Pub Date : 2024-07-25DOI: 10.2519/josptcases.2024.11791
Steven Labate, Guang-Ting Cong, Albert Lin
{"title":"270° Glenoid Labral Tear and Posterior Capsule Rupture in a Collegiate Athlete","authors":"Steven Labate, Guang-Ting Cong, Albert Lin","doi":"10.2519/josptcases.2024.11791","DOIUrl":"https://doi.org/10.2519/josptcases.2024.11791","url":null,"abstract":"","PeriodicalId":73565,"journal":{"name":"JOSPT cases","volume":"52 36","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141804907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-25DOI: 10.2519/josptcases.2024.12030
Andrew Johnson, Chad Cherny, E. Grigoriou
{"title":"Lumbar Spine Fractures in a 14-Year-Old with Lateral Hip Pain","authors":"Andrew Johnson, Chad Cherny, E. Grigoriou","doi":"10.2519/josptcases.2024.12030","DOIUrl":"https://doi.org/10.2519/josptcases.2024.12030","url":null,"abstract":"","PeriodicalId":73565,"journal":{"name":"JOSPT cases","volume":"50 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141805812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-05DOI: 10.2519/josptcases.2024.0011
Benjamin Davis, Craig Hensley, Jonathan Samet
{"title":"Occult radial neck fracture after a fall","authors":"Benjamin Davis, Craig Hensley, Jonathan Samet","doi":"10.2519/josptcases.2024.0011","DOIUrl":"https://doi.org/10.2519/josptcases.2024.0011","url":null,"abstract":"","PeriodicalId":73565,"journal":{"name":"JOSPT cases","volume":" 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141675149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-02DOI: 10.2519/josptcases.2024.0034
Mohammad Jamali, Kevin McEnroy, Logan W. Gaudette, Zafeer Baber, Ryan J. Stoddard
BACKGROUND: A plethora of treatment approaches are used to manage persistent pain, disability, and fear associated with restricted knee range of motion following knee surgery. We used the pain and disability driver model (PDDM) and exposure in vivo (EIV) concepts to manage pain-related fear and disability. CASE PRESENTATION: A 68-year-old male who underwent arthroscopic partial meniscectomy presented to physical therapy with a medical diagnosis of Complex Regional Pain Syndrome Type I (CRPS-I) and knee range of motion restriction. Despite extensive medical care and physical therapy for three years (202 visits) he continued to experience debilitating knee pain and demonstrated a high level of fear. To ambulate, he wore a knee brace and used a trekking pole. OUTCOME AND FOLLOW UP: Interventions to address the knee stiffness included combined tibiofemoral joint mobilization and high velocity low amplitude thrust manipulation (HVLAT) targeting tibial internal rotation and low load long duration sustained capsular stretching using total end range time (TERT) principle for extension. His fear was managed using techniques inspired by in vivo exposure concepts. Total knee range of motion improved 110 degrees and the patient was able to ambulate for 30 minutes (0.5 mile) without an assistive device with <2/10 pain intensity. DISCUSSION: Outside-the-box clinical reasoning suggested poor outcomes with previous interventions were likely due to hypervigilance and pain-related fear. This case delineates the value of non-reductionist clinical reasoning in diagnosis and management of musculoskeletal conditions. It also outlines how the exposure in vivo approach helped the patient overcome his long-established avoidance behaviors.
{"title":"Diagnosis and Management of Knee Arthrofibrosis and Associated Pain-Related Fear Using Multidimensional Clinical Reasoning and Exposure In Vivo Concept: A Case Report","authors":"Mohammad Jamali, Kevin McEnroy, Logan W. Gaudette, Zafeer Baber, Ryan J. Stoddard","doi":"10.2519/josptcases.2024.0034","DOIUrl":"https://doi.org/10.2519/josptcases.2024.0034","url":null,"abstract":"BACKGROUND: A plethora of treatment approaches are used to manage persistent pain, disability, and fear associated with restricted knee range of motion following knee surgery. We used the pain and disability driver model (PDDM) and exposure in vivo (EIV) concepts to manage pain-related fear and disability. CASE PRESENTATION: A 68-year-old male who underwent arthroscopic partial meniscectomy presented to physical therapy with a medical diagnosis of Complex Regional Pain Syndrome Type I (CRPS-I) and knee range of motion restriction. Despite extensive medical care and physical therapy for three years (202 visits) he continued to experience debilitating knee pain and demonstrated a high level of fear. To ambulate, he wore a knee brace and used a trekking pole. OUTCOME AND FOLLOW UP: Interventions to address the knee stiffness included combined tibiofemoral joint mobilization and high velocity low amplitude thrust manipulation (HVLAT) targeting tibial internal rotation and low load long duration sustained capsular stretching using total end range time (TERT) principle for extension. His fear was managed using techniques inspired by in vivo exposure concepts. Total knee range of motion improved 110 degrees and the patient was able to ambulate for 30 minutes (0.5 mile) without an assistive device with <2/10 pain intensity. DISCUSSION: Outside-the-box clinical reasoning suggested poor outcomes with previous interventions were likely due to hypervigilance and pain-related fear. This case delineates the value of non-reductionist clinical reasoning in diagnosis and management of musculoskeletal conditions. It also outlines how the exposure in vivo approach helped the patient overcome his long-established avoidance behaviors.","PeriodicalId":73565,"journal":{"name":"JOSPT cases","volume":"27 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141685248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-02DOI: 10.2519/josptcases.2024.0052
