a long time before you start treatment, but after a year of pain and worry, but for Karen it seems like just yesterday.

The Story So Far

We are now 8 weeks into Karen’s treatment and she is able to walk her dog for as long as she likes and continue with her day-to-day activities without feeling stiff or achy in the evening. There is still progress to be made, but Karen is now finally starting to enjoy her well-earned retirement.

If this all sounds a bit simple, it wasn’t all smooth sailing! Some exercises worked better than others for Karen. However when we experienced a problem, like a pinching feeling in the groin or too much strain being felt in the lower back, we were able to make small changes or substitute different exercises. In some cases even this proved useful as it showed Karen that there is always a solution to any obstacle.

Karen’s pain levels are much improved for now, and she has the confidence to manage her own progress, with occasional support from us.

So what did we do differently to turn Karen’s fortunes around?

There were 3 main problems that needed addressing for Karen:

• She was worried that her spine was damaged and that moving might make that worse

• She’d been given too many exercises and this was exacerbating, not helping, her problem

• She didn’t feel heard and had felt unable to discuss progress - or lack of it - with her previous practitioner

Once we were able to address Karen’s anxieties about her spine and give her adequate support with the right exercise programme, she was quickly able to get moving again. 

Karen's case highlights the importance of finding the right practitioner for you. If you feel like you are stuck and could do with changing things up, I’m offering 10% off for new Sports Therapy patients this month with the code SPRING2024 - book online now to get your healing journey started.