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As promised the update on the patient with testicular pain:

Main complaint: Sharp pain left testicle, with swelling, right testicle elevated since his hydrocele op. and pain in the op. scar.

In the assessment I found pain across the low back and testicle. Also pain (sharp) over the scar area, following his operation for his hydrocele. Lumbar spine: good flexion and sideflexion, extension = 1/2 ROM, rotation of the spine was 3/4 ROM + pain across the low back. Neuro: normal SLR, positive L3 stretch left. No other neur. signs. Shortening of bilateral iliopsoas and left rectus femoris. I did not find any evidence of troublesome zones (CTM) over his back.

The treatment consisted of teaching him how to mobilise the scar, stretches for iliopsoas and r. femoris, mobilisations and mobilising and stretching exercises.

His scar pain had settled well, his low back pain has gone. Still pain in his left testicle, but less and his right testicle remains elevated.

Curiously enough I had another patient who came for low back pain radiating to his left leg and testicle, also with very tight iliopsoas, bilateral and rectus femoris. Following stretches (had to think of Henry Tsao, where has he gone to?), mobilisations and exercises he is now virtually painfree!

 

Bernadette