First patient of the day had pain inferiorly to the medial malleolus of his lef foot. It is a football-specific injury that occured two weeks ago. Swelling has gone down since. He is capable to fully weight-bear, but there is still pain occuring in AROM & RROM during eversion and plantarflexion. Functional tests such as the squat caused soreness around the medial malleolus and up the medial portion of the achilles tendon. The treatment prescribed following regaining ankle stability and reducing of pain through isometric and isotonic strengthening. Dynamic proprioceptive work was introduced using a 1/2 swiss ball. On the follow, after a full re-evaluation, more open-chain exercises can be introduced (Hallen, 2014).
Second patient of the day exhibited symptoms of an irritated sciatic nerve. A week ago these symptoms were prevalent on the right leg, while in the last couple of days they have transferred onto the right. There was no neurological or discogenic abnormality following the evaluation, neither was there any great degree of piriformis tightness during Assited STR. After conducting the Dynamic walking gait analysis it was concluded that the sciatic symptoms are coming from a hypertrophied piriformis as a result of poor ankle biomechanics follwing her previous P1 injury. She was prescribed gluteus medius exercises to perform at home, but on her next visit further focus will be placed on her left ankle (Enseki, 2006).
The last two patients were from the Cancer clinic, coming down for their free initial check-up. First patient requested purely a massage on her calves due to tightness and swelling occuring post-exercise and walking. When performing RROM in pl flx and dorsi flx there was a noticable difference in strength between her left and right ankle. Home based exercises were prescribed to bring back strength symmetry within the ankle (Harvey, 2012). The second patient complained of pain in lateral dorsal portion of her left foor. After fusion of the 4th and 5th metatarsal, a noticable deformation had occured cadung her pain and discormfort during walking and palpation. The pain has diminished after removing the plates but it still remains prominent, 4-5/10, during physical activities. Stage 1 home conservative exercise treatment was prescribed to regain AROM, after that is achieved adaptations of the exercises were provided so that RROM could reach a 5/5 scaling on the Oxford Scale (Lewis, 2008). A full re-evaluation of the condtions will be conducted upon the patients’ second visit.