Traumatic knee crush injuries of degloving nature carries a greater risk for the multitude of complications rendering emergency surgical intervention the treatment of choice in the majority of such injuries. These types of injuries commonly result in a unique post- operative complication such as arthrofibrosis and it presents overly challenge for Physiotherapists managing it. In this retrospective single-case report, we describe the challenges of in – and out- patient physiotherapy treatment planning for a 16-year old boy throughout the continuum of care for his knee arthrofibrosis following a series of surgical procedures. As result of his complex medical situation, the time-specific physiotherapy intervention during the immediate post-operative period failed to improve our patient’s knee function. The knee function with regard to range of motion ( especially extension), muscle strength(quadriceps) improved considerably with the adoption of an aggressive physiotherapy intervention approach that included specific quadriceps muscle strengthening, joint mobilization (rotation/traction) in sitting position with legs over the edge of table and contract-relax quadriceps stretching in prone position using theraband.
Recent evidences suggest functional thoracic hyperkyphosis (FTH) could be a different approach in the management of subacromial impingement syndrome (SIS). This case study aims firstly with the development of evidence informed FTH model for SIS. Secondly this study aimed to develop well defined multimodal physical therapy intervention for FTH and its related mechanical consequences in elderly patient with chronic SIS. As a result, Level IV positive evidence was found in both the short and long-term pain and disability of chronic SIS, using FTH model with 26 months of follow-up.
Osteitis pubis among soccer athletes is a disabling painful condition and it is difficult to manage without integrating a multimodal treatment approach. There is limited scientific evidence on the effectiveness of exercise in treating Osteitis pubis especially when it progress to a chronic painful condition. The purpose of this case report is to discuss the successful multimodal physiotherapeutic management for a 15-year old soccer athlete diagnosed with stage-IV Osteitis pubis. Land and water based active core muscle strengthening exercises, Proprioceptive neuromuscular facilitation techniques (PNF) and Manual Therapy are some of the essential components incorporated in multimodal intervention approach with emphasis to water based strength and endurance training exercises. The athlete was able to make progress to a successful recovery from his chronic painful condition and accomplished the clearly established clinical outcomes during each phase of rehabilitation.