Clinical Cases

High school athlete with ankle avulsion fracture:

On my first clinical rotation, I got to work with a high school freshman track and basketball player. He first started coming to therapy about 3 weeks for a minor ankle fracture, and he did not need a brace. He didn't have any pain, but his balance was significantly off. In our sessions, we primarily worked on balance activities such as single leg stance and controlled rocking back and forth on a balance board. In addition, we worked on the agility ladder for sport specific drills. He was able to complete them, but he did so hesitantly and tripped a few times. We also did some step ups and downs on the trampoline to improve his proprioception. His home exercise program consisted of light ankle strengthening with a resistance band as well as some active range of motion. Throughout the session, he received consistent feedback and verbal cues to make sure he was doing his exercises properly. I perceived he was still in the cognitive stage of learning since he was still learning how to do them.

High school athlete with shoulder impingement:

I also had the opportunity to observe and work with a high school senior baseball player. He had been attending therapy for around 2 months to treat his symptoms for shoulder impingement. This is typically caused by overhead repetitive movements, which can inflame the supraspinatus tendon, causing pain. At this point, he only had had a twinge of pain at the end range of external rotation, so the primary focus was increasing his shoulder and scapular strength/stability. Our exercises were geared towards more functional strengthening activities, considering that he was nearly recovered. For strength, we worked with high resistance therabands, heavily emphasizing internal and external rotation. We also focused on shoulder extension, working on exercises such as lat. pull downs and horizontal rows with weight. He also performed prone exercises with dumbells, such as horizontal rows, abduction, and scaption. In addition, we implemented some plyometric exercises, which included throwing and catching a 3- pound medicine ball utilizing internal and external rotation and throwing the ball against a trampoline with the same motions. Some of the exercises for scapular stability included rhythmic stabilization and a 3-way stability exercise with a theraband against the wall.

Because he had been coming to therapy for a while, he knew many of the exercises and independently performed the majority of them without errors. If he did make a mistake, he was able to self-correct. I perceived him to be in the associative stage of learning since he was working on refining his skills.