Rehab Assignment – Lumbo-Pelvic-Hip Complex Impairments Case Study

We’ll finish this Module Series on Lumbo-Pelvic-Hip Complex Impairments with your third Case Study Assignment of the semester. This format will be similar to the case study assignments from Modules 4 and 7. The point value for the case study assignment is 50 Points.

Use only the provided template for this assignment which can be found at the bottom of this page. You can insert/ add rows if you need more room.

Please read all of the following…your grade depends on it!

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
Low Back Rounds
Excessive Forward Lean
Asymmetric Weight Shift to the Right
Thoracic Spine
Increased Kyphosis
Arms forward
Goniometric Assessment:

Ankle Dorsiflexion: 20 is ideal

Left= 11
Right= 4
90/90 Knee Extension: 10-20 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 Limits
Right= 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

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 sub-system 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 2-3 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 warm-up 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?


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