Rehabilitation – Case Study
This case study is based on a twenty four year old Rugby Union winger. The injury the client has is a grade two hamstring tear in the left leg which also happens to be the dominate leg, this was caused by deceleration from a sprint and change of direction. Specifically it is the bicep femoris that is ruptured and is also the first time he has received this particular injury. The incident occurred four days ago, the player will be on a crotch for another three days, although the athlete is on crutches he can still do rehabilitation exercises. Early treatment for the injury has consisted of protection, rest, ice, compression and elevation. The main ...view middle of the document...
Subjects with poor hamstring flexibility had a greater knee flexion angle for maximum knee flexion torque in an isometric contraction test, comparing to those with normal flexibility. (Liu, 2012). This test result highlights that an athlete with poor hamstring flexibility, may have shorter optimum hamstring muscle length in contrast to athletes with normal hamstring flexibility, meaning greater injury risk.
The exercise has been chose for early flexibility, because it will contract lower back which in research has been found to be a cause for hamstring injuries. Hamstring injuries may occur due to poor functioning of the lumbar spine (Hoskings and Pollard, 2005). This exercise also engages the glutes and hamstrings. Regarding progression, during later stages of rehab it can also be developed into partial weight bearing (PWB) and full weight bearing (FWB), depending on stage of rehabilitation it also gives the option to rest the injured leg during exercise. Studies by (Arvinen, 2007) state that re-ruptures are common at site of trauma if active mobilisation is begun immediately after injury. Due to this factor one leg will be left on the floor nevertheless by conducting placid isometric contractions this will give memory to hamstrings on how to contract, which in long term will lead to concentric and eccentric contractions allowing a greater range of motion (ROM).
Resisted Ankle Movements
This exercise has been chosen because of how important the ankle is to maintaining postural stability. Since the ankle is the insertion point of most muscles below the knee, it is vital that the muscles the ankle is surrounding are kept durable in order to have a strong foundation. It has been found that the ankle maintains effective foot contact to the supporting surface (Lee and Powers, 2013). As the athlete is a winger during the later stages, there will be an emphasis on speed and agility so it is vital that the lower leg muscles are maintained throughout programme in order to deal with exercises ahead. A study by (Hoskins and Pollard, 2005) states that the bicep femoris has a strong fascial connection to the peroneus longus at the fibula linking it to the action of the foot and ankle. This too is important as bicep femoris long head inserts at the fibula and peronous longus originates at the fibula, so there is a correlation between the two muscles.
The exercise has been selected for middle stage flexibility for the reason that, the client has spent over a week immobilising the tissue and according to a study by (Arvinen and Lehto, 1993) reveals that any longer and marked atrophy can occur. Consequently it is key that muscle fibres are mobilised in order to create stronger scar tissue. Mobilization should include pain-free strengthening (beginning with isometrics then concentrics and eccentrics last), flexibility and endurance exercise programs (Geffen, 2003). At this point of the programme concentric...