Sport Physiotherapy Case Study

Athlete 

Emma is a 22 year old, Female Under.23 National Team Football (Soccer) Player.

Position: Striker

Past Medical History

Asthma Controlled with Medication

Left Grade 1 Ankle Sprain

  • 18 Months Ago
  • Conservative Management
  • Return to Train 2 Weeks
  • Return to Competition 4 Weeks

Right Grade 2 Medial Collateral Ligament Tear

  • 8 Months Ago
  • Conservative Management
  • Returned to Train 5 Weeks
  • Return to Competition 8 Weeks

Drug History

Serotide Evohaler 125mg 

Ventolin Evohaler 100mg (As Required)

Social History

Full Time Student - Final Exams in 3 Months

Sport History

Played Mix Sports as Child - Athletics, Swimming and Football

Played Football since Age.12 

Specialised in Football from 16 years old 

Plays for University Team - Captain for past 2 years

Under Age. National Team Member since U.16

  • U.16 European Championships
  • U.18 European Championships
  • U.23 European Championships x 3

Training History

8 to 10 Sessions per week including:

  • Field Based Team Sessions x 3 - 4
  • Strength & Conditiong Gym Work x 3
  • Cardiovascular Fitness x 2-3
  • Mobility & Stretching Daily
  • Video Analysis

Has access to Nutrition Support, and Physiotherapy Support as member of National Team

Presenting Condition

Match Conditions

  • League Semi-Final Match
  • Second Half 15 Mins Left on Clock
  • Score 2-1 to Opposition
  • Intermitant Rain during Game - Soft Ground

Mechanism of Injury

Athlete competed for ball in the air, headed ball towards Goal, landed and tried to pivot to get around defending player to move towards the goal and then went down on the ground. Play continued and was stopped about 45 seconds later when the ball went out of play.

On Field Assessment

See

Emma was on the ground where she fell in the fetal position, holding the knee and crying

Ask

Reported an Audible 'Pop' and instability of the knee on landing

Reported Severe Pain 9/10 initially, now 7/10 - Difficult ro pin point pain

Look

Gross Effusion ++

No Discolouration

No Obvious Deformity

No Bony Abnormality

Touch

Pain ++ Medial Joint Line 

Pain ++ Medial Coallateral Ligament

Active

Apprehension with extensive guarding and spasm of the hamstring

Knee Extension -10 Degress Pain 7/10

Knee Flexion 95 Degress Pain 6/10

Passive

Apprehension with extensive guarding and spasm of the hamstring

Knee Extension -10 Degress Pain 7/10

Knee Flexion 105 Degress Pain 6/10

Special Tests

Lachmans - Inconsistent secondary to swelling and apprehension with extensive guarding and spasm of the hamstrings

Pateall Apprehension -ve

Varus -ve

Valgus +ve 

Outcome

Unable to weightbear on affected lower limb

Removed from the field of play by stretcher

Imaging

X-Ray - 1 Day Post Injury

Negative for any Bony Injury

MRI - 7 Days Post Injury

Showed O’Donohue’s Triad Injury:

  • Ruptured ACL
  • Grade 2 MCL Sprain
  • Medial Meniscus Bucket Handle Tear

Lateral Femoral Condyle Bone Contusion was also present

Treatment

Rehabilitation