Case study: Sporting knee injury and physiotherapy
Are you curious about what to expect in an appointment at Malvern East Physiotherapy? Our physiotherapist Sarah Yule guides us through her recent case study where she was able to diagnose and treat a patient’s sporting knee injury successfully.
This case study will provide a general summary of my overarching treatment timeline of a patient who first presented to the clinic following an acute knee injury during a soccer match. This is an outline of his physiotherapy journey and gives a brief insight into what processes are involved when I treat patients with similar injuries.
Initial Appointment for a sporting knee injury
This patient first presented to me following an acute knee injury during a soccer match one day prior. As physiotherapists, when we first look to diagnose a new sporting injury, we are interested in knowing the specific mechanism of injury, therefore it is very helpful to try and remember how the injury occurred (eg. I landed on my right leg and my knee hyperextended). We are also interested in obtaining as much information from our patient relating to the injury. You may expect to be asked some of the following questions in your initial appointment:
- What was your mechanism of injury?
- How severe was/is the pain and where is it located?
- What activities make your injury worse?
- What activities make you injury feel better?
- Do you have any past history of similar or significant injuries?
- What specific goals would you like to achieve along your rehab journey?
Once all information was gathered, I physically assessed the injury and determined a diagnosis that aligned with both subjective and physical assessments. Treatment on day one largely consisted of pain management techniques, manual therapy and taping the knee. I also provided education on recovery timeframes and the anatomy and physiology of the knee injury.
We also began commencement of a home-based exercise program– facilitated by our online exercise program PhysiApp, which is equipped with exercise video demonstration and written instructions.
Follow up appointments:
Over the next two weeks, we worked closely together with twice-weekly appointments to work towards the patient’s return to sport goal as quickly as possible. Our initial aims focused on regaining full knee mobility, minimising pain and restoring a normal walking pattern without crutches.
As we progressed through this initial treatment phase, our focus changed to our next main aims, including restoring motor control, joint proprioception, muscle strength/endurance as well as addressing suboptimal biomechanics and improving the way in which our body performs certain movements. After two weeks of working hard both in session and at home to improve these new focus areas, we progressed to more dynamic activities (eg. running, changing direction, jumping, acceleration/deceleration) and the patient was cleared for a modified return to training with knee strapped.
Having pulled up well following his modified return to sport, our reviews reduced to once weekly sessions utilising our clinical strength gym to train at a higher level focusing on more sports specific exercises. During this phase we were able to get quite creative with our rehab, focusing on developing high-level hip, knee and ankle stability and lower limb power specific to the movements required in soccer.
Having returned and successfully completed four full training sessions over the past two weeks, we underwent some return to sport physical testing to ensure readiness for return to competition. The patient passed having no significant difference between the injured and non-injured leg. We caught up one final time post return to soccer to ensure the knee tolerated the return well and to set up some continuing high level rehab exercises to continue over the next few months to reduce the risk of recurrence and to further enhance performance.
A few months down the track and I have followed up with this patient, he tells me that he is feeling fit, strong and healthy, and that he has had no problems with the knee since. He is also happy to notice improvement in his overall performance and feels that he can now take his game to another level.