35 y.o. female

Medical Diagnosis: Acute Lumbar Back Strain

Mechanism of Injury: Lifting a 30 lb. trash can when handle broke and she fell backward. Next day had a limp and severe low back pain. Described the pain as a sharp stabbing pain that traveled into the right buttocks.

Aggrevating Activites: Walking, Bending forward, Sitting

Easing Activities: Pt. reports no activity that eases the pain

Medical History: Unremarkable

Pt. Goal: To return back to work full duty.

Objective Assessment
Observation: Decreased lumbar lordosis and slow transitory movements
Range of Motion: Forward Bending limited 75%, Backward Bending limited 90%, Bilateral Side Bending: limited 85%. All movements limited by pain and Forward and Backward Bending produced radicular pain into right buttock.
Strength: Hip Flexors 4/5, Quadriceps 4/5, Anterior tibialis 4+/5, Extensor hallucis longus 5/5. Poor activation of transverse abdominus and multifidus
Neurological: Unremarkable
Palpation: Tenderness to palpation of Lumbar segments L1-L5
Special Tests: Positive straight leg raise with pain in low back and radicular pain down right lower extremity at 10 degrees.

Treatment: Electrical stimulation to low back, ATM for forward bending, and Therapeutic Exercise increase activation of transverse abdominus and multifidus

Results: ATM immediately increased lumbar ROM to only being limited by 50% and reproting less pain in low back. After the second session the patient had forward bending that was only limited by 25% and back wards bending that was limited by 50%. The pt. also reported feeling better and being able to do more activity. The last visit (Session 6)patient had lumbar ROM that was within normal limits and had myotoaml strength that measured 5/5. Pt was also without any any tnederness to palpation to lumbar segments L1-L5. Pt was able to return to full duty without any problems.