CASE STUDY: CASE STUDY - The Performance Matrix

Introduction to the Patient

Patient A, a 49-year-old desk-based worker, presented with ongoing neck and low back pain associated with prolonged sitting. Symptoms included stiffness, reduced movement, and poor sleep quality.

Investigations

Assessment focused on clinical examination and movement analysis using The Performance Matrix.

Why The Performance Matrix (TPM)

TPM was selected to objectively assess movement quality, identify key restrictions, and guide a structured, progressive rehabilitation program.

Subjective & Objective Key Findings

Subjective findings:

• Neck and low back stiffness 
• Poor sleep quality 
• Symptoms aggravated by prolonged sitting 

Objective findings:

• Postural imbalances
• Reduced spinal mobility 
• Tightness in upper trapezius, lumbar spine and right shoulder

Initial TPM Assessment - Key Findings

Performance Matrix Score: 7/25

• Reduced movement coordination
• Limited shoulder and spinal mobility 
• Compensatory movement patterns 

Key Exercises Prescribed

Low Threshold:

• Oblique abdominals through range activation to control low back/pelvis rotation
• Gluteus maximus inner range hold to control low back/pelvis extension
• Semispinalis inner range hold to control neck rotation

High Threshold:

• Oblique abdominals through range resistance to control low back/pelvis rotation
• Lower trapezius static resistance in neutral to control shoulder blade winging 
• Gluteus maximus through range resistance to control low back/pelvis extension

Reassement (12 weeks)

TPM score improved to 3/25

• Improved spinal mobility 
• Reduced neck and low back symptoms 
• Improved movement control 

Progression of Program 

Progressed to Strength and Speed Matrix following improvement in coordination and movement quality. 

Final TPM score: 2/25

Conclusion

This case demonstrates the effectiveness of combining manual therapy with structured movement rehabilitation using The Performance Matrix to achieve long-term improvements in paid, posture and function. 

Patient Feedback:

"I’m very happy to share some feedback on my experience with the TPM programme.

I attended the clinic with ongoing back, shoulder, and neck pain and stiffness. After starting with sports massage, TPM was recommended and I completed several rounds, first non-fatiguing, followed by fatiguing exercises, all tailored to my assessments and adjusted as I progressed.

The structured approach and regular reassessments made a big difference. The exercises were clear, well explained, and progressively adapted, which gave me confidence throughout the process. I’m really pleased with the outcome, my pain and stiffness have resolved and I’ve now been discharged feeling strong and back to normal.

Thank you to the team at Wimbledon Physiotherapy Clinic for such a positive experience. I would happily recommend the TPM programme."