Date of Award

5-2021

Document Type

Thesis

First Advisor

Meridee Danks

Keywords

Fascial counterstrain, Athlete, Pediatrics, proprioceptive neuromuscular facilitation (PNF), Bankart labrum, anteroinferior tear of the labrum, multiple anterior shoulder dislocations, isometric to isotonic motion

Abstract

Background and Purpose: This case study will address the use of fascial counterstrain, proprioceptive neuromuscular facilitation (PNF), and range of motion (ROM) to rehabilitate an arthroscopic anterior Bankart labrum repair in a pediatric patient. Bankart labral tears are defined as an anteroinferior tear of the labrum, frequently caused by multiple anterior shoulder dislocations. Fascial counterstrain can be used in post-surgical patients to reduce swelling, decrease healing time, and reduce pain. PNF and ROM allow the patient to return to a functional lifestyle and are included in most protocols provided by the surgeon. The purpose of this study is to demonstrate the benefits of combining traditional therapeutic treatment methods with fascial counterstrain to rehabilitate post-surgical patients.

Case Description: The patient was a 15-year-old male who presented post-surgically with low pain levels, no active range of motion, limited passive range of motion, strength limited by pain, and slight edema around the left shoulder.

Intervention: Treatment included strength progressions from isometric to isotonic motion, fascial counterstrain, passive range of motion, joint mobilizations, and neuromuscular re-ed using PNF patterns.

Outcomes: Following PT intervention, the patient achieved increased strength, improved range of motion, reduced pain, and improved posture.

Discussion: The patient’s range of motion and strength were improved ahead of protocol with low to no pain throughout all rehabilitation. He progressed from no active motion to active shoulder flexion and abduction to 90 degrees with resistance to increase strength. The patient has improved his rounded shoulder posture with the reduction of tension in his anterior shoulder. By combining fascial counterstrain and traditional therapy methods, we were able to quickly progress the patient while reducing joint inflammation and pain.

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