Case Study: Lucas
15-year old Lucas, a right-handed, high performance golfer presents to the Brad Brewer Golf Academy due to a reduction of his ball distance after impact. As stated by Lucas’s mother, he recently went through growth spurts, which was accompanied by a decrease in his lower body flexibility. Upon observation of Lucas’s swing pattern during his lesson with Brad, it was apparent that Lucas demonstrated an inability to adequately separate upper body rotation, accompanied by a decrease in torso-pelvic separation.
Functional assessment – to determine if there are any muscular imbalances, of Lucas’s flexibility revealed he was unable to perform a standing toe touch, exhibits decreased external rotation on his right leg, was unable to perform a modified Gaenslen’s test, nor perform a sitting squat and, lastly, displayed Achilles tendon medial sway on the left.
Failure to perform a standing toe touch indicates tight hamstrings and Lucas’s right hamstrings were tighter then his left hamstrings. This indicates a posterior inferior rotation of the pelvis, which leads to decreased fluid motion in the pelvis, contributing to his lack of torso-pelvic separation. Also contributing to the lack of torso-pelvic separation is his lack of external rotation on his right leg.
There are many muscles that contribute to external rotation of the hip, the gluteus minims and gluteus medius are the bigger two and the piriformis.
Without external rotation of the hip, Lucas is unable to stabilize his pelvis during the back swing.
Modified Gaenslen’s test was conducted with Lucas lying on his back. He was instructed to bring his right knee up to his chest while keeping his other leg flat on the table. Failure to keep the opposite leg on the table is indicative of tight Quadriceps and tight iliopsoas muscles. This was observed to be more pronounced on Lucas’s left leg. Over-contraction of the Iliopsoas will cause an exaggerated lordosis of the lumbar spine and over-contraction of the quadriceps will cause an anterior inferior rotation of the pelvis. This will decrease the ability of Lucas to rotate counterclockwise through his left hip and pelvis during impact.
The Anterior Tibialis muscle is responsible for controlling a sitting squat (when moving into a full squat with heels in contact with the ground). The inability to perform this indicates a weak Anterior Tibialis. The left Anterior Tibialis muscle works to roll the left foot and move the left knee simultaneously, which initiates Lucas’s downswing. Lucas’s medial Achilles tendon sway indicates the loss of the arch in his left foot. Also reducing Lucas’s ability to roll his left foot out and initiate his left knee movement.
Lucas’s inflexibility coupled with decreased joint motion reduces the ability for him to reach his optimal distance after impact. Proprioceptive Neuromuscular Facilitation (PNF) stretching was performed on Lucas. PNF stretching is performed to increase range of motion and promote flexibility. Increased range of motion and flexibility makes for better bio-mechanics, reduces fatigue and helps prevent overuse injuries. PNF stretches coupled with chiropractic manipulation will allow Lucas to increase his flexibility, improve his joint motion, improve his upper body rotation and increase his torso-pelvic separation, thus increasing his ball distance after impact.
To contact Dr. Matt Ort to schedule an appointment, call the Academy at 407.996.3306, or his cell, 407. 739.6337 or email firstname.lastname@example.org
For more on PNF visit: www.stretching-exercises-guide.com/pnf-stretching.html
Dr. Matt Ort graduated cum laude from Palmer College of Chiropractic’s Florida Campus. His undergraduate studies at Nazareth College in Rochester, New York focused on biology with a concentration in pre-medical. He was a member of Nazareth’s Men’s Lacrosse team earning a National Championship appearance in 2004.
While attending Palmer he was instrumental in developing their sports council which provided chiropractic treatment to participants at athletic events. In 2008 Dr. Ort traveled to Kona, Hawaii as an essential member of the medical staff selected to provide treatment before, during and after, to the athletes competing in the Kona Ironman World Championship.
The following summer he traveled to India offering chiropractic treatment; 9,000 Hyderabad natives were treated by the 48 member team. Dr. Ort was a chiropractic physician for the Central Florida Kraze, a local PDL soccer team whose players received treatment on location and continued their care in the office.
Lacrosse continues to fuel Dr. Ort’s passion. He is the head varsity boy’s lacrosse coach at Olympia High School. When he is not in the office or on the Lacrosse field, you can find Dr. Ort working on his golf game at the Academy!