Updated: Aug 1, 2020
Hannah is a 11-year-old girl, who is enjoying competitive basketball and softball in youth group. Her pediatrician and parent brought concerns on pain and double jointed issue (called as "hypermobility syndrome") in the knees and ankles associated with squating, stair climbing, pivoting, hopping, jumping, and running.
These concerns are not uncommon for those who are in the peak of developmental growth and excessive exposure to many different sports participations in youth group. Comprehensive physical therapy management is highly recommended to address predisposing and perpetuating factors (finding contributing factors of problem lists) associated with lack of control of leg stability, especially single limb static and dynamic loading. The initial photo demonstrates Star Excursion Balance Testing (SEBT) medial reach, resulting poor trunk-pelvic control resulting in a torso lean/rotation to the left, elevated pelvis to the right and the knee caving inward.
We used the "MAT" to take objective measurements of lower extremity range of motion, balance, and coordination during treatment sessions including SEBT, single-leg balance, lunge, and hopping ability. Hannah underwent training using biofeedback beginning with core stability, double limb load exercises and progressed to single-limb load exercises when appropriate to allow her to return to her recreational activities with improved motor control and form to reduce risk of re-injury to her knees and ankles.
The second photo demonstrates the significant perceived improvement of medial reach control during SEBT after training to improve the pelvic-hip-knee control to maintain proper body alignment/coordination including upright trunk and pelvis and knee aligned under the hip to reduce undue stress on the knees and low back/hip region. Overall plan of care was implemented over 10 weeks of one-on-one individualized motor control/functional rehabilitation program as well as home based exercises.