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Hip Case Study 1

Hip Case Study 1

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Published by superhoofy7186

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Published by: superhoofy7186 on Feb 03, 2009
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09/21/2010

 
Hip Case Study 2: Thigh Strain
Karen Patton is a 21 year old club footballer who has recently pulled a muscle at thefront of her right thigh. The injury occurred whilst kicking a ball 5 days ago. Sheattended the local walk-in centre where a diagnosis of grade 2 rectus femoris strainwas made and she was referred to physiotherapy. Karen walks on elbow crutches andis partial weight bearing through her right leg. She is off work from her job as postalworker. Apart from a previous similar injury 8 months ago she is otherwise fit andwell.
Anatomy & Pathology
 
Muscle Strains assosciated with overstreching of muscle tissue – in thigh. Hamstringsstrain come during active contraction – quadriceps – strain somes through direct blow.Grades of muscle strains :Grade 1 < 5% fibres damages - 2-3 weeks to recover Grade 2 >5% damage - 3-6 weeksGrade 3 – rupture – surgey may be necessary in sports person – 3 months
Subjective Examination
Where\What
: pain in rectus femoris
When
: 5 days ago
How
: kicking a ball
 0-10 rating
: mid range
24 hour cycle
: none
Better for
: ask 
Worse for
: walking, stairs , stretching
Type of pain
: expect burning/ tearing – not tingly or crepitus
Past Medical History/ General History
: none
Red Flags and general concerns
: proximal femur tumor – gives pain in groin at restor night.
 
SH
: postman
DH
: none
Patients main outcome
: return to work 
Objective Examination
Working Hypothesis
: strain of rectus femoris
Advice & Consent
: give and obtain
General Observations
: abnormal gait – partial weight bearing
Acute Observations
:Skin colour SwellingPostureMuscle bulk Deformity - none
Active Tests
:adduction abduction – no problemmedial rotation lateral rotation – no problemflexion + knee extension – pain because of tear extension + knee flexion – more pain because of stretching torn muscleadding knee movements distinguishes the rectus femoris from other quads whichdon’t attach below the knee
Passive Tests
:

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