Sesamoid Injury Case Study

Rehab is essential for any athlete who has sustained a debilitating injury to the musculoskeletal system. Below is a sample protocol that can be used to treat an athlete who has sustained a sesamoid stress fracture that required surgical repair. An athlete returning from surgical repair of a great toe stress fracture can be expected to be out for approximately two to four months. Likewise, it is important that the clinician working with the athlete keeps in mind that the athlete will not only be going through the rehab physically but also emotionally. It is best if the athlete is not given specific dates of when they will return to play, and that the clinician tries to keep the athlete surrounded by their team atmosphere as much as they can.

Calf Raises: The athlete will stand on a surface that is slightly higher than the floor. They then will move their ankle into planter flexion and dorsiflexion. This exercise will not only aid to strengthen their calves, but it also will help recreate the toe off motion that the athlete will be expected to perform during gait. This exercise will be introduced toward the end of the four weeks as test to see if the athlete is ready to perform gait pain free.

After performing the above exercises, the athlete will return to the bike to perform a cardiorespiratory fitness maintenance workout. This workout will alter in intensities and times, the athlete will be expected to maintain those intensities for a set total time. The athlete will begin with performing the workout for fifteen minutes and aiming to increase the total time to thirty minutes. In weeks five and six, the athlete will no longer be walking in the splint and will be permitted to wear normal shoe wear. At this time, a clinician will perform gait analysis to ensure the athlete is using proper form while walking (Figure #). The athlete will be asked to walk on the treadmill for maximum time of five minutes while walking at a steady pace. At this time, the athletic trainer and/or physical therapist working with the athlete will correct any abnormalities in their gait. This new exercise, along with the exercises mentioned prior will be performed every day. Furthermore, balance and proprioceptive exercises will also be instated at this time. Exercises that can be used along with progressions are