Pernille Thomsen from Denmark feedbacks on a case review
At the age of 11 years old, ‘G’ was one of the best swimmers in her year and showing the potential to do something special; but her patellofemoral pain was real issue. How could we turn potential into gold?
This case study is presented by Pernille Thomsen, assistant professor, and physiotherapist who illustrates the benefits of the movement management system, The Performance Matrix which sits at the heart of TPM Pro business solution. Here Pernille, describes the use of a multi-joint, multi intensity, cognitive testing protocol and the retraining it inspired.
When I tested ‘G’, it was very clear she struggled with bilateral hip medial rotation control, inefficient inner range hold into hip extension and rotation control issues of the low back pelvis. She also showed an excess of range of motion into low back extension, and a bilateral restriction of rectus femoris. Additionally, as is often common with young, talented athletes, she was showing signs of stress due to a huge training load.
I started working by targeting gluteus medius, employing an inner range hold approach to improve this muscle’s recruitment efficiency, aiding its control qualities. The first exercise was just standing, feet on the floor, producing lateral rotation of the hips. When performance of this retraining strategy improved, we progressed to partial range squats, focussing on knee and second toe alignment. We also targeted the glutes to address the low back extension control issue and added reciprocal inhibition work to manage the myofascial restrictions of the two joint hip flexors.
During the Spring I saw her 4 more times, progressing her exercises and adding factors such as perturbation which I consider an effective method to simulate working in water. At this point of the programme all exercises were focussed on ensuring she remained a robust, stable structure, in order to limit the effects of drag.
Gold, silver, bronze
At the Danish Championships in June, 2015 we got to see the results of all her hard effort, both in and out of the pool; 5 gold medals, 2 silver and 1 bronze.
With this success in the bag we are now focusing on performance, improving endurance and movement efficiency in the water. Six months and five golds later, pain is not the limiter on potential as her movement and performance become ever more streamlined. The work continues, guided by the analysis of The Performance Matrix, targeting the deficits and fixing those blocks on realising potential.