Anatomy:
Tendons attach muscle to bone. There are 5 key muscles which play a role in wrist flexion (bending) and forearm pronation (turning the forearm downward). These muscles attach to the inner aspect at the front of the elbow. The attachment of these muscles to the bone is thought to be via the common flexor tendon.

Mechanism of injury:
Golfers elbow is thought to be caused by the repetitive overuse the muscles which are responsible for flexing the wrist and pronating the forearm. This injury is not only seen in golfers but also tennis players who play single forehanded shots, in rock climbers and in handymen. The mechanism in golf is thought to be due to eccentric wrist flexion and forearm pronation (contraction of wrist flexors and forearm pronators whilst in a stretched position). This in conjunction with gripping of the club places significant load through the common flexor tendon. In rock climbing, the injury is associated with recurrent strain the tendon is placed under during finger gripping, wrist flexion and forearm pronation.

Risk factors
Occupation/sports which involve repetitive movements that overload the wrist flexor, finger flexor and forearm pronator muscles.
Between the ages of 35-50
Statin use for cholesterol
Diabetes

Signs and symptoms
Pain isolated to the inner elbow.
Pain on resisted wrist flexion.
Pain and weakness with gripping.
Stiffness at the wrist.

Physiotherapy management
Physiotherapy has been shown to successfully manage golfers’ elbow. The aim of rehabilitation is to reduce pain and gradually work on regaining mobility and strength to return to sport or work without pain. To prevent reoccurrence, it may be advised to consult a golf or tennis coach to assist with form and technique.

Physiotherapy management
Soft tissue massage of associated muscles.
Active range of motion exercises.
Strengthening of wrist and elbow musculature
Bracing to alleviate load placed through muscle.
Gradual return to play.

If you think you may be battling with golfers elbow, do not hesitate to call our rooms for a thorough assessment and management plan.

References

Amin NH, Kumar NS, Schickendantz MS. Medial epicondylitis: evaluation and management. JAAOS-Journal of the American Academy of Orthopaedic Surgeons. 2015 Jun 1;23(6):348-55.
Ciccotti MC. Diagnosis and treatment of medial epicondylitis of the elbow. Clin Sports Med. 2004.
MARKSCHICKENDANTZ M. 28 Medial: Flexor-Pronator Tendon Injury. Shoulder and Elbow Injuries in Athletes: Prevention, Treatment and Return to Sport. 2017 Oct 17:461.
Michael C. Ciccotti , MA, RA, Michael A. Schwartz, MD, Michael G. Ciccotti, MD. Diagnosis and treatment of medial epicondylitis of the elbow. Clin Sports Med 23 (2004) 693-705
Todd S. Ellenbecker RNPR. Current Concepts in Examination and Treatment of Elbow Tendon Injury. Sports Health; 5(2): 186–194.

Mechanism of Injury:
Sternoclavicular joint injuries typically occur due to falls on the outer aspect of the shoulder which transmits force from the outer shoulder to the clavicle (collarbone) near the sternum (breastbone). This force causes the collarbone to move forward or backward. This may result in a subluxation or dislocation.

Anatomy:
The SC joint is the only bony joint that connects the axial (Central/Midline) skeleton to the appendicular (Peripheral) skeleton. The joint is formed by the Clavicle (collarbone) and Sternum (breastbone). Between these 2 bones there is a disc. Furthermore, the joints are held in place by ligaments which provide anterior/forward and posterior/backward stability.

• Signs and Symptoms:
• Pain and swelling at the clavicle and sternum junction.
• Reports of clicking/popping.
• Complaints of instability.
• Step deformity.
• Feelings of shortness of breath, choking or tight feeling in the throat in situations where the dislocation is in the direction of the chest.

Assessment:
Emphasis is place on making an accurate diagnosis. The above signs and symptoms are observed and assessed. Additionally, imaging in the form of an x-ray and/ or ultrasound may be required to confirm any subluxation or dislocation and associated ligament injury.

