A treatment and rehabilitation protocol was implemented on a university football player sustaining a second-degree lateral ankle sprain. The initial treatment plan involved the application of the RICE principle (rest, ice, compression, and elevation). This particular rehabilitation protocol was aimed at restoring range of motion and function at the earliest possible time with the use of a cryokinetic technique developed by Knight and with progressive exercise. The subject in this case study returned to full participation 6 days postinjury. The results from this report indicate that a program of cryokinetics and functional progressive exercise performed within pain-free limits can greatly enhance the return of an athlete to competition.
Danny Pincivero, Joe H. Gieck and Ethan N. Saliba
David J. Pezzullo
Plantar fasciitis is one of the most common foot injuries athletes sustain. The painful heel is the result of overloading and inflammation of the plantar fascia at its insertion into the medial process of the tuberosity of the calcaneus. Many different treatment approaches have been used to address this overuse problem. Treatment for plantar fasciitis has included decreased weight bearing, nonsteroidal anti-inflammatory drugs (NSAIDs), orthotics, arch taping, weight loss, steroid injections, ultrasound, ice, physical therapy, and surgical release. Clinically the use of night splints has been found to be very successful in the treatment of plantar fasciitis, as described in this case study.
Christine C. Center, Samuel J. Wilkins, Ross Mathiasen and Adam B. Rosen
The purpose of this report is to present the case of a high school football player who sustained an injury during a game, resulting in an acute subdural hematoma (SDH). The patient underwent an emergent decompressive craniectomy. The uniqueness of the case is due to both rare pathology and treatment. The athlete had a positive outcome due to prompt on-field assessment and advanced surgical treatments. Athletic trainers should know how to recognize symptoms of emergent traumatic brain injuries and be prepared to implement an emergency action plan when necessary.
Brandon C. Platt, Sue Falsone and Kenneth C. Lam,
A 21-year-old male baseball catcher sustained an injury to the right testicle from a foul ball that ricocheted from the ground to his groin. The athlete was removed from competition when testicular pain began to increase. Ice was applied to the affected area and nonsteroidal anti-inflammatory drugs (NSAIDs) were utilized through the evening. Further diagnosis and treatment were warranted the following morning. Diagnostic ultrasound revealed a fracture to the right testicle, necessitating surgical repair. The athlete followed a return-to-play progression and returned to play 20 days postinjury. This case describes evaluation and treatment of a rare acute condition and the need for early recognition and diagnosis.
Lucas C. Bianco, James M. May, Smokey L. Fermin, Robert Oates and Scott W. Cheatham
In the current case series, three male patients aged 19–21 years, all participating in basketball activities during their competitive season, were evaluated and classified with patella tendinopathy. A combination of positional release therapy (PRT) treatment with therapeutic exercises was used to decrease pain and improve function. Over the course of the treatment, each patient improved outcomes at discharge and sustained the improvements at follow-up. The purpose of this paper is to compare the results of this case series with a study of the effects of eccentric exercises on physically active patients diagnosed with patella tendinopathy and participating in jumping sports.
Jose Lam and Jacqueline Walsh
This case illustrates the challenges entrepreneurs experience as they try to guide a new venture to the commercialization stage in the entrepreneurial process. Steve Wheeler, Mike Maddock, and Marcel Savidon are three young entrepreneurs and friends who founded Magine Snowboards, a company focused on the manufacturing of snowboards. This case is set in January of 2012 as Steve Wheeler debates the next strategic step for the company. Magine has developed an innovative product—a snowboard that uses environmentally friendly and sustainable materials. The entrepreneurs have been able to start the business through bootstrapping. However, they now need to develop a strategy that can guide the company forward.
Anna R. Cruz and Kenneth Mautner
In this case series, three elite college-level female volleyball players between 21 and 22 years old experienced acute abdominal pain during an overhead swinging motion. All three athletes were diagnosed with acute rectus abdominis (RA) muscle strain using musculoskeletal ultrasound, without the need for MRI. Each athlete sustained severe RA injury resulting in substantial loss of playing time and warranted a focused rehabilitation program, which emphasized core strengthening, physical modalities, and altering athletes’ hitting technique. RA muscle strain is a relatively infrequent, yet potentially severe, injury in elite volleyball players that necessitates early diagnosis and treatment to avoid prolonged or incomplete recovery.
Markéta Schüblová and Barbara Billek-Sawhney
A 17-year-old high school football player sustained a chest contusion during football practice. He did not seek medical attention from his athletic trainer until the following day when he was referred to a physician. Radiographs were unremarkable, and he was cleared to play. There was no change in the athlete’s status, and he was referred for repeat radiographs. These, too, were unremarkable. Two weeks postinjury, the athlete was hospitalized with pneumothorax, acute respiratory distress, and pneumonia from 3 rib fractures. Relative difficulty in diagnosing this injury resulted in hospitalization with severe, life-threatening complications and may have led to death.
Raymond Chronister, George C. Balazs, Adam Pickett, John-Paul H. Rue and David J. Keblish
Acute lateral patellar dislocation is a common injury sustained by athletes, and often requires several months to recover and return to play.
To describe a novel protocol for the treatment of acute lateral patellar dislocation that returns patients to play far sooner than traditional treatment protocols.
Case series and review of the literature.
Division I NCAA institution.
Two collegiate athletes who sustained first-time acute lateral patellar dislocations.
Traditional standard of care for acute lateral patellar dislocation after reduction involves 1–7 weeks of immobilization in full extension. Knee stiffness commonly results from this method, and return to full activity typically takes 2–4 months. We used a protocol involving immobilization in maximal flexion for 24 hr, with early aggressive range of motion and quadriceps strengthening in the first week after injury.
Main Outcome Measures:
Time to return to play.
Immediate on-site reduction of the patella followed by 24 hr of immobilization in maximal knee flexion was performed. Following an accelerated rehabilitation regimen, patients were able to return to sport an average of 3 days postinjury. Neither patient has experienced a recurrent dislocation.
Our protocol is based on anatomic studies demonstrating reduced tension on the medial patellofemoral ligament, reduced hemarthrosis, and reduced soft tissue swelling in maximal knee flexion. This method apparently bypasses the knee stiffness and deconditioning commonly seen with traditional nonoperative regimens, allowing return to sport weeks or months sooner.
Kevin R. Heinsimer, Nicolas G. Nelson, Kristin J. Roberts and Lara B. McKenzie
The objective was to describe the patterns and mechanisms of water tubing–related injuries treated in U.S. emergency departments.
The National Electronic Injury Surveillance System was used to examine cases of water tubing–related injuries. Sample weights were used to calculate national estimates of water tubing–related injuries. Analyses were conducted in 2010.
From 1991−2009 an estimated 69,471 injuries were treated in US emergency departments for water tubing–related injuries. The annual number of cases increased 250% over the 19-year study period (P < .001). Sprains and strains accounted for the largest portion of injuries (27.2%). The head was the most frequently injured body part (27.5%). Children and adolescents ≤ 19 years were more likely to be injured by contact with another person (OR: 2.47; 95% CI = 1.61−3.80) and were more likely to sustain injuries to the head (OR: 2.61; 95% CI = 2.01−3.38) compared with adults. Adults ≥ 20 years, were more likely than individuals ≤ 19 years to sustain sprains and strains (OR: 2.11; 95% CI = 1.64−2.71) and were most commonly injured by impact with the water (54.6%).
Patterns of water tubing–related injuries differ for children and adults. Research is needed to determine how best to reduce these injuries.