Female alpine skier on professional level came to the clinic with problems in her right and left thighs. Symptoms were burning, loss of strength and cramping on the anteromedial side. She has not been able to train correctly nor compete. Her training and skiing only worsens the symptoms. A lot of specialists and physios had previously tried to help her without any luck. No pathology and tests for lactic acid were negative at all times tested. Problems have been present for several years and it now looks like she has to put her career. (Case from 2012).
Our examination revealed decrease ROM in hip extension, reduced strength in flexion and motions in all directions of the lumbar spine. As she goes down into the alpine skier position, the symptoms start after 20 seconds. Palpation examination of the femoral nerve between the psoas and iliacus reproduced her symptoms on both sides.
We started to treat ligaments and core muscles of the lumbar spine with ART to increase the motions L1 to L5. Then we treated her psoas and iliacus before retesting. The skier position took now 1 min. to reproduce symptoms. We continued treatment by increasing the gliding potential of the femoral nerve between the psoas and iliacus. From there we continued down the tract and worked also on the gliding potential by the inguinal ligament and distal parts of iliacus/psoas. Proper gliding and stretching exercises were introduced and the trainer was informed on what to focus on.
Symptoms were no longer a problem after 3 to 4 visits. She could train properly again. We continued to work together for some time (performance/prevention). When she did her comeback at the X-games in Aspen, she took home the silver medal.