Name: ---------Sport: Varsity Wrestling Date: 1/15/14 Time: 4:15 pm S: An 18 year old male varsity wrestler complains of bilateral

thumb pain during activity. About two weeks ago, he went for an ankle pick during practice, but the teammates ankle didnt move. His left thumb felt like it opened and has been hurting since. Yesterday, about a week and a half later, he was wrestling and winning in the match when the opponent cranked on his right thumb. Both ache and cannot allow him to perform his normal moves that are critical to wrestling, and he does not feel like the left thumb has improved. The left thumb has been taped with a spica practice continually, which he reports only sometimes seems to help. Patient does not recall a prior injury to either thumb. O: There is equivocal pain and tenderness along the medial aspect of the metacarpalphalangeal joints bilaterally. The left side presents with mild swelling over the joint, but there is no discoloration, deformities, bleeding or bruising on either. Bilaterally pain is with PROM: thumb extension and RROM: thumb extension and flexion. Positive valgus stress test for pain and laxity bilaterally with the metacarpal joint in extension. The left presents with more laxity but less pain. Stress with the metacarpal stabilizied and the thumb in 30 0 of flexion and radial stress causes mild pain bilaterally. Patient is able to hold a grip with the thumb and index finger together. A: The signs and symptoms indicate a possible ulnar collateral tear or sprain, non-displaced fracture, or strain to the adductor and flexor pollicis muscles. The most significant finding is the laxity with valgus stress on metacarpal joints, and with significant opening of the left thumb. P: Refer to team physician for further testing. Continue to tape both hands with even more limited thumb motion. Practice as tolerated until conclusive testing. Continue to ice immediately after practice for 20 minutes. Contact medical help if symptoms worsen significantly overnight. ******Morgan Uhen, student