Felipe Ponce-Fuentes, Iván Cuyul-Vásquez, Juan Carranza, Enrique Lluch, Joaquín Calatayud, J. Casaña, Chad Cook, Filip Struyf
BACKGROUND AND PURPOSE: Rotator cuff tears are commonly addressed through arthroscopic surgical intervention and postoperative rehabilitation exercises. The addition of postoperative Blood Flow Restriction Therapy (BFRT) in patients with arthroscopic rotator cuff repair has not been described in the literature. The purpose of this case report was to describe the use of BFRT in the postoperative rehabilitation of a patient with arthroscopic rotator cuff repair. CASE PRESENTATION: A 54-year-old male with an arthroscopically treated full-thickness rotator cuff tear completed a 12-week postoperative rehabilitation included low-intensity resistance exercises with BFRT. Assessment was performed at baseline, six weeks, twelve weeks, and at six months follow-up. At baseline, the patient presented with a reduction in shoulder muscle thickness, strength and active range of motion, and reported shoulder pain and limited physical function. OUTCOME AND FOLLOW-UP: At the 12th week of postoperative physical therapy discharge, the patient showed clinically significant improvements in biceps brachii muscle thickness, abduction and external rotation strength and range of motion of the shoulder, movement-evoked pain, and physical function. DISCUSSION: The addition of BFRT to postoperative rehabilitation exercises may be a valuable therapeutic strategy in arthroscopically treated rotator cuff tears. Randomized clinical trials are needed to evaluate the efficacy of BFRT in patients with arthroscopic rotator cuff repairs.
{"title":"Early Rehabilitation with Blood Flow Restriction Therapy Following Arthroscopic Rotator Cuff Repair: A Case Report","authors":"Felipe Ponce-Fuentes, Iván Cuyul-Vásquez, Juan Carranza, Enrique Lluch, Joaquín Calatayud, J. Casaña, Chad Cook, Filip Struyf","doi":"10.2519/josptcases.2024.0052","DOIUrl":"https://doi.org/10.2519/josptcases.2024.0052","url":null,"abstract":"BACKGROUND AND PURPOSE: Rotator cuff tears are commonly addressed through arthroscopic surgical intervention and postoperative rehabilitation exercises. The addition of postoperative Blood Flow Restriction Therapy (BFRT) in patients with arthroscopic rotator cuff repair has not been described in the literature. The purpose of this case report was to describe the use of BFRT in the postoperative rehabilitation of a patient with arthroscopic rotator cuff repair. CASE PRESENTATION: A 54-year-old male with an arthroscopically treated full-thickness rotator cuff tear completed a 12-week postoperative rehabilitation included low-intensity resistance exercises with BFRT. Assessment was performed at baseline, six weeks, twelve weeks, and at six months follow-up. At baseline, the patient presented with a reduction in shoulder muscle thickness, strength and active range of motion, and reported shoulder pain and limited physical function. OUTCOME AND FOLLOW-UP: At the 12th week of postoperative physical therapy discharge, the patient showed clinically significant improvements in biceps brachii muscle thickness, abduction and external rotation strength and range of motion of the shoulder, movement-evoked pain, and physical function. DISCUSSION: The addition of BFRT to postoperative rehabilitation exercises may be a valuable therapeutic strategy in arthroscopically treated rotator cuff tears. Randomized clinical trials are needed to evaluate the efficacy of BFRT in patients with arthroscopic rotator cuff repairs.","PeriodicalId":73565,"journal":{"name":"JOSPT cases","volume":"7 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141687669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-02DOI: 10.2519/josptcases.2024.0007
Eldon Graham, Michael Johnson, Christopher K Wong
BACKGROUND: Cremaster Muscle Strain (CMS) is an uncommon condition characterized by persistent testicular pain without clinical guidelines for conservative care. This case demonstrated how an applied anatomical analysis influenced the framework of care after which the patient had reduced pain and returned to running. CASE PRESENTATION: The 32-year-old man had 16-years of unremitting CMS that began during high school cross country training. His 5-8/10 intensity pain, aggravated by sexual or physical activity, limited his ability to sit for work >30 minutes or run. Manual therapy to mobilize anatomic structures potentially affecting cremaster muscle function was followed by graded return to running. OUTCOME AND FOLLOW-UP: After 5 sessions, pain intensity had decreased to 0.5/10 at worst, hip flexibility and strength impairments had resolved, and he had returned to running without increased pain. His Chronic Prostatitis Symptom Index score improved from 19/45 to 8/45. DISCUSSION: Anatomical analysis and the organized care framework led to sequenced treatment starting with body structures affecting the cremaster including mobilization of spinal and peripheral joints, and myofascial structures; followed by exercise and neuromotor training. Despite his condition’s chronicity, treatment culminated in return-to-running. This case informs the differential diagnosis of lumbo-pelvic-hip problems because concurrent CMS may be under-reported.
