• Buns C
• Sockrider A

• Achilles Tendon / injuries
• Adult
• Golf / injuries
• Male
• Open Access Document

Objective: To discuss assessment and management of a golfer with ankle pain and decreased hip mobility.

Clinical Features: A 51-year-old male had left ankle pain during golf and walking activities of 1-year duration. Previous manual therapy and self-directed ankle mobility regimen yielded short-term symptomatic relief after activity, with symptoms returning after resuming golf or walking activities. During his typical golf season, symptoms increase in intensity and frequency, then decreased similarly during the off-season when treated focusing on ankle mobility and myofascial release techniques.

Intervention and Outcome: Initial treatment focused on manual therapy with instrument-assisted procedures and chiropractic manipulation. Therapeutic exercises to improve dorsiflexion were given to patient to perform at home. Eccentric loading of the soft tissue was added to treatment immediately after the instrumented procedures, leading to elimination of symptoms except for off-season golf swing activities. Next season, symptoms returned and continued to increase like previous episodes. Activity modification of current golf swing focused on stabilization of lead foot. Symptoms again were eliminated when patient was able to focus on this change. Treatment for increasing internal rotation of lead hip helped to make the new golf motion achievable more frequently. This led to elimination of symptoms, in season, when the patient performed exercises for increasing hip mobility.

Conclusion: This case discusses an athlete with activity-specific ankle pain and dysfunction not responding to local interventions long term. Selective functional movement assessment identified a mobility dysfunction at the lead hip, which requires almost full rotational range of motion in a golf swing. Treatment focused on the hip improved symptoms in-season and long term.

Author keywords: Chiropractic; Achilles Tendinosis; Manual Therapy; Golf; Movement Assessment; Regional Interdependence; Mobility Dysfunction

This abstract is reproduced with the permission of the publisher. Click on the above link for free full text.