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Rehabilitation of an elite gymnast with a type II manubriosternal dislocation.

Pidcoe PE, Burnet EN

Department of Physical Therapy, Virginia Commonwealth University, Richmond, VA 23298, USA. pepidcoe@vcu.edu

BACKGROUND AND PURPOSE: This case report describes the rehabilitation of an elite, 15-year-old gymnast after a nonreduced type II manubriosternal dislocation. The rehabilitation took place in a gymnastics venue but was guided by a physician and a licensed physical therapist. CASE DESCRIPTION: The gymnast participated in a 13-week rehabilitation program for range of motion and strengthening that was based on a biomechanical hierarchy. Rehabilitation began at week 2 after injury for the lower extremities and at week 4 for the upper extremities. OUTCOMES: By week 4, the patient began upper-extremity strengthening, and by week 6, the patient had no pain with palpation and tolerated light sternal loading. At week 9, a plain-film radiograph revealed a stable manubriosternal joint, and by week 13, the patient returned to gymnastics pain-free. DISCUSSION: This case report shows that, after a 13-week regimen of progressive and repetitive, cyclical tensile and compressive loading, the manubriosternal joint was stable, and the elite gymnast was able to return to the sport, successfully competing in a regional competition.

Published 2 April 2007 in Phys Ther, 87(4): 468-75.
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