This golfer presented with very frutstrating dystonia that developed post shouder surgery in pro-supination movement. The main treatment component was motor control training.
Starting point was “what is possible without dystonia?”. High speed pro-supination motion and highly loaded pro-supination motion were free of tremor.
The problem only occurred in slow, unloaded movements so this determined the baseline for the start of neuromuscular control training.
Goal: To decrease the speed and the load during pro-supination motion free of dystonia. The exercise program consisted of varying pro-supination exercises with the minimal speed that allowed fluent motion and minimal load with which the pro-supination motion was free of tremor. Gradually speed and load were decreased until he was able to control slow and unloaded motion. Besides this, he trained to restore remaining post-surgical deficits like decreased external rotation range of motion and strength. He successfully recovered and is now back to competition.