Rehabilitation and Return to Sport Following Surgical Repair of the Rectus Abdominis and Adductor Longus in a Professional Basketball Player: A Case Report

Abstract

Study Design Case report. Background Acute traumatic avulsion of the rectus abdominis and adductor longus is rare. Chronic groin injuries, often falling under the athletic pubalgia spectrum, have been reported to be more common. There is limited evidence detailing the comprehensive rehabilitation and return to sport of an athlete following surgical or conservative treatment of avulsion injuries of the pubis or other sports-related groin pathologies. Case Description A 29-year-old National Basketball Association player sustained a contact injury during a professional basketball game. This case report describes a unique clinical situation specific to professional sport, in which a surgical repair of an avulsed rectus abdominis and adductor longus was combined with a multimodal impairment- and outcomes-based rehabilitation program. Outcomes The patient returned to in-season competition at 5 weeks postoperation. Objective measures were tracked throughout rehabilitation and compared to baseline assessments. Measures such as the Copenhagen Hip and Groin Outcome Score and numeric pain-rating scale revealed progress beyond the minimal important difference. Discussion This case report details the clinical reasoning and evidence-informed interventions involved in the return to elite sport. Detailed programming and objective assessment may assist in achieving desired outcomes ahead of previously established timelines. Level of Evidence Therapy, level 4. J Orthop Sports Phys Ther 2016;46(8):697-706. Epub 3 Jul 2016. doi:10.2519/jospt.2016.6352.

A Combined Treatment Approach Emphasizing Impairment-Based Manual Therapy and Exercise for Hip-Related Compensatory Injury in Elite Athletes: A Case Series

“…(Table 4) Subject 1 Initially, the athlete was withheld from two practices. Due to scheduling, one week of active rest occurred two weeks after the initial examination, in which nonaggravating cardiovascular activity and basic lumbopelvic exercise 48,56 were performed. No competitive games were missed.…”

“…Tasks such and jogging, shuffling, jumping and skill development were implemented along with continued sport-specific cardiovascular conditioning. 56 In this phase, four out of five subjects returned to sport participation and/or competition. (Figures 14-20) …”

“…A scheduled break in competition allowed for the acute phase of rehabilitation to then appropriately take place with no games to be missed. Practice was missed for two weeks before graded reconditioning 56 and sporting skill drills were allowed. The subject returned to full participation six weeks following initial evaluation.…”

Designing a Return to Training Model for Professional Athletes after Sport Injury

“…This periodisation design is a complex process that integrates conditioning adaptations, workout programing, the physical and cognitive complexity of exercises and the specificity of the drills [1,12,13]. Always following sport physician *Corresponding author: Toni Caparrós, Insititut Nacional d'Educació Física de Catalunya (INEFC), Barcelona, España, Tel: +34636789552; E-mail: info@tonicaparros.eu guidelines and timing, the design must to achieve the same competition patterns [9,11,14], which will define the thresholds, in terms of functional quantity (load) and quality (intensity) [1,12]. Prevention protocols, both general and specific, can't be avoided on the design.…”

“…Main concepts and variables inherent in the injury that must be monitored and assessed at all times, and they are: the perception of pain [8,9], defined as asymptomatic, educating the athlete in its management as in the expression of perceiving it [10,11]; personal trust between the athlete and all the professionals involved; and setting specific, short term and achievable goals to prevent and challenge on the day by day motivation and concentration [4].…”