Management:

• Initial management will place focus on protecting the site of injury.
• Immobilization of the upper limb in a sling.
• Referral to an orthopaedic surgeon may be necessary.
• To manage pain, swelling and inflammation, rest, the use of ice, and topical anti-inflammatory is encouraged.
• Whilst the above settles, it is important to maintain function and strength through exercise in the wrist and elbow without placing load/pressure on the shoulder.
• Once enough time has been given to allow the SC joint to heal, it is important that shoulder mobility be regained to prevent complications.
• Gradual strengthening of shoulder.

References

Groh, G.I. and Wirth, M.A. (2011) ‘Management of traumatic sternoclavicular joint injuries’, American Academy of Orthopaedic Surgeon, 19(1), pp. 1–7. doi:10.5435/00124635-201101000-00001. 
Ingoe, H.M.A. et al. (2023) ‘Traumatic posterior sternoclavicular joint dislocation – current aspects of management’, Injury, 54(11), p. 110983. doi:10.1016/j.injury.2023.110983. 
Justin E. Hellwinkel, Eric C. McCarty & Morteza Khodaee (2019) Sports-related sternoclavicular joint injuries, The Physician and Sportsmedicine, 47:3, 253-261, DOI: 10.1080/00913847.2019.1568771
Morell, Daniel & Thyagarajan, David. (2016). Sternoclavicular joint dislocation and its management: A review of the literature. World Journal of Orthopaedics. Vol 7. 244-250. 10.5312/wjo.v7.i4.244.
Rosie Helen Broadbent, Sarah Mary Barkley, Margo Dirckx, Hassaan Sheikh, The sternoclavicular joint: a review of anatomy, injury and management, Orthopaedics and Trauma, Volume 37, Issue 5, 2023, Pages 314-319.

Anatomy: 
The brachial plexus is a complex network of nerves formed by the four cervical/neck nerves (C5-C8) and the first thoracic (upper back) nerve (T1). These nerves travel through the neck, shoulder, and arm, branching out to supply motor and sensory function to the muscles and skin of the upper limb.

Mechanism of Injury:
Stinger and burner injuries typically occur when the head and neck are forcefully and suddenly moved sideways, causing stretching or compression of the nerves in the brachial plexus. This can happen during tackles, collisions, or falls, leading to a sharp, shooting pain down the arm. It may also be caused by a direct blow to the area above the clavicle/collarbone.

Stingers and burners can range from mild where pain lasts for a few minutes up to severe injuries. With any neck injury it is important to rule out more serious conditions such as neck fractures, spinal cord injury, blood vessel damage and in the case of head injuries, concussions.

• The signs and symptoms of stinger and burner injuries are listed below
• Sudden, intense pain radiating down the arm.
• Numbness or tingling in the arm or fingers.
• Weakness in the affected arm.
• Difficulty in moving the arm or shoulder.
• Depressed shoulder.
• Wasting/Atrophy/Observable loss of muscle mass
• Shaking of upper limb
• Holding extremity close to body.
• Burning sensation along the nerve pathway
• Loss of sensation or feeling in the arm or hand

• The Physiotherapy Assessment should be a detailed subjective and objective evaluation and should include but is not limited to:
• A thorough history including the mechanism of injury.
• Observation for indication of muscle wasting or weakness.
• Postural assessment
• Sensation tests.
• Reflexes.
• Strength testing
• Neck, shoulder and elbow active range of motion assessment

Physiotherapy management is aimed at reducing pain and regaining strength and mobility to ensure a successful return to sport or work. This can be achieved through:

1. Rest and Immobilization: Resting the affected arm and avoiding activities that exacerbate symptoms is crucial in the initial phase of recovery. Immobilization in the form of a sling may be required in severe cases where pain is easily triggered by movement.
2. Ice: The application of ice over painful and swollen areas may help alleviate inflammation.
3. Soft tissue massage: This will assist in reducing muscle spasm and regaining mobility.
4. Medication: Non-steroidal anti-inflammatory drugs (NSAIDs) or analgesics may be prescribed by your GP to manage pain and inflammation in the acute phase of injury.
5. Strengthening: Gradual strengthening will be important to regain optimal function of the upper limb.

