Client Case Study: Wrist and Knee Injury

The client is a 60-year-old boilermaker who sustained a distal radial fracture of his right wrist and tear of the posterior horn of right medial meniscus at his workplace on the 12th January 2018. The insurer referred him to Absolute Balance on the 22nd February 2018 as his recovery had plateaued after undertaking physiotherapy for his right knee and occupational therapy for his right wrist. At the time of the referral to Absolute Balance the client had an antalgic gait with restricted range of movement (ROM) through his right knee approximately 70% of full ROM and limited range of movement through this right wrist and thumb as it was still in a splint. The client was certified totally unfit.

Job Specific Program

The exercise rehabilitation program began on 23rd February 2018, initially focused on increasing pain-free range of motion through his right wrist, thumb and knee using a series of active and passive stretching exercises. The program progressed to improve stability of his right wrist through a progression of proprioception exercises, improve stability in his right knee; and supporting lower limb musculature for correct gait patterns and muscular recruitment patterns when performing work tasks. Work tasks involve walking on uneven surfaces, stair climbing carrying tools up to 15kg, working in awkward bent over and kneeling postures. Required to lift from floor to waist up to 25kg, waist to shoulder height up to 15kg and overhead up to 10kg. The final goal was to increase his right-hand grip, knee and supporting upper and lower body strength, combined with correct manual handling technique to reduce the risk of future injury.

Outcome of Exercise Rehabilitation

The client is now at 100% functional capacity following eleven supervised sessions, combined with completing the exercise program independently two to three times per week. The client showed significant improvements in range of motion through his right wrist and knee, and strength through his upper and lower limbs. The client is now competent in self-managing his exercise rehabilitation program focussing on increasing grip strength and lower limb strength while ensuring correct manual technique is performed throughout all work tasks; in order to maintain his current level of function. The client has reached all outcome measures set by Absolute Balance. As a result, the client obtained a final medical certificate following three months of exercise rehabilitation.

Daniel Nguyen (B.Sc. Exercise Physiology)

Accredited Exercise Physiologist (AES, AEP)(ESSAM)