History:  An offensive lineman comes to the clinic complaini…

Questions

Histоry:  An оffensive linemаn cоmes to the clinic complаining of low bаck pain.  He reports having several similar episodes over the past year but cannot recall a specific mechanism of injury.  He tells you that he just has a “bad back” and gets pain frequently.  Physical Exam Findings: OBSERVATION: excessive L/S lordosis PALPATION: You notice asymmetric muscle tone in the paraspinals.  You also locate several trigger points in quadratus lumborum on the right and the paraspinals on the left. SPINE AROM: Complains of pain with L/S flexion at a certain point in the motion but then it goes away.  On the way back up, he complains of pain and has a (+) Gower’s sign.  He reports low back discomfort with extension.  Sidebending is not painful.  All motions appear to be full.  SPECIAL TESTS: (+) prone instability test, (-) standing flexion test, (-) Laslett cluster; Spring testing over L4-L5 segments elicit pain and muscle guarding (spasm) of the erector spinae.   Answer the following: 1) Which treatment classification would you use and why?  2) Describe your treatment approach 

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