In conclusion, stinger and burner injuries can be debilitating, but with prompt assessment and comprehensive management, most individuals can achieve full recovery and return to their pre-injury level of function. Early intervention, appropriate rehabilitation, and preventive measures are key in optimizing outcomes and reducing the risk of long-term complications

References

Meyer, S., Schulte, K., Callaghan, J., Albright, J., Powell, J., Crowley, E. and El-Khoury, G. (1994). Cervical Spinal Stenosis and Stingers in Collegiate Football Players. The American Journal of Sports Medicine, [online] 22(2), pp.158-166.
Nissen SJ, Laskowski ER, Rizzo TD Jr. Burner syndrome: recognition and rehabilitation. Phys Sportsmed 1996; 24:57.
Poindexter, D.P. and Johnson, E.W., 1984. Football shoulder and neck injury: a study of the" stinger". Archives of physical medicine and rehabilitation, 65(10), pp.601-602.
Pujalte, George G. & Floranda, Eric. (2012). Stingers and Burners. Athletic Therapy Today. 17. 24-28. 10.1123/ijatt.17.1.24.
Weinstein SM. Assessment and rehabilitation of the athlete with a "stinger". A model for the management of noncatastrophic athletic cervical spine injury. Clin Sports Med 1998; 17:127.

Optimal Loading
Gradual Weight Bearing: As your healing progresses, slowly reintroduce weight-bearing activities.
Physiotherapy Exercises: Engage in prescribed exercises to strengthen the area without causing undue stress.

Ice
Reduce Swelling and Pain: Apply ice packs to the affected area for 15-20 minutes every 2-3 hours.
Careful Application: Use a cloth barrier between the ice pack and your skin to prevent ice burns.

Compression
Manage Swelling: Use an elastic compression bandage or garment as instructed.
Balanced Compression: Ensure the bandage is snug but not too tight to avoid restricting blood flow.

Elevation
Reduce Swelling: Elevate your foot and ankle above heart level when possible, especially after activity or during sleep.
Supportive Positioning: Use pillows or cushions for comfortable elevation.

Recovery Tips
Monitor Your Progress: Be aware of your pain levels and swelling. Contact your physiotherapist if you notice increased pain or other concerning symptoms.
Follow-Up Appointments: Regularly attend your scheduled follow-up appointments for optimal recovery.

Immediate Post-Operative Care

Splint Care: Keep the splint on until your first post-operative appointment. Avoid getting it wet. If it becomes wet, contact our office immediately.

Stitches and Staple Care

SFirst 2 Weeks: Stitches or staples will be removed during your first post-op appointment, usually around 2 weeks after surgery.

Showering and Bathing

• Initial Period: Take sponge baths until your first post-operative visit. Do not submerge your wound in water.
• After Stitches Removal: Showering is allowed, but avoid scrubbing the incision. Gently pat the area dry after washing with warm water.
• Bathing Precautions: Avoid baths, swimming pools, lakes, or oceans for at least 3 weeks post-surgery or until given specific permission.

Managing Your Bandage

• Incision Care: Keep any bandage over your incision clean and dry, following your doctor’s instructions.
• Ape Strips: If tape strips are used, leave them on for a week or until they fall off, keeping the area dry.

Splint and Cast Guidelines

• General Care: Keep your splint or cast dry and refrain from inserting anything between it and your skin.
• Dressing Layers: Understand the three layers of your post-operative dressing for proper care.
• Removable Boot: Once placed in a boot, you can remove it for showers, but avoid submerging the wound.

Special Considerations

• DuraPrep Stains: Yellow discoloration from DuraPrep can be cleaned with rubbing alcohol the day after surgery.
• Steri-Strips: Leave Steri-Strips in place until sutures are removed, typically 10-12 days post-surgery.

