Management of lower extremity malalignment during running with neuromuscular retraining of the proximal stabilizers

This case report presents a high-level female runner with a history of more than 25 years of recurrent lower extremity (LE) injuries and LE malalignment problems during running. Due to her LE malalignment, she has been unable to run for the past 3 years. A definitive diagnosis was not found for her inability to run so by exclusion we diagnosed dysfunction of the hip, spine, and pelvic stabilizers that resulted in her in LE malalignment. To treat this muscle weakness, we designed a Pilates-evolved functional movement intervention to improve the control and strength of the proximal stabilizers and regain normal LE alignment. The Pilates-evolved treatment approach involved a series of functional and progressive resistance exercises designed to dynamically stabilize the spine, pelvis, and hip through all planes of motion. After 1 year of Pilates-evolved training, the athlete's disabling movement pattern resolved and she has returned to a regular running program. The purpose of this case report is to describe a Pilates-evolved functional movement intervention that resolved this runner's LE malalignment and returned her to running when other traditional treatment approaches were not effective in doing so.

Differential diagnosis in physical therapy evaluation of thigh pain in an adolescent boy

Slipped capital femoral epiphysis (SCFE) is a condition of the adolescent hip in which the femoral head displaces relative to the femoral neck. This disorder is characterized by a synovitis of the hip joint or a mechanical limitation of motion with pain referred to the thigh or knee. The case described in this report is typical of an adolescent with SCFE. A brief review of epidemiology, etiology, clinical presentation, and treatment is presented to facilitate the physical therapist's knowledge of this condition and its proper management. Delay in diagnosis and treatment of SCFE may result in progression of the slip and chronic disability from osteoarthritis. It is imperative, therefore, that a patient suspected of having this condition be promptly referred to an orthopaedic surgeon for radiographic evaluation.