Introduction
This case study is about a fifty-three year old male plumber. He is a volleyball player who has a pain on the right anterior of his knee, during and post activity. On observation around the injured area the right patella is higher than the right and both feet over pronate, on quick touch it is slightly warmer on injured side. It could be a chronic injury because it has bothered the client on and off for the last two months, in terms of previous injuries the client had an ankle inversion sprain nine months ago that was never rehabilitated which could play significance to the injury. On active movements and isometric testing the quadriceps and the rectus femoris flagged up negative when being tested due to pain. All of the above including signs and symptoms will be assessed in greater detail in relevance to what the injury could be.
S.I.N
Severity
This is based on the seriousness of an injury and is a measure of the client's perceptions of their symptoms; rating is scored on a scale from 1-10. 1-3 low, 4-6 moderate and 7-10 high, it also helps you determine what to do next, like having to refer them. In this particular case study, the client has 7/10 in the first pain (p1) and 3/10 the second pain (P2) on the visual analogue scale (VAS). P1 is a severe pain, where p2 is more of a dull ache. In his current situation he noticed the pain straight away after recovering from illness, it has been on and off but present condition is not improving. Primarily the pain transpired irregularly but now it is post activity. The problem is at the right patella from the top to the tibial tuberosity region.
Irritability
This relates to the amount of activity done to aggravate a client's symptoms, the scale of it and time taken for...
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...nd peroneal longus during the landing phase. This means that due to the surrounding muscles being weak the ankle is not fully stabilised which makes it vulnerable to injury again. The client did not receive any rehab therefore the surrounding muscles are not strong and reoccurrence of the injury may happen.
Conclusion
Both injuries, upon assessment indicates the client more than likely has patella femoral syndrome. The reason for this is even though patellar tendinopathy is very common injury in jumping sports, taking into consideration is the previous injury, this is a major reason in the assessment because the feet pronate the knee compensates, then in turn the knee behaves in ways it should not such as quadriceps pulling on the patella which will result in it rubbing on the femur over a long period. An MRI scan will confirm or deny this on further investigation.
Background. Dorrence Darling II, at eighteen years old student who broke his right leg playing college football. Darling II was taken to the emergency room at Charleston Community Memorial Hospital for medical attention and treatment. Charleston Community Memeorial Hospital was a “rural, fifty-bed hospital in downstate Illinois” (Weit, p.399). Dr. John R. Alexander, the emergency room physician, treated Dorrence by applying traction and placing his leg in a cast. Shortly after the cast dried, “Dorrence began experiencing pain in his toes, which became swollen and discolored and later cold and insensitive. On several occasions thereafter, Alexander made slight modifications to the cast including
The most common knee injury in sports is damage to the anterior cruciate ligament (ACL) through tears or sprains. “They occur in high demand sports that involve planting and cutting, jumping with a poor landing, and stopping immediately or changing directions” (University of Colorado Hospital). The ACL is a ligament that runs diagonally in the middle of the knee and found at the front of the patellar bone. Its function involves controlling the back and forth motion of the knee, preventing the tibia from sliding out in front of the femur, and providing rational stability to the knee. Interestingly, women are more prone to ACL injuries than men. The occurrence is four to six times greater in female athletes.
If the injury is lower down in the foot you might not be able to see any signs.
Once school was out last year, I had done something to my foot. I don’t know what happened to it, but I know a general time frame it happened in. At first, I thought it was just my foot getting used to the new summer conditioning. After about three weeks, the pain had moved towards my achilles tendon. Once that happened, I only had pain when I pointed my toes, or pushed through my toes. The pain was to a point where my coach was noticing a change in tumbling, so she had me go to a doctor to make sure everything was
whether or not the client is experiencing more or less impairment compared to peers, or whether
After the injury has occurred, the injured should see the family doctor or possibly a specialist to see if something is torn. The doctor will do some range of motion testing. Theses test are the Lachman, Dynamic extension and the pivot jerk.
