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I would like to share an inspirational story about a 38-year-old man, with asperges, that came to see me last year.

The man was referred from the GP  for bilateral knee pain which had begun to severely affect his quality of life both physically and mentally. There was no particular cause for the onset of the pain which had an insidious onset. His X-rays showed mild arthritis. He also complained of not being able to ‘feel his feet’ which he had had for a few years and always been dismissed by other professionals. He was a good stone overweight, poor muscle tone, and stooped posture ….likely reflecting what was going on inside!  His pain levels were high enough for him not to want to bother with walking anymore, he used a stick, and definitely avoided steps and stairs wherever possible. He was becoming increasingly isolated and low and came across as quite angry. He had tried conventional quads strengthening exercises and physio but that had made him worse. He was very negative and not very cooperative at the beginning of his first session with me, but his dad brought him under protest and in desperation, seriously worried about his mental health and well being.

I listened and affirmed the man’s worry, concern, pain and frustration. I suggested to him addressing the problem from a totally different perspective so he knew he was not going to go away in more pain as he had done previously. I then, as best as could, explained to him the activation approach and asked for his permission to give it a go. He grunted an, I suppose so, which I took as an OK!

I got him to just walk up and down as a baseline and see how he felt. He could not feel his feet, his knees both hurt and he did not feel good about anything.

On examination, his SLR was 45 degrees, calf-length 90-degree max (which means he had zero range of movement), and zone 1 and 2 failed, appearing to be using his feet and neck for everything.

On session 1 I just did some diaphragm release work and belly breathing with him, as best I could as he found it difficult to fully understand. His SLR improved to 65 degrees and he had a small 2/10 connection on psoas re-testing. I asked him to have a walk again and let me know how he felt this time. He walked, and kept walking! Looked at me and said ‘ i can feel my feet !’ His knees were 20% less painful also. He smiled …his dad smiled!! The journey was about to begin.

The following sessions over a period of 3-4 months we gradually built up an activation program that worked for him and his dad did it daily with him. On his last session he came in with a huge bunch of flowers and a big smile, he had just returned from a 2-week walking holiday, up and down hills with his dad, and was just off to the pub with his mates !!

I wanted to cry, I would never have believed it possible if I hadn’t seen it with my own eyes and it will remain my most inspirational story ever and hope it encourages all those reading to believe the impossible is possible.

Alison Tarleton-Hodgson  Physiotherapist