Mechanism of injury

In dancing, turf toe is caused by the repeated hyperextension movement of the big toe during demi-pointe as well as during jumping and landing. The injury commonly occurs when the forefoot is fixed to the ground whilst the big toe is hyperextended (4). With a load through the heel, this combination may lead to tearing of the plantar plate (a tough structure made of cartilage which attaches the big toe to the metatarsal head) (5).

Turf toe classification (4)

Signs and symptoms of turf toe (1)

• Pain located at the underside of big toe.
• Bruising
• Tender to touch at the underside of the big toe.
• Inability to push off with big toe.
• Pain with extension of the big toe

How is turf toe diagnosed? (1)

Turf toe can be diagnosed clinically based on the presentation. X-rays taken from different weight-bearing views can also exclude a fracture. In severe cases where there is concern regarding the integrity of the affected structures, an MRI will be useful with the diagnosis and its severity.

Grade 1 and in some instances, grade 2 injuries can be managed conservatively. Surgical intervention is advised for grade 3 injuries and for grade 2 injuries where conservative management has failed. As a result of the minute size of the affected joint, quite often an injury here, is not given enough attention. However, the big toe plays a critical role in the ability to run, jump, change direction and push off your foot and is thus an essential structure.
Rehabilitation for turf toe should follow a loading continuum which is dictated by the severity of the injury and the associated structural damage.

1 Joint protection
During the early stages after the injury, it may be necessary for the foot to be placed in a moon boot and for the dancer to use crutches. This will assist in restricting movement and reduce load/weight through the joint.

2 Sub-maximal strengthening
These exercises look to strengthen the intrinsic foot muscles and consist of the piano toe series. No pain should be felt during these exercises.

3 Range of motion
Once symptoms have subsided, it is important to ensure that the joint range of movement going to extension is maintained. This can be done actively and/ or passively. This is essential as this joint movement is important for dancers. These exercises can also be prescribed in different loading positions, depending on the phase of rehabilitation and stage of healing.

4 Strengthening
This again is done in accordance with the loading continuum. Calf muscle strength is an important factor to address. Calf raises should be commenced in a seated position and progressed to double leg and single leg standing positions.

5 Balance training
It is important to retrain single leg balance as the injury will most likely affect this. Balance should be retrained in the static and dynamic forms.

6 Agility training
The big toe plays an important role in changing direction and being able to ‘push off’ whilst doing so. Thus, certain agility drills need to be carried out.

When can I return to dancing/sports?
At Floyd Lebatie Physiotherapy we are committed to evidence-based outcomes to determine return-to-play readiness. These criteria will look at the joint range of movement, muscle strength and endurance, the ability to successfully complete balance, walk run cycles and agility training.

References

Aran, F., Ponnarasu, S., & Scott, A. (2022). Turf Toe. Statpearls.
       2. Fraser, T., & Doty, J. (2019). Turf toe: review of the literature and surgical technique. Annals of Joint, 4(28), 1-6.
        3. Hainsworth, M. (2018). The management of turf toe - A systematic review. Baltic journal of spport and health sciences, 25-37.
        4.McCormick, J. J., & Anderson, R. B. (2010). Turf Toe: Anatomy, Diagnosis and Treatment. Sports Health, 2(6), 487-493.
        5.Najefi, A.-A., Jeyaseelan, L., & Welck, M. (2018). Turf toe: A clinical update. Sport and Arthroscopy, 3, 501-506.

Description

TFCC injuries refer to damage or tears in the triangular fibrocartilage located at the base of the wrist. This complex structure comprises ligaments, cartilage, and other connective tissue, contributing to wrist stability and smooth joint movement.

Anatomy
The TFCC is an intricate network of ligaments, cartilage, and tendons that connect the ulna (inner arm bone), radius (outer arm bone), and several carpal bones of the erist. It provides stability during rotational movements and weight-bearing activities of the wrist. The TFCC is made up of the following:

• Ulnotriquetral ligament.
• Ulnolunate ligament.
• Radioulnar ligament.
• Articular disc.
• Extensor carpi ulnaris tendon sheath.

