Eduction
Life Style Modification
- vocational Counselling / ergonomic work environment
- activity modification
- home modifications
Pharmaceuticals
- symptomatic
- disease modification
Orthotics
Physiotherapy
- local symptomatic
- range of motion
Throwing injury
- seen in the throwing athlete
- repetitive microtrauma / valgus stress
- develop laxity
Initially
- lose velocity / accuracy
Develop medial pain
40% ulna nerve symptoms
Osseous canal between talus and calcaneum
- interosseous talo-calcaneal ligament
- cervical ligament
- joint capsule
- nerve endings / arterial anastomoses
Flat foot / overpronation
Inversion / sprain
ITB rubbing on LFC
- long distance runners (slow running more at risk than fast)
- cyclists (seat too high, improper technique)
ITB becomes tight, especially posterior portion
Develop inflammed tissue under ITB
- synovium
- bursa
Overuse
- sudden increase in distance
- hill running
- genu varum
- improper shoe wear
European Orthopaedic Paediatric Study JPO 1999
- 452 patients
- juvenile and adult
Findings
- stable lesion with cartilage intact and no dissection had good prognosis
- if signs dissection, surgical management better than non surgical
- sclerosis on x-ray poor prognostic sign
- lesions > 2cm poor prognosis
- 20% OCD in juveniles abnormal x-ray findings at 3 years (not benign process)
Return to Sport
Shelbourne et al. Am J Sports Med 1999
- 133 patients with isolated PCL injuries followed for mean of 5 years
- 1/2 returned to sport at same level of play
- 1/3 returned to sport at lower level of play
https://pubmed.ncbi.nlm.nih.gov/10352760/
Agolley et al. Bone Joint J 2017
1. Painful Bunion / Hallux valgus
2. Metatarsalgia / MTPJ dislocation
3. Claw toes
Complain of pain with prolonged standing
Complain feet tire easily
Overall alignment
Heel raises
Intra-articular proximal ulna fracture
Articulates with trochlea
- may have a central bare area
Triceps insertion
- via broad aponeurosis which blends with anconeus and CEO
Undisplaced fracture
- need to ensure triceps mechanism is intact
Lateral : Medial 9:1
4th & 5th decades
- M = F
- 75% dominant arm
50% of regular tennis players
- especially > 2 hrs / week
Insertion pathology / Enthesopathy
Over-extension of the elbow with supination / pronation
Lateral epicondyle
- anconeus from posterior face
- ECRB and EDC from anterior face (CEO)