Hi Luis,
If stability and intraarticular structures are not a problem, how about an agressive stretching protocol? The following procedure has helped most of my patients with similair symtoms: 1) 3 treatments per wk for 2-3 wks with deep myofascial and massage techniques to affected hip and thigh muscles (especially outer thigh/hip area) plus manual streching (preferably CRS type stretching) of tight lower limb muscles/connective tissues. 2) Pat stretches daily at home (you have to teach him and make sure he performes his stretching correctly) in combination with (low impact) aerobic exercises that do not aggrevate symptoms, e.g. indoor cycling, acuatherapy etc. After a couple of weeks symtoms are often minimal and pat can start regular training with caution. N.B. As a preventative procedure pat should CONTINUE stretching eventhough symtoms are no longer present! Hope this was of some help. Good luck with your patient!
Sincerely,
Tobias
PS. You did "rule out" his lumbar spine, right...?
--------------------------------------------
Tobias Sundberg, PT
[log in to unmask]
--------------------------------------------
-----Original Message-----
From: Luis M. Barbado <[log in to unmask]>
To: physio <[log in to unmask]>
Date: Wednesday, September 15, 1999 2:42 AM
Subject: Tendonitis?
Hello:
I would like to explain you a case.
Young man (19), football player amateur. After one month
without training since the end of the regular season, he began the new
season with a proffessional team. The first day he took a very hard
training. After it he complained of pain in lateral side of the knee.
The diagnosis was tendonitis in the tibial inserction of m. tensor
fasciae latae. He stopped trainig and began rehab treatment (US,
massage). Two weeks after he was infiltarted and one week after he was
able to began soft (quite soft) training. He was increasing intensity
of trainings but he always finished them with pain. Two days ago he was
not able to finish the training after two days of rest. Total time since
the begining is more than one month and a half. The NMR did not show any
problem in the knee (meniscus,...). What do you think about it? Can you
help me?
Thank you very much.
--
=========================
Luis M. Barbado Mellado
Physiotherapist
Málaga (Spain)
LMBM'99
=========================
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|