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Tyreek Hill Carted off with left knee dislocation. Apparent multi-ligament tear. Hope nerve and artery ok. Horrible end to season.

812,511 Aufrufe • vor 11 Monaten •via X (Twitter)

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Consent ✅ The thing I enjoy most in my job is collaboration with expert physiotherapists on complex cases, especially in elite sportsmen & women It’s a symbiotic relationship – there is mutual learning & professional growth - and the patient gets the best of both worlds I had the privilege of assessing a professional ballet dancer who flew in from Budapest alongside the amazing Liz Bayley recently I thought I’d summarise our joint knee assessment for those interested (get a cup of tea! 😆) 2 months ago, sharp pain in the medial knee after sitting with legs crossed for 30 minutes ‘Instability’ during Swan Lake rehearsals, with pinching pain and fear of knee buckling – had one fall on stage during a performance One episode woke up one morning with local swelling, ‘pressure’ in the joint, and diffuse anteromedial knee pain - unable to walk or fully extend / flex the knee Currently experiencing sensation of pain, ‘swelling’ & fullness, particularly anteromedial patella - burning, prickly sensation Warms up with activity – latent post exercise pain Aggs - Grand plie in first position, squatting, bridges with hip adduction, transferring weight in turned-out position, down stairs Reviewed MRI in Hungary – Normal menisci, Hoffa's fat pad & articular cartilage – but report missed adductor magnus distal tendinopathy! (see sagittal image) – always check the images yourself Exam- Hip joint & lumbar spine clear Full squat sore especially with R leg bias Tender medial aspect of the knee, particularly in the region of the pes anserinus Fat pad compression test negative Mild awareness PFJ compression Knee flexion pain at end range but other meniscal tests negative Adductor loading / stretch tests (including adductor magnus bias) negative Prone knee bend neural tension test with saphenous nerve bias – minimally provocative DDs: · Patellofemoral pain – ‘common things are common’ · Pes anserine bursitis with associated infrapatella branch of saphenous nerve irritation? · Distal adductor magnus tendinopathy with associated saphenous nerve irritation? (AM forms floor of Hunter’s canal) POCUS in clinic – Great for tracing saphenous nerve & distal branches reliably; no nerve pathology seen or pain reproduction on systematic Tinel’s test using probe. Adductor magnus tendinopathy confirmed – but on further review of MRI, the inflamed adductor magnus tendon seems some distance from saphenous nerve (see axial image), so symptoms less convincing related to secondary nerve irritation However, pes anserine fluid noted vs contralateral side & correlates with her typical pain US guided local anaesthetic injection (video) significantly improves symptoms on comprehensive testing in gym & pilates studio P - Liz Bayley refined a Ballet specific rehabilitation plan now we have more diagnostic confidence - so cool watching her piece this together! Observe how symptoms respond over 6-8 weeks If no improvement, consider definitive injections to pes & / or PFJ – but need to exercise caution especially around tendons that are placed under huge athletic demand

James Noake

21,546 Aufrufe • vor 1 Jahr

This is the prompt for figure 4 head lock: Begin with a low three-quarter view from Honoka’s left side, showing Arisa standing behind her head. Move closer gradually while keeping Arisa’s hips, knees, ankles, and Honoka’s defensive movements fully visible. 0.0–1.5 sec: Honoka lies facing upward, breathing heavily, with both knees slightly bent and her gloves near her chest. Arisa stands behind Honoka’s head with a wide, balanced stance. She studies Honoka briefly, then bends her knees and lowers into a controlled squat. 1.5–3.0 sec: Arisa sits onto the canvas directly behind Honoka’s head. She places both palms on the mat beside Honoka’s shoulders for balance, without grabbing Honoka’s wrists or arms. Honoka reacts by lifting her head and shoulders slightly and raising both gloves defensively. 3.0–4.8 sec: Arisa shifts onto her left hip and slides her right thigh beneath the back of Honoka’s neck and upper shoulders. Arisa’s right knee points diagonally toward Honoka’s left shoulder, while her right lower leg extends along the canvas beside Honoka’s head. Honoka tries to turn toward Arisa and pushes against Arisa’s thigh. 4.8–6.5 sec: Arisa swings her left leg across the front of Honoka’s upper chest and near shoulder. The back of Arisa’s left knee settles beside Honoka’s right cheek and shoulder line. Arisa keeps her left foot elevated briefly while adjusting the angle, preventing Honoka from sitting upright. 6.5–8.0 sec: Arisa bends her left knee more deeply and brings her left ankle toward the bend behind her right knee. At the same time, she lifts her right lower leg from the canvas and folds it inward, crossing it over the left ankle. Her knees close around Honoka’s head-and-shoulder line, creating a compact closed loop. 8.0–9.5 sec: Arisa secures the crossed-leg arrangement by placing the back of her right knee firmly over her left ankle. She flexes both feet, draws her heels closer to her hips, and rotates her torso slightly toward Honoka’s right side. One hand remains posted on the canvas while the other steadies her own shin. 9.5–11.5 sec: Honoka struggles fiercely. She grips Arisa’s lower leg with both gloves, bridges her hips high, twists her shoulders, and plants both feet against the canvas. She tries to turn onto her side and slide her chin and shoulder toward the open space. 11.5–13.2 sec: Arisa follows Honoka’s movement by scooting her hips backward several inches, keeping her knees tightly connected. She lowers onto one forearm, slightly straightens her upper leg, and pulls the opposite heel inward to stop Honoka from rotating free. 13.2–15.0 sec: Honoka continues resisting without surrendering. She bridges again, kicks her heels against the canvas, pushes at Arisa’s knee, and twists her torso from side to side. Arisa maintains the secured leg configuration with steady posture and controlled pressure. End with Arisa holding the dominant position while Honoka remains conscious, active, and still refusing to tap.

Angel Combat

14,668 Aufrufe • vor 1 Monat