Dave,
X-rays have proved negative. Should I still look into
a bone scan?
Nabil
--- David Riddell <[log in to unmask]> wrote: > Hi
Nabil
>
> Have you definitively ruled out a Lx condition such
> as a pars
> defect/stress fracture (spondylolysis). The initial
> presentation was
> perhaps not typical of this injury but considering
> she is a gymnast
> (high risk group) and extension is a problem it
> would be worth
> considering this if you have not done so already.
>
> Dave r
>
>
>
>
> -----Original Message-----
> From: - for physiotherapists in education and
> practice
> [mailto:[log in to unmask]] On Behalf Of nabil
> keshavjee
> Sent: 06 January 2004 10:29
> To: [log in to unmask]
> Subject: ?treating SI jt.
>
> Hi,
> Hope you all can give me some suggestions as I've
> run
> out of ideas.
> 11yo girl, came in with pain on the right side of SI
> jt.
> Mechanism: during landing from vaulting in
> gymnastics.
> Stuck the landing but was bent over.
> She has had this pain before a couple of years ago,
> but does not remember mechanism. But was
> participating in Gymastics then. Pain gradually
> dissipated.
> On first assessment 6 weeks ago, FABER, compression
> and distration produced the pn, but no longer do.
> Currently,
> Lumbar Extension in standing is pnful at the end of
> movement.
> Lumbar Flexion is not restricted and not pnful.
> During treatment, LEIS is increased and less pnful
> with facilitation of anterior mob of sacrum.
> Glute strength is 5/5.
> Hip Abductors is 5/5.
>
> Looking for a method to increase extension?
>
> Any suggestions would be greatly appreciated.
>
>
> --- David Riddell <[log in to unmask]> wrote: >
> Nabil
> >
> > Try the Physician and Sports Medicine - it's free
> > and has some very good
> > articles. You can find and print out full text
> > articles .PDF or copy
> > them to Word documents - it's at
> > <http://www.physsportsmed.com/>
> > www.physsportsmed.com. This one in particular may
> > help you:
> > Moeller James L., Rifat Sami F., (2001):
> > Spondylolysis in Active
> > Adolescents Expediting Return to Play. THE
> > PHYSICIAN AND SPORTSMEDICINE
> > - VOL 29 - NO.12 - DECEMBER 2001 .
> > I also suggest that you check hamstring and glut
> > length (glut max). I f
> > you are going to test rectus, hip flexors etc why
> > not rather do the
> > testing in the Thomas Test position - I am not
> going
> > to describe it in
> > detail: you or one of your colleagues probably
> > knows the test but
> > remember - butt at the edge of the bed. One knee
> > flexed to chest . Level
> > ASIS's, neutral spine etc. You can also
> > differentiate between rectus
> > tightness and tightness of the other quads - the
> > prone test may give
> > you a false positive for rectus as you are not
> able
> > to get enough knee
> > flexion if the other quads are relatively more
> > tight.
> > Hope this helps
> > Cheers
> > Dave riddell
> >
> >
>
>
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