rehab assignment
Case Study
Our subject for this case study is a female recreational triathlete.
For background information only, our case subject has a history of:
Intermittent low back pain on the left side
Right Groin Strain
Right knee pain that gets worse with increased activity/ training
Kinetic Chain Assessment
Overhead Squat:
Foot/ Ankle Complex:
Right Foot Flattens
Left Foot Turns Out
Knee Complex:
Right Knee Moves Inward
LPHC
Low Back Rounds
Excessive Forward Lean
Asymmetric Weight Shift to the Right
Thoracic Spine
Increased Kyphosis
Shoulders
Arms forward
Goniometric Assessment:
Ankle Dorsiflexion: 20 is ideal
Left= 11
Right= 4
90/90 Knee Extension: 1020 is ideal (closer to 0 is better)
Left= 55
Right= 43
Hip Abduction: 45 is ideal
Left= 39
Right= 21
Hip Internal Rotation: 45 is ideal
Left= 19
Right= 27
Hip External Rotation: 45 is ideal
Left= Within Normal LimitsRight= 33
Hip Flexion: 120 is ideal
Left= 104
Right= 114
Modified Overhead Squat:
Some improvement with Right Knee Valgus
Single Leg Squat:
Left Leg:
Outward Trunk Rotation
Right Leg:
Foot Flattens
Knee Moves Inward
Hip Drop
Inward Trunk Rotation
Manual Muscle Testing:
The following Muscles Tested “Weak”:
Bilateral Anterior Tibialis
Right Posterior Tibialis
Left Adductors
Bilateral Glute Maximus
Bilateral Glute Medius
Bilateral Hip Flexors
Instrinsic Core
Bilateral Lats
Task
Leveraging your current understanding of Human Movement Science, CEx, clinical experience, and
the demands of this subject’s activites, please address and include all of the following in your
Assignment Submission:
Correlation between the identified impairments and the Left side low back pain, Right side groin
strain, and right side knee pain
Primary subsystem impairment relating to this case and why
In an organized fashion and using the provided templates, design TWO CEx/ Injury Reduction
Programs that address this subject’s impairments as identified during the kinetic chain assessment and
that adhere to the scientific principles/ structure of the CEx system:
One Long Program, that will take no more than 60 minutes to complete to be performed 23 days per week
Be Creative Here…
At the end of your corrective routine and as part of your integration step include a few exercises
that would encompass a total body integrated strength training program appropriate for this athlete
and that will complement/reinforce the goal of correcting her LPHC impairments. Here is a guide to
help you organize this section. You do not have to include an exercise for each body part/ area if you
feel it is inappropriate; however, in your summary section you must explain why you did not include
an exercise for a certain area:
Total body exercise
Back exercise
Chest exercise
Shoulder exercise
Leg exercise
One Short Program that can be used as a warmup prior to triathlon training workouts on the bike, in
the pool, or pounding the pavement that will take no more than 15 minutes to complete. Take
equipment type/availability into consideration as well when designing this program.
Your Programs must contain the following elements and meet the following criteria:
Inhibition Techniques (list specific exercises/ techniques)
Lengthening Techniques (list specific exercises/ techniques)
Activation Techniques (list the specific exercises you’d use, not just the muscle names)
Integration Techniques (list the specific exercises)
List acute variables for each technique/ exercise
If you include exercises in your program that are unique to your environment and have names that I
may not recognize, please explain what areas/ muscles the exercise is designed to target.
Provide a detailed summary for each program with clinical and/ or scientific rationales that justify
your specific exercise technique selections, i.e.:
Why did you choose the specific techniques/ exercises outlined in your program?
What compensations do they address?
What tissues/ muscles/ subsystems do they target?
How does each technique you selected benefit our subject specifically, given her impairments and
sport?
