Effect of neuromeningeal mobilization and postural re-education exercises for persistent hamstring strain: a case report.

Abstract

Introduction: Despite appropriate interventions, healing following hamstring strain tends to be slow. Prediction for return to play is inconsistent, and recurrence of injuries is high, which poses a challenge and burden to athletes, sports physiotherapists, and trainers. The exact mechanism of hamstring strain injury or re-injury still remains unclear. The primary focus of this case report was to discuss a patient's course of treatment with relentless symptoms of hamstring strain and how he responded to neuromeningeal mobilization and postural re-education.

Case description: A 20-year-old male Arabic martial artist had a history of left hamstring strain for the past 5 weeks. He had undergone pharmacological and physiotherapeutic interventions for his clinical conditions but had not responded favorably. Further clinical assessment had ruled out hamstring syndrome. The patient refrained from all sports activities.

Intervention: The patient was treated using a modified slump mobilization technique with four repetitions for 3 consecutive days, together with postural retraining. Results of the numeric pain rating scale and Knee Society score before and after the interventions were obtained.

Results and discussion: Pre-intervention score of the numeric pain rating scale was 5/10 and 7/10 at rest and with activity, respectively. Assessment on the 3rd consecutive day of intervention, the numeric pain rating scale decreased to 2/10 and 4/10 at rest and with activity, respectively. Similarly, the pre- and post-intervention Knee Society score improved from 22 to 61 in pain and from 30 to 80 in function. At the 2-month follow-up, the patient reported a complete recovery from symptoms and resumed his sports activities without any disruption.

Conclusion: Neuromeningel mobilization and postural re-education exercises are suggested as mainstream of treatment for hamstring strains, even when the slump test is negative. This report calls for a need of advancement in diagnostic procedure dealing with all hamstring strain injury conditions. More prospective studies are recommended to confirm the current findings.