You may be at risk due to the below:

• Repetitive wrist movements (as seen in sports or certain occupations).
• Trauma or sudden impact on the wrist
• Aging, leading to degeneration of the TFCC
• Specific sports activities stressing the wrist joint (e.g., tennis, gymnastics)

Signs and Symptoms

You may have a TFCC injury if you present with the following:

• Pain, often located on the ulnar side/inner side of the wrist.
• Swelling or tenderness
• Reduced grip strength
• Clicking or popping sensations during wrist movements
• Difficulty in rotating the forearm or performing weight-bearing activities

Diagnosis

The diagnosis is made clinically based on your subjective complaints and physical examination. Your physiotherapist will conduct a thorough assessment in order to get an accurate diagnosis.

Assessment

Your clinical evaluation will look at the following:

• Observation of any deformities or swelling.
• Range of motion at the wrist.
• Strength testing if symptoms are not irritable or painful without easing.
• Special tests to stress the TFCC structure.

Management

Conservative Approaches: Rest, immobilization, ice application, and anti-inflammatory application during the initial stages.
Orthopedic Surgeon’s Role: Your orthopedic surgeon may refer you for further imaging in order to detect which structure(s) have been injured.
Physiotherapy’s Role:
Strapping to stabilize the wrist joint.
Pain avoidance advice.
Soft tissue mobilization.
A rehabilitation program focussing on strength, stability and mobility.

If you think you may have injured your TFCC, we strongly suggest that you get it looked at in order to avoid complications.

References

Jawed, A., Ansari, M.T. and Gupta, V. (2020) ‘TFCC injuries: How we treat?’, Journal of Clinical Orthopaedics and Trauma, 11(4), pp. 570–579. doi:10.1016/j.jcot.2020.06.001. 
Lerma, E.G. et al. (2022) ‘Rehabilitation in triangular fibrocartilage complex injuries: Treatment algorithm’, Revista Iberoamericana de Cirugía de la Mano, 50(01). doi:10.1055/s-0042-1748854. 
Palmer, A.K. (1990) ‘Triangular fibrocartilage disorders: Injury patterns and treatment’, Arthroscopy: The Journal of Arthroscopic & Related Surgery, 6(2), pp. 125–132. doi:10.1016/0749-8063(90)90013-4. 
POGLIACOMI, F. et al. (2021) ‘Traumatic triangular fibrocartilage complex tears: “State of the art” from diagnosis to treatment’, Minerva Orthopedics, 72(2). doi:10.23736/s2784-8469.20.04029-1. 
Skalski, M.R. et al. (2016) ‘The traumatized TFCC: An Illustrated Review of the anatomy and injury patterns of the triangular fibrocartilage complex’, Current Problems in Diagnostic Radiology, 45(1), pp. 39–50. doi:10.1067/j.cpradiol.2015.05.004. 

Description
Tarsal tunnel syndrome (TTS) is a condition in which the tibial nerve or 1 of its terminal branches is compressed within the tarsal tunnel of the medial malleolus (inner ankle bone).

Anatomy
The tarsal tunnel is formed by a bony floor and a connective tissue roof. The floor is concave and formed by the medial/inner tibia, talus/ankle bone and calcaneus/heel bone. The roof is formed by the flexor retinaculum which is a fibrous tissue that runs from the medial malleolus to the calcaneus.

What are the contents of the tarsal tunnel

• Tibialis posterior tendon
• Flexor digitorum longus tendon
• Flexor hallucis longus tendon
• Posterior tibial artery
• Tibial nerve

What are the associated Risk factors?

• Extra and accessory muscles around the ankle – flexor digitorum accessorius longus muscle, tibiocalcaneus internus muscle or accessory soleus.
• Chronic instability of the ankle.
• Surgical procedures to correct angulation of the hind foot.

