Table.
Date |
Signs and Symptoms |
Treatments |
Progression |
May 29, 2012 | Low back pain Radicular testicular pain Tight hip musculature (adductors, gluteus maximus, iliacus, rectus femoris) |
Manual therapies Postisometric relaxation SIJ distraction METs to gluteus maximus, medial hamstrings, piriformis, psoas |
Noted improvement ↓ Neurologic symptoms ↑ Lumbo-pelvic-hip mobility, forward bending |
June 5, 2012 | Continued pressure and numbness in buttocks SIJ had left inferior rotation, posterior upslip, right side had anterior upslip |
IASTM for gluteal muscles, prone stretching PIR to ↑ left hip flexion, extension METs to left psoas, inferior rotation Distraction to right ilium HEP to improve left hip extension |
Noted ↓ sharp pain Improved mobility |
June 14, 2012 | Pain isolated to left SIJ Continued SIJ dysfunction with 1/4 in (0.64 cm) leg-length discrepancy |
IASTM to gluteal fascia Left ilium distraction HEP progressed to ↑ flexion, flexibility in latissimus dorsi, paraspinals, quadratus lumborum |
Pain much improved ↓ Radiating testicular pain Left hip extension still restricted but inferior rotation resolved |
July 9, 2012 | ↑ Lower back pain due to work ↓ Left hip external rotation, flexion, rotation |
IASTM, PIR to improve motions METs to left psoas Left SIJ distraction HEP progressed to stretch left extensors, hip flexors, hip internal rotation and strengthen left psoas |
Minimal tingling Setback due to work |
July 26, 2012 | ↑ Pain due to prolonged sitting Left-leg discrepancy back to 1/4 in (0.64 cm) Inferior, medial rotation of left ilium |
Same treatment as 7/9/12 Kinesiology taping of SIJ Continued HEP adding left hip-abductor isometrics |
Some setback No tingling |
August 9, 2012 | Minimal pain, tingling 1/4 in (0.64 cm) Leg-length discrepancy in prone position Medial tilt, rotation of left ilium |
PIR to left hip adductors, internal rotators METs to hip abductors, external rotators Left ilium distraction |
Overall much improved Tingling accompanied by SIJ pain |
August 29, 2012 | Transient tingling in posterior left hip with certain movements (forward flexion) Left medial tilt |
Left medial tilt corrected with METs to left hip abductors | Overall improvement Released from treatment Advised to continue HEP |
Abbreviations: HEP, home exercise program; IASTM, instrument-assisted soft tissue mobilization; METs, muscle energy techniques; PIR, postisometric relaxation; SIJ, sacroiliac joint.