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CPG UNI -BECOME AN ALL ROUNDER
40 members • $8/m
5 contributions to CPG UNI -BECOME AN ALL ROUNDER
Feb 2 •
SECOND COMPLEX CASE STUDY OF THE YEAR 🚨
37 y.o.M boxer presented with L) Elbow pain especially when blocking punches. Has been boxing for about 3 years. Looking to have his first pro fight in 3 months and really wants to fix his elbow by then. Had a car accident 20 years ago and dislocated same elbow causing prolonged instability for about 7 years. Had a building accident a few years ago knocking the same elbow leading to ongoing pain. Has tried rehab before at a few different places over the years but the pain and fear that the elbow was going to dislocate has never really went away. Works as a landscaper – does a lot of weeding, lifting and hedge trimming. Has no imaging. Palpation: Tenderness at forearm extensors, forearm flexors, triceps insertion Elbow AROM: full rom but apprehensive with full extension and 2/10 pain Elbow PROM: full ROM firm bony end feel for extension Here are my questions to you- A) What would your assessment and differential diagnosis be? B) What would your treatment be based on the above (short term and long term)? C) How would your treatment plan shape your rebooking strategy? READY. SET. GO 🚀🚀🚀🚀🚀🚀🚀
1 like • Feb 9
SUBJECTIVE: - 37-year-old male boxer with left elbow pain, primarily during blocking maneuvers - Significant trauma history: Elbow dislocation from MVA 20 years ago with 7-year instability period Recent building accident with direct elbow trauma - Occupational demands: Landscaping (repetitive lifting, weeding, hedge trimming) - Competition goal: First professional fight in 3 months - Psychosocial factors: Notable fear/apprehension about redislocation - Previous unsuccessful rehabilitation attempts at multiple facilities - Pain behavior: Mechanical, activity-dependent OBJECTIVE: - Palpation findings: Tenderness: Forearm extensors, flexors, and triceps insertion - ROM Assessment: AROM: Full range but with apprehension at end-range extension, 2/10 pain PROM: Full range with firm end-feel in extension - Additional tests needed: Valgus/varus stress tests for ligamentous stability UCL special tests Neurodynamic testing (ulnar nerve) Grip strength comparison Moving valgus stress test Functional boxing-specific movement assessment A) ASSESSMENT: Primary Working Diagnosis: - Lateral epicondylosis with underlying chronic elbow instability Differential Diagnoses: 1. Posttraumatic Ulnar Nerve Irritation Given history of dislocation and chronic instability Need to assess for neural symptoms 2. UCL Insufficiency Common in throwing/impact sports History of instability increases risk 3. Posterior Impingement Syndrome Full extension symptoms Combat sports involvement Red Flags: - Complex trauma history warrants imaging (X-ray, MRI) to assess joint integrity - Combat sport participation with instability history needs careful consideration B) TREATMENT PLAN: Short-term (0-6 weeks): 1. Pain Management: Soft tissue release of forearm extensors/flexors Taping for proprioceptive feedback Activity modification for landscaping tasks 2. Stability Training: Isometric forearm strengthening in protected ranges Rotator cuff/scapular control exercises Proprioceptive training with closed chain exercises 3. Neural Mobility: Gentle nerve gliding if indicated Joint mobilizations avoiding end-range extension
1 like • Feb 10
@Rulan Albarouki plugged into it for refinement, but I will endeavour to make it my words for the next case my bro, thank you
Aug '24 •
FREE FIRE CUPPING RESOURCES 🔥
Hey everyone! I have attached some FREE fire cupping resources for you! Why are they free? Coz I’m not an ass and an am not going to charge $100 per document even tho I could 🤣 Enjoy!
2 likes • Jan 28
These are Fire @Rulan Albarouki !!!🔥
Jan 24 •
MAKE THIS YEAR COUNT
Your biggest problem is that you are SCARED. You are scared to make that rebooking. You are scared to increase your price of $20. You have this irrational fear that you’re going to lose half of your weekly revenue because you pushed your price by $20 after going so long charging the same rate.. Pay the cost of resentment or rejection. Choose wisely!
2 likes • Jan 28
Man I am even more keen to try running my own private practice caseloads after I graduate, seeing your posts @Rulan Albarouki
Jan 27 •
MY FIRST CPG CASE STUDY BREAKDOWN OF THE YEAR!!!
You guys wanted my case study break down on the last case? Well, HERE IT IS! I am not going to word vomit on here, I am going to keep it succinct & clear - Time is $$! DDX - 1) Wrist = CPT pathology (mod/chronic) ; secondary transient median nerve neuritis (mod/chronic) ; muscular overload symptoms of wrist flexors/extensors (mod/chronic) ; L > R 2) Neck = ?Cx spine Disc pathology (mod/chronic) ; ?Multi-level stenosis ; C6-C7++ (Mod) ; radiculopathy ; postural overload symptoms of cx spine stabilisers/scapulothoracic stabilisers (mod/chronic) The second DDX is purely a QUERY! My hypothesis is that is is CPT pathology w/ secondary neuritis ; the above is just to show how i structure my DDX & problem list based on - Locality/structure ; chronicity ; severity Why do I believe it's wrist? Not because of the scan, but there were no Cx spine aggs leading up to the consult to point towards a Cx spine pathology ; nor could I reproduce the symptoms in the clinic.. Also, most Cx spine pathologies that cause a radiculopathy usually pass through the UL before they make it into the hand.. Mx plan - A) Deep tissue massage through wrist flexors/extensors - 10 mins (both sides) B) Deep tissue ; fire cup gliding ; fire cupping through neck/scapular/thx spine/lower back for maintenance - 20 mins Rehab - Priority - re-introduction of loaded gripping for wrist & elbow stabiliser conditioning before introducing loaded wrist extension movements These exercises are to be performed with firm grip - A) DB Hammer curls B) DB Prone Hammer curls C) Farmer carries - kettle bell Volume - 15 x 2 ; 10 x 1 Frequency - x2-3/week ; begin with x2/week for first microcycle (two week introductory phase) Plan - x1 weekly treatment for next 4 weeks If no improvement, no time wasting - straight for regenerative medicine opinion ; likely PRP Then return to maintenance for x1/fortnight ; until x1 per month Okay, plenty of word vomit LOL Overall, you all did very well! I was very impressed by your objective testing & management plans.
Poll
12 members have voted
1 like • Jan 28
That's why you're the GOAT physio @Rulan Albarouki tks for the insight
Jan 23 •
A FREE CPG. U TRIAL IS ON FEB 1!!!!
MASSIVE ANNOUNCEMENT!! The CPG UNIVERSITY will OFFICIALLY be LIVE again on the 1st of Feb! And this time, there will be a 30 DAY FREE TRIAL of the CPG.U. This time, members won’t just have access to a couple of clinical modules with different clinical skills to learn, but there will be WEEKLY group Q&As and 1:1 check ins EVERY WEEK. The ONLY catch is that you have to be on LEVEL 2!! All you need to do, is like and comment on this post to earn 5 POINTS to access Level 2! Let’s make it happen! If you don’t, I hope you enjoy every other clinician in Dubai on Jet Skis with UFC fighters because they joined 😘 LessoGGG Lahhd
1 like • Jan 26
Keen to learn lot's from you and the team @Rulan Albarouki , let's go!!!
1 like • Jan 28
Keen to be apart of it @Rulan Albarouki tks for having me, keen to learn from the entire group!
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@dhyan-karunatilake-4755
I'm the PwrPhysio babayy!!!
Active 65d ago
Joined Jul 11, 2024
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