Case study: treatment of lumbar back pain of a female volleyball player practising volleyball at the professional level at the BKS BOSTIK zgo Bielsko-Biała Club

Characteristics of the athlete

• Age: 26 years
• Height: 185 cm
• Weight: 74 kg
• Pitch position: centre

Description of the injury

After one of her gym workouts, the athlete began to report complaints of lumbar pain. Concerned about the feeling of ‘currents’ in the lumbar region, she reported her distinctive complaints to the team physiotherapist. The symptoms also extended to the right lower limb. After the first intervention and a reduction in her discomfort, the athlete decided to take part in indoor training. The next day, however, the pain reappeared and, despite the lack of peripheral sensation to the lower limb, the current was nagging. The physiotherapist decided on a medical consultation after speaking to the athlete.

Functional limitations of the athlete prior to treatment

• Pain occurred during normal functioning in daily life – 7/8 on the VAS scale
• Jumping and running caused pain of 9/10 on the VAS scale

Diagnostic examination

Postural defect, lowering of the shoulder and right scapula, slight left-sided curvature in the thoracic region with rotation to the left, painful rotation to the left, painful hyperextension, equal lower limbs, normal knee axis, contracture of the hip and lumbar muscles, adductors especially on the right side and contracture of the gluteal muscles especially on the left side. No changes in the X-ray image taken immediately after the consultation. Additional diagnostic MRI also showed no significant lumbar lesions.

Treatment and rehabilitation

Pharmacological treatment included Ketonal fast (ad hoc) and Neurovit.

Treatments performed: TECARIS

Additional rehabilitation treatments

Therapeutic massage of the lumbar region and gluteal muscles:

• Manual therapy in the area of the iliopsoas muscle
• Chiropractic
• Dry needling of the multifidus muscle in the lumbar region
• Pinotherapy
• Foam rolling
• Stretching of the adductors, iliopsoas muscles, quadriceps, glutes, and piriformis muscle
• Stretching and strengthening exercises for the gluteal muscles
• Central stabilisation exercises
• Self-mobilization exercises for the thoracic spine
• Kinesiotaping
• Acupressure mat

Therapy results

The lumbar discomfort subsided approximately two weeks after the initial pain incident. The volleyball player took part in training despite her injury. She reduced the load during strength training and slightly limited the number of jumps during indoor sessions. She took pain medication on an as-needed basis twice and only on game days.

Player feedback

“This is my first season that has been so intense at the club level. Together with the team, we are competing in national league games as well as international cup competitions. During this period, where we play matches almost every three days, we are forced to stay within a specific microcycle. Unfortunately, there is very little time for rest, especially when we are traveling.  Fortunately, after consulting with the staff, we managed to find a way to overcome my injury. Recently, ASTAR provided us with a tecar therapy device, which we have been using very frequently.  I must admit, I really like this type of therapy because of the pleasant warmth I feel during the treatment. I am already feeling much better, but I am aware that I cannot neglect my exercises and regular visits to our physiotherapist’s office, as the injury could return at any time.”

Conclusions

Overload problems in the lumbar region are a common issue that many volleyball players face throughout the season. Although many athletes have developed their own ways of dealing with this condition, not everyone can manage such overloads without the intervention of a physiotherapist or doctor. Fortunately, there are many therapeutic options available for these types of ailments. However, it is important to take care to prevent the issues from returning. Tecar therapy is a proven method, recognized by many sports physiotherapists, that supports the rehabilitation of the common “low back pain.”