Sports chiropractors are increasingly being sought by professional and amateur athletes to fulfil their sports medicine needs. This paper describes a case of successful chiropractic clinical management of a post-surgical shoulder rehabilitation program.
Case Presentation: A 25-year-old male suburban-districts level (amateur) rugby union player sought assistance from a AICE titled sports chiropractor who was acting in their capacity as a qualified team sports trainer during the match whilst on-field for right shoulder pain and dysfunction following a tackle where he fell heavily onto the point of his right shoulder. Subsequent radiographic and orthopaedic referral identified an unstable acromioclavicular joint dislocation (type III) and reconstructive surgery was performed. Following the surgical procedure, the post-surgical rehabilitation was completed under the guidance of a sports chiropractor. Over a fifteen week period a multimodal management approach was applied in the post-surgical care that included: physical modalities, soft tissue therapy, functional shoulder and spine exercises, spinal and peripheral joint mobilisations and manipulations. Emphasis during management was given to the sports specific functional exercise progressions. Outcome measures at weeks six, nine, fifteen and 21 weeks 18 months post-surgery, recorded patient change and included: the disabilities of the arm, shoulder, and hand questionnaire (DASH), goniometric measures, visual/verbal analogue scales for pain and shoulder muscle str ength by manual muscle testing. This case describes the clinical management after surgical repair of the grade three acromioclavicular ligament tear over a 20-week period with a 12-month follow-up and a full return to pre injury status, function and sporting activity. Management was divided into acute, early recovery, late recovery and functional phases of care. Functional goals and advancement criteria are described for each phase of rehabilitation.
Conclusion: This case documents a sports chiropractor’s approach to multimodal rehabilitation of a rugby athlete. This paper describes an example of the integration of the sports chiropractor into the sports medicine team and the skill set in assessment and management required of that role
Author keywords: Shoulder, Acromioclavicular Joint, Rehabiliation, Chiropractic, Spinal, Extremity, Manipulation
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