DOI: 4/24/2013. This is a case of a 59-year-old female customer service representative who sustained injury to her left ankle when she got up after her foot “fell asleep”. As per OMNI notes, patient underwent ligament reconstruction with Brostrom repair on 1/16/2014 and left knee arthroscopy on 10/8/2014. As per office notes dated 6/21/16, the patient returns for interval followup visit. The patient has been working more and is explaining to me that she is having exacerbation of symptoms. The patient admits to increasing neuropathic pain secondary to complex regional pain syndrome. It was mention that the patient has been on Topamax and tramadol which allow the patient to get some improvement. She admits 40% improvement in the pain and she also
Injuries to the Anterior Cruciate Ligament (ACL) are one of the most frequent and devastating knee injuries that occur during sporting activities, accounting for one fifth of all sport related knee injuries ¹ ². Injury estimates have been reported in current literature to be between 1.5% - 1.7% per year within a healthy athletic population ³ ⁴. However, incidence rates for ACL injury prove difficult to access as not all individuals with ACL injuries seek medical attention ⁵. Current trends show a direct correlation between the rising incidence of ACL injury and increased sporting participation ⁶. In spite of increasing incidence rates, ACL injuries remain fairly uncommonly in relation to the amount of individuals participating in sporting activities ⁷ ⁸. Nevertheless, they still prove to be a frequent source of disability for those individuals affected ⁷ ⁸. Individuals affected with ACL injury may suffer from a number of adverse effects including dynamic knee instability, altered movement patterns, reduced functional performance and debilitating pain ⁷⁻¹⁰.
Usually the onset of OSD is gradual with minimal intermittent pain that progresses to continuous and more severe in the acute phase (Kaya). Pain is intensified with physical activity that entails jumping, kneeling or running (Kaya). OSD is diagnosed first through a physical examination where swelling over the tibial tuberosity and tenderness to palpitation is typically found (Kaya). Radiography may be used to show if calcification or thickening of the patellar tendon, soft tissue swelling and the fragmentation or irregular ossification at the tibial tubercles has occurred (Chang). However, radiographic changes are not always present in the early stage as the tibial tuberosity is predominately cartilaginous (Hirano). MRI technology can be used to demonstrate soft tissue swelling anterior to the tibial tuberosity, edema of the inferior patella tendon, and/or infrapatellar bursitis, which are the most significant diagnostic criteria of OSD (Chang). In the majority of OSD cases, symptoms usually diminish within 2 years of onset with excellent long-term prognosis (Kaya). In patients presenting with chronic cases of OSD complications such as genu recurvatum, patella alta or fragmentation of the ossicles may cause the long-term outcome to decline and progress to early onset osteoarthritis
attention. The Athletic Trainer will tell you to get the injury checked out by going to the hospital and
When an athlete catches the sound of their knee crack and pop, they better prepare themselves for a long journey. The Center for Injury and Policy (CIRP), from Science Daily, reports that, “Knees are the most accident prone part of the body in high school athletes.” Knee injuries are very common; in fact, they are responsible for 45% of the injuries that occur in high school athletics across America. Knee injuries are well known to not just those in the medical field, but also to athletes. Injuries to the knee are caused by many factors, and what happens after the injury has taken place is what’s most concerning (Science Daily).
“Doc, I fell and twisted my knee. I heard a pop. It hurt briefly. When I stood up, the knee felt as if it was not underneath me, and the knee gave way. It swelled up by the next day and ever since feels as though it would pop out when I twist or even cross the street quickly.” In almost all cases the above complaints occur due to an injury to the ACL (Anterior Crucial Ligament) of the knee. The ACL is a very important ligament in the knee that controls the pivoting motion of the knee. This joint guides the femur and tibia through a regular range of motion. It is the most common and serious of injury sustained to the knee (Duffy, f9). How this injury happens, who is most susceptible, and how it is treated are a few questions athletes are becoming heavily concerned with.
The patient will identify discomfort and rate his pain on a scale and rate of the pain will be assessed consistently, as appropriate.
...tein, G. and Stubhaug, A. (2008). Assessment of pain. British Journal of Anaesthesia. 101 (1), pp 17-24.
"Sports Injuries Rehabilitation - Cedars-Sinai." Sports Injuries Rehabilitation - Cedars-Sinai. Cedars-sinai.edu, 2014. Web. 08 May 2014.