Case Study 1-acl

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School

Texas Tech University *

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Course

2198

Subject

Medicine

Date

May 3, 2024

Type

pdf

Pages

4

Uploaded by CommodoreFieldOtter10 on coursehero.com

Willa Lamb has been the athletic trainer at Hall and Peck School, a college preparatory boarding school in the Northeast for four years. She had previously worked in the clinical/outreach setting for three years and had developed a wonderful appreciation for her athletic trainer and physical therapy colleagues. In the clinic, there were discussions and staff in-services about the latest in research and how to incorporate the recent findings into the rehabilitation programs of the patients. While the daily professional interactions proved to be very stimulating, she realized that she very much enjoyed working with her more active, athletic patients than the general orthopedic population she saw in the clinic. In the clinic, there were also time limitations placed on the care she could provide to her patients. Insurance reimbursement played a large part in this. However, the same time limitations were of little significance in her high school setting. Because of this, her recent interest in a job focusing solely on the high school athlete was piqued. She noticed an opening for a 10-month athletic trainer position at an independent school a few miles away from where she currently worked and decided to apply for it. She was offered the job 10 days later. Now, four years later, Willa has an athletic training room frequented each afternoon by many of her athletes who are working on rehabilitation programs. She enjoys this aspect of the job because she can see the concrete evidence of the daily improvements of her athletes following injuries. However, she realizes that with the other demands of the day-to-day operations required of her in her athletic training room, she does not focus as much time on her rehabilitation research as she used to. Many of her patients are also referred out for their therapy once or twice a week so they may supplement with off-campus physical therapy in addition to the therapy Willa provides at the school. She is now working with one of the three athletes who had recent ACL surgery. It has been at least four or five years since she'd had an athlete with an ACL injury but in the last two years, she has had six. Two of these were girls soccer players, one girls lacrosse player, one girls basketball player and the other two were football players. Today, she is working with Mandy, a freshman from New Mexico on the girls’ varsity soccer team, who was playing in only her fifth game at the high school level. Mandy had been a 'frequent flyer' to the athletic training room since the beginning of the season. Original concerns were that she was homesick but seemed to have found a comforting and nurturing atmosphere in the athletic training room. This is her first time away from home and at a boarding school. At the age of 14, she finds this adjustment a little challenging and misses her family and what was ‘comfortable’. She also is a very skilled player who is well known back home for her athletic talents. At Hall and Peck, she is adjusting to being “just a new kid” at the school. While each of her aches and pains were addressed as she came in each week, a number of these, after evaluation, turned out to be just that---"aches". When the call came on the walkie-talkie that she was down on the soccer field with an injury, Willa's first thoughts were, "not again, probably another ache." When Willa arrived on the field, Mandy was standing and attempting to walk off on her own. The coaches gave Willa a look that expressed they also thought Mandy might just be
having another one of her 'aches' again. She stated she was in pain but did not appear in any distress. Upon evaluation by Willa, it was determined that Mandy was clearly suffering from an ACL injury. She exhibited a positive Lachman’s sign as well as anterior drawer testing. She was beginning to show signs of swelling early on. She was referred to Dr Biscotti, the school's orthopedic physician for the last 15 years, and further diagnostic testing was completed. It was revealed that Mandy did indeed suffer an ACL tear and a surgery date was scheduled for the end of the week. With this being the sixth ACL injury, Willa began to wonder if there were specific reasons for these injuries occurring. The condition of the athlete, the surface they were playing on, the lack of conditioning or just an unlucky day for each of them were just a few of her thoughts. Most of the injuries were to her female athletes but there were also a couple that occurred to male athletes. Some were seemingly in better shape than others. All occurred on various fields and indoor surfaces. She was aware of the increase in ACL injuries in females due to a variety of predisposing factors. She had read about these through various articles in her professional journals. Some of these articles would hypothesize on theories while others appeared more scientifically based. Some appeared to be very limited in the number of participants. All seemed to show a variety of ways in which to decrease the incidence of injury. She wanted to determine if any of these studies were valid. If only she had her former colleagues to discuss these concerns with each day. Over the next week she sat at home, immersing herself in readings and research articles related to this topic. She discovers that one doctor has apparently developed a program that states "it is the ONLY scientifically proven program to reduce the risk of serious knee injuries in females, increase vertical jump, improve hamstring to quadriceps strength and symmetry, improve landing mechanics and reduce side-to-side movements of the knee." It seems like it would be a great program. If it states that “it is the only proven program,” then there must be some validity behind the statement. Willa begins to consider implementing this program with all of her female athletes. She draws up a plan to meet with all the coaches of her female athletes to share her thoughts on how to incorporate such a program into the weekly schedule. She sees this as a positive and proactive approach. The program also states that it can be used for male athletes as well. Willa thinks through it a bit more and has some additional thoughts. She tucks these into the back of her head but does not forget them when thinking how she would implement the same program for the male athletes of the school. Analy&cal Ques&ons 1. What varying factors could Willa have looked at regarding causes for the increase of ACL injuries? Anatomical Factors: differences in knee joint anatomy and alignment between genders
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