What are the signs and symptoms?

• Paraesthesia in the heel, medial ankle and under surface of the foot.
• Aggravation of the above symptoms with activity and ease with rest.
• Paraesthesia whilst sleeping with the foot in certain positions.
• Wasting/atrophy of muscles on the underside of the foot.
• Weakness of the above muscles.

Assessment
Diagnosis of TTS is mainly based on clinical examination. This includes a series of special tests. Due to strength and range deficits which tarsal-tunnel syndrome could cause, it is also essential to assess range of motion at the ankle and strength of the surrounding muscles. When there is a high index of suspicion for this condition, your attending physiotherapist should send you for nerve conduction tests.

What does treatment consist of?

• Activity modification and relative rest.
• Optimal loading.
• Ice, compression and elevation.
• Orthotics if applicable.
• Appropriate footwear selection.
• Active range of motion exercises of the foot and ankle
• Strengthening of foot intrinsic muscles
• Strengthening of larger muscle groups – calf and tibialis anterior.

Surgical intervention
If conservative management does not provide optimal symptom relief, surgical intervention must be considered. Operative management consists of decompression of the nerve within the tarsal tunnel. The surgeon releases the nerve of any structure which is causing compression. Post operative management will look to address any deficits as a result of the surgery.

References

Fortier, L., Leethy, K., Smith, M., McCarron, M., Lee, C., Sherman, W., . . . Kaye, A. (2022). An Update on Posterior Tarsal Tunnel Syndrome. Othopaedic Reviews, 14(3), 1-8.
Gallas, J., & Gearhart, M. (2015). Conservative Management of Tarsal Tunnel Syndrome in a Competitive Distance Runner. Orthopaedic Practice, 27(2).
Gretter, T., & Wilde, A. (1970). Pathogenesis, diagnosis, and treatment of the tarsal-tunnel syndrome. Cleaveland clinic Foundation, 37, 23-29.
Kushner, S., & Reid, D. (n.d.). Medial Tarsal Tunnel Syndrome: A Review. The Journal of Orthopaedic and Sports Physical Therapy, 6(1), 39-45.
Romani, W., Perrin, D., & Whiteley, T. (1997). Tarsal Tunnel Syndrome: Case Study of a Male Collegiate Athlete. Journal of Sports Rehabilitation, 6, 364-370.

Anatomy of the Scapula
The scapula is a triangular-shaped bone located on the upper portion of the back. The scapula forms a false joint with the back of the rib cage referred to as the scapulothoracic joint. The front of the scapula is lined by the subscapularis and serratus anterior muscles. The scapula has 3 bursa which are fluid filled sacs that prevent friction between bone and the muscle attachments.

Who is commonly affected by SSS?

• Young active patients.
• Overhead athletes.
• Repetitive overhead overuse.

Causes:

• Anatomical/bony variations.
• Repetitive trauma.
• Increased thoracic kyphosis/curvature.
• Uncoordinated movement of shoulder muscles

Symptoms

• Pain with overhead movements.
• Audible and palpable sounds with shoulder movements.
• Pain located at the upper and inner part of the shoulder blade.

Diagnosis

Diagnosis is made clinically. Imaging in the form of x-rays and/or MRI is useful in detecting the exact cause of the condition.

Physiotherapy Management of Snapping Scapula Syndrome

• Education on avoidance of painful activities.
• Optimizing range of motion at the neck and upper back.
• Strengthening of muscles acting on the shoulder and scapula.
• Advised for 3-6 months in conjunction with anti-inflammatories.

Invasive management:

• Corticosteroid injection into the bursa.
• Shockwave therapy which enhances blood flow and encourages healing at the site of injury.
• Bursectomy in which the bursa is removed.

If you are battling with shoulder pain, it is advised to have it assessed by an experienced physiotherapist. Call 011 027 211 to do so.

