Motion Physical Therapy & Rehab

Here is a calcaneus fracture that required internal fixation. This patient fell from a ladder and required pins in her calcaneus for proper alignment. . Injury Background: A calcaneal fracture is a break of the heel bone. These commonly happen from falls from a high height or from a motor vehicle accident. Signs of a fracture include immediate bruising, pain and inability to put pressure on your foot. The calcaneus is the most commonly broken bone in the foot. .... As long the bones stay aligned then casting for 2-4 weeks can heal the injury. If the bones are not aligned then pins during surgery may be used to line up the bones so they heal in proper alignment. . If surgery is required then the patient is usually non-weight bearing for a few weeks followed by a few more weeks in a walking boot. Physical therapy is usually started between the 2-4 week post-operation mark. . Physical Therapy Protocol: The first stage of PT is usually from weeks 2-6. We want to work on ROM, strength and flexibility, all in non-weight bearing. . Second stage of PT involves starting to put weight through the foot, we start gently and eventually work up to putting full weight through the foot by the end of this stage. Walking training also starts in this stage. . Third Stage consists of regaining toughness in the foot. Return to sport training begins after 12 weeks. . Exercises: 1 Single leg balance on Airex with T-Band reach outs - Working on balance and intrinsic foot muscle/core strength in this exercise. The lower leg and foot muscles should burn from the effort needed to maintain balance. 2 Slider Reach Downs - Great exercise for balance, mobility and control. She is reaching down to touch her ankle while the other foot slides back like a lunge. 3Lunge KB Cross-Overs - She’s loaded up the ankle in a mini lunge position and is doing cross overs with a a kettle bell. Good way to work on ankle mobility, leg strengthening and ankle loading. . Checkout our IG profile @motionptr for a break down of injuries and their rehab. . Also checkout our website https://motionptr.com for great rehab content. See more

New article on one of the worst type of knee injuries. https://motionptr.com/blog/tibial-plateau-fracture-orif

Here’s an update to our tibial plateau fracture patient. He is now walking short distances without a cane or crutch. He feels some instability in the knee but notes it’s getting better. . He recently met with the surgeon who was very pleased with his progress and wants him to focus on strengthening and walking more. . Injury Background:... These are some of the nastiest knee injuries we see in PT. The bottom half of the knee joint (tibia) breaks/shatters due to blunt force trauma common in high speed falls (skiing/snowboarding) and car accidents. . In this case the patient was a pedestrian who was struck by a speeding car. . The surgeon had to put the bottom-half of the knee back together using pins and plates. The pins and plates hold the knee in place while the bone heals. It usually takes 6-8 weeks for the bones to heal and for the structure of the knee to be stable enough to start putting weight through. . Physical Therapy Protocol: Recovery is long and painful. It usually takes up to a year for a patient to return to their prior level of activity. . In this case, we have spent 6 months pushing his knee ROM. The surgeon cleared him to start putting some weight on the leg at the 10-week mark after surgery, once the x-rays showed good alignment in the healed bone. We have slowly been pushing his weight bearing tolerance over the past 3 months. . Strengthening started immediately in the non-weight bearing stage. He performed a lot of exercises on his stomach and on his back. . Exercises: 1Bridge walk outs - Great exercise for the gluteals and hamstrings. You can see how he struggles to maintain the bridge all the way through the walkout. 2TRX Squats - Leaning back on the TRX straps helps him limit the stress on his, allowing him to use his glutes more. My cue to him was to reach back with his but like he’s going to sit in the chair. 3Wall Marching - Great way to load the leg in single leg stance. His cues are to push the wall back and to drive with his legs. Great way to activate the quads and gluteals. . Check http://motionptr.com for more rehab break downs.

https://motionptr.com//patellar-tendon-repair-rehab-in-phy

Our patellar tendon repair patient is progress well. His knee bend has improved to 130 degrees, goal is 145 degrees. . In this video we are working on his agility and eccentric strength. He has good concentric strength but he still does not trust his knee to go down stairs with normal mechanics. . Exercises:... 1 Agility Ladder - He’s doing agility ladder at slow speeds to build confidence in quick movements. 2 Ladder Mini Hops - He still cheats by leaning over to the right leg when landing, his cues are to land with his weight balanced non both legs. 3 Assisted Step Downs - We kept the step small so he can start gaining confidence as his quad has to eccentrically control the knee bending as he steps down. . Background . In this case the patient was playing soccer when he suffered a patellar tendon rupture on a high speed cut. . Rehabilitation for these repairs is straight forward. Patient will be in a brace that is locked in full extension for 6 weeks with crutches. During the 6 weeks patient is allowed to slowly progress the range of the knee bend to 90 degrees. They are also allowed to work on non-weight bearing strengthening exercises for the leg with the brace on. . The brace is unlocked at the 6-week mark to allow active motion and patient can start standing exercises as tolerated. Gait training is usually started at this time as well. . To goal is to regain full range in the knee so it matches the non-injured knee. Strength wise we want at least 85% strength in the injured knee compared to the non-injured knee before we allow patients to return to their sport. Agility exercises can be started around the 3 month mark and low grade explosive/power exercises can be started around this time as well. . Return to sport usually happens between 9 to 12 months after surgery . . Checkout our profile @motionptr for a break down of injuries and their rehab. . Also checkout our website https://motionptr.com for great rehab content. See more