{"title":"Return to Running After Manual Therapy for Chronic 16-year Cremaster Muscle Strain: A Case Study","authors":"Eldon Graham, Michael Johnson, Christopher K Wong","doi":"10.2519/josptcases.2024.0007","DOIUrl":"https://doi.org/10.2519/josptcases.2024.0007","url":null,"abstract":"BACKGROUND: Cremaster Muscle Strain (CMS) is an uncommon condition characterized by persistent testicular pain without clinical guidelines for conservative care. This case demonstrated how an applied anatomical analysis influenced the framework of care after which the patient had reduced pain and returned to running. CASE PRESENTATION: The 32-year-old man had 16-years of unremitting CMS that began during high school cross country training. His 5-8/10 intensity pain, aggravated by sexual or physical activity, limited his ability to sit for work >30 minutes or run. Manual therapy to mobilize anatomic structures potentially affecting cremaster muscle function was followed by graded return to running. OUTCOME AND FOLLOW-UP: After 5 sessions, pain intensity had decreased to 0.5/10 at worst, hip flexibility and strength impairments had resolved, and he had returned to running without increased pain. His Chronic Prostatitis Symptom Index score improved from 19/45 to 8/45. DISCUSSION: Anatomical analysis and the organized care framework led to sequenced treatment starting with body structures affecting the cremaster including mobilization of spinal and peripheral joints, and myofascial structures; followed by exercise and neuromotor training. Despite his condition’s chronicity, treatment culminated in return-to-running. This case informs the differential diagnosis of lumbo-pelvic-hip problems because concurrent CMS may be under-reported.","PeriodicalId":73565,"journal":{"name":"JOSPT cases","volume":"344 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141686521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-11DOI: 10.2519/josptcases.2024.0008
Ugochi C. Okoroafor, Benjamin A. Nwadike, David E. Teytelbaum, Scott G. Kaar
{"title":"Isolated Abductor Pollicis Brevis Tear in a Division I College Basketball Player","authors":"Ugochi C. Okoroafor, Benjamin A. Nwadike, David E. Teytelbaum, Scott G. Kaar","doi":"10.2519/josptcases.2024.0008","DOIUrl":"https://doi.org/10.2519/josptcases.2024.0008","url":null,"abstract":"","PeriodicalId":73565,"journal":{"name":"JOSPT cases","volume":"15 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141355897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-07DOI: 10.2519/josptcases.2024.11709
Lindsay Brantingson, Rachel Stitt, Stephen Kareha, Christopher Fisher
{"title":"Unicameral Bone Cyst in Pediatric Patient with Hip Pain: An Imaging Case","authors":"Lindsay Brantingson, Rachel Stitt, Stephen Kareha, Christopher Fisher","doi":"10.2519/josptcases.2024.11709","DOIUrl":"https://doi.org/10.2519/josptcases.2024.11709","url":null,"abstract":"","PeriodicalId":73565,"journal":{"name":"JOSPT cases","volume":" 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141372016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-07DOI: 10.2519/josptcases.2024.11705
Josh Landers, Evan Rosenzweig
{"title":"Subtle Avulsion of the Anterior Superior Iliac Spine with Incidental Finding of Coxa Profunda","authors":"Josh Landers, Evan Rosenzweig","doi":"10.2519/josptcases.2024.11705","DOIUrl":"https://doi.org/10.2519/josptcases.2024.11705","url":null,"abstract":"","PeriodicalId":73565,"journal":{"name":"JOSPT cases","volume":" 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141373256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-06DOI: 10.2519/josptcases.2024.11718
Matthew E. Mantanona, John Umlauf, Joshua J. Van Wyngaarden
{"title":"Synovial Sarcoma within Femoral Triangle","authors":"Matthew E. Mantanona, John Umlauf, Joshua J. Van Wyngaarden","doi":"10.2519/josptcases.2024.11718","DOIUrl":"https://doi.org/10.2519/josptcases.2024.11718","url":null,"abstract":"","PeriodicalId":73565,"journal":{"name":"JOSPT cases","volume":"18 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141380020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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