rehab assignment

Case Study

Our subject for this case study is a female recreational triathlete.

For background information only, our case subject has a history of:

Intermittent low back pain on the left side

Right Groin Strain

Right knee pain that gets worse with increased activity/ training

Kinetic Chain Assessment

Overhead Squat:

Foot/ Ankle Complex:

Right Foot Flattens

Left Foot Turns Out

Knee Complex:

Right Knee Moves Inward

LPHC

Low Back Rounds

Excessive Forward Lean

Asymmetric Weight Shift to the Right

Thoracic Spine

Increased Kyphosis

Shoulders

Arms forward

Goniometric Assessment:

Ankle Dorsiflexion: 20 is ideal

Left= 11

Right= 4

90/90 Knee Extension: 10­20 is ideal (closer to 0 is better)

Left= 55

Right= 43

Hip Abduction: 45 is ideal

Left= 39

Right= 21

Hip Internal Rotation: 45 is ideal

Left= 19

Right= 27

Hip External Rotation: 45 is ideal

Left= Within Normal LimitsRight= 33

Hip Flexion: 120 is ideal

Left= 104

Right= 114

Modified Overhead Squat:

Some improvement with Right Knee Valgus

Single Leg Squat:

Left Leg:

Outward Trunk Rotation

Right Leg:

Foot Flattens

Knee Moves Inward

Hip Drop

Inward Trunk Rotation

Manual Muscle Testing:

The following Muscles Tested “Weak”:

Bilateral Anterior Tibialis

Right Posterior Tibialis

Left Adductors

Bilateral Glute Maximus

Bilateral Glute Medius

Bilateral Hip Flexors

Instrinsic Core

Bilateral Lats

Task

Leveraging your current understanding of Human Movement Science, CEx, clinical experience, and

the demands of this subject’s activites, please address and include all of the following in your

Assignment Submission:

Correlation between the identified impairments and the Left side low back pain, Right side groin

strain, and right side knee pain

Primary sub­system impairment relating to this case and why

In an organized fashion and using the provided templates, design TWO CEx/ Injury Reduction

Programs that address this subject’s impairments as identified during the kinetic chain assessment and

that adhere to the scientific principles/ structure of the CEx system:

One Long Program, that will take no more than 60 minutes to complete to be performed 2­3 days per week

Be Creative Here…

At the end of your corrective routine ­­and as part of your integration step­­ include a few exercises

that would encompass a total body integrated strength training program appropriate for this athlete

and that will complement/reinforce the goal of correcting her LPHC impairments. Here is a guide to

help you organize this section. You do not have to include an exercise for each body part/ area if you

feel it is inappropriate; however, in your summary section you must explain why you did not include

an exercise for a certain area:

Total body exercise

Back exercise

Chest exercise

Shoulder exercise

Leg exercise

One Short Program that can be used as a warm­up prior to triathlon training workouts on the bike, in

the pool, or pounding the pavement that will take no more than 15 minutes to complete. Take

equipment type/availability into consideration as well when designing this program.

Your Programs must contain the following elements and meet the following criteria:

Inhibition Techniques (list specific exercises/ techniques)

Lengthening Techniques (list specific exercises/ techniques)

Activation Techniques (list the specific exercises you’d use, not just the muscle names)

Integration Techniques (list the specific exercises)

List acute variables for each technique/ exercise

If you include exercises in your program that are unique to your environment and have names that I

may not recognize, please explain what areas/ muscles the exercise is designed to target.

Provide a detailed summary for each program with clinical and/ or scientific rationales that justify

your specific exercise technique selections, i.e.:

Why did you choose the specific techniques/ exercises outlined in your program?

What compensations do they address?

What tissues/ muscles/ subsystems do they target?

How does each technique you selected benefit our subject specifically, given her impairments and

sport?

 

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