Case study report

Well, I was a slacker and didn't report as I go, so here's I've been doing the last 3 weeks.

Started working with a 70 year old male, obese, played football in college, served in the Marines in Vietnam--in summary, has had an active but physically wear-and-tear life. Had spinal stenosis; in 2006 had a L knee total replacement which was not properly rehabbed, and subsequently has developed major arthritis in the L hip as well as general deterioration from compensating for the knee. In March 2013 finally had a spinal fusion of L3-L5, widening of vertebral foramen, and rods fused to his spine. Was sent to a physical therapist for post surgery rehab, and I came in to the picture near the end of his tenure to help transition on to his own.

Main goals of physical therapy were regaining basic mobility of the spine and hip and strengthening the L hip, as the back surgery has led to further weakening on that side.

The patient has been doing 2 days per week of basic hydrotherapy (mostly just walking and light strengthening exercises) and 2-3 days per week of light gym work. The basic gym routine has included stretches for the back and hip, side lying hip abduction, calf raises, very light lat pull downs and rows, and 15 minutes each on the bike and elliptical.

This past week he had his final appointment with the physical therapist and follow up appointment with the surgeon, who both have given him the all clear. Now my main goals are to continue to strengthen the left hip, improve gait function and strength, and weight loss. I performed fitness testing on Monday and started implementing the progressed routine today.

Unfortunately, after a visit last week to his GP, he has been referred on to a urologist as his PSA had increased by almost 3 points since October 2012. He does have a family history of prostate cancer, so there is some legitimate cause for concern. So, it turns out my purely musculoskeletal patient may now become a normal patient of mine. Lucky for me he's got a condition that I know what I'm doing with.