References

1.Baldawi, H. et al. (2021) ‘Diagnosis and treatment of snapping scapula syndrome: A scoping review’, Sports Health: A Multidisciplinary Approach, 14(3), pp. 389–396. doi:10.1177/19417381211029211. 
2.Carvalho, S.C. et al. (2019) ‘Snapping scapula syndrome: Pictorial essay’, Radiologia Brasileira, 52(4), pp. 262–267. doi:10.1590/0100-3984.2017.0226. 
3.Kibler, W.B. and Sciascia, A. (2019) ‘Evaluation and management of Scapular dyskinesis in overhead athletes’, Current Reviews in Musculoskeletal Medicine, 12(4), pp. 515–526. doi:10.1007/s12178-019-09591-1. 
4.McClure, P. et al. (2009) ‘A clinical method for identifying scapular DYSKINESIS, part 1: Reliability’, Journal of Athletic Training, 44(2), pp. 160–164. doi:10.4085/1062-6050-44.2.160. 
5.Nascimento, A.T. and Claudio, G.K. (2018) ‘Snapping scapula syndrome: Arthroscopic surgical treatment’, Revista Brasileira de Ortopedia (English Edition), 53(6), pp. 728–732. doi:10.1016/j.rboe.2017.09.012.

The cause

Mal-tracking/asymmetrical movement of the patella may be due to various contributing factors. These range from muscle strength imbalances, alignment issues of the lower limb, poor flexibility and strength of lower limb musculature and changes to training regimens in which the training volume, intensity and frequency are too high or increased too soon (1,2,3). Other external factors also include training footwear and terrain (2,3,5).

The assessment
Each patient with this condition has a unique cluster of contributing factors. Therefore, we at Floyd Lebatie Physiotherapy ensure that we carry out an assessment that is individualized, holistic and athlete-centered, comprising observational and objective measures. This includes gait analysis, running mechanic analysis and cadence. Furthermore, the assessment is broken down into objective measurements of muscle strength, joint range of movement, flexibility, and endurance. As part of an holistic approach, if required, referrals to other disciplines, e.g. Orthotists or Podiatrists, for footwear adaptations should be considered.

Management
During the initial stages of injury, it is essential that inflammation be managed in conjunction with a rehabilitation program and training regimen modification (1,2,3). At Floyd Lebatie Physiotherapy, the rehabilitation program will include gait re-education, strength and flexibility training as well as muscular endurance (1,2,3,4,5). Inflammation and swelling can be managed by ice application, compression bandages, elevation, activity modification and if necessary, anti-inflammatories. To facilitate optimal running mechanics, taping and bracing can be used (3,4). As symptoms improve, gradual increases in training volume, frequency and intensity can be made.

If you think you battle with PFPS, do not hesitate to make a booking and let us help you get back on track! To schedule an appointment, call 011 027 2111

References

1.Esculier, J.-F., Bouyer, L., Dubois, B., Fremont, P., Moore, L., & Roy, J.-S. (2016). Effects of rehabilitation approaches for runners with patellofemoral pain: protocol of a randomised clinical trial addressing specific underlying mechanisms. BMC Musculoskeletal Disorders, 17(5), 1-7.
2.Kunene, S., Nomathemba, T., & Ramklass, S. (2020). Rehabilitation approaches to anterior knee pain among runners: A scoping review. South African Journal of Physiotherapy, 76(1), 1-8.
3.Kunene, S., Ramklass, S., & Taukobong, N. (2019). Anterior knee pain and its extrinsic risk factors among runners in under-resourced communities in Ekurhuleni, Gauteng, South Africa. SAJSM, 1-6.
4.Pollatos, D., Chandolias, K., Giodamni, M.-A., Chalkia, A., & Trevlaki, E. (2021). Review of New Data in Physiotherapeutic Approach to Patellofemoral Pain Syndrome (PFPS). Journal of Biosciences and Medicines, 9(2).
5.Willy et al. (2019). Patellofemoral Pain. Journal of Orthopaedic & Sports Physical Therapy, 49(9), 1-95.