Patient: 34-year-old female, currently 15 weeks pregnant.
Diagnosis: Ehlers–Danlos syndrome (diagnosed 2021), hypermobility type (hEDS).
Surgical history: Four right hip surgeries between 2021–2024 for a torn labrum, ultimately requiring a cadaver graft, as well as repair of a femoral head injury. All four procedures have been deemed unsuccessful. In 2022, she also underwent shoulder surgery for a labral tear.
EXSTORE findings: Weakness noted in the L gluteus maximus, R adductor magnus, R hip flexors, L serratus anterior, and supraspinatus.
Current symptoms: Significant discomfort localized to the R greater trochanter, adductors, and hamstrings, with associated low back pain.
Pain management history: Prior to pregnancy, symptoms were managed with Baclofen, which was discontinued during pregnancy and is planned to resume postpartum. She claims she has had relief from DN in the past.
My understanding is that Ehlers–Danlos syndrome is an umbrella term encompassing 13 connective tissue disorders; this patient has the hypermobility type (hEDS).
Questions:
- I am assuming pts with EDS are treated as CS- is this accurate?
- In patients with hEDS, is there any special considerations to soft tissue work?
Athletic Intensive Myofascial Release
Location: Shokunin CrossFit, Mesa, AZ
Pre-requisite: EXSTORE
Register here:
https://aseseminars.com/event/athletic-intensive-myofascial-seminar/
This is why I stopped automatically giving a set % discount to whatever group/type of patient.
Athlete with sub-acute second metatarsal stress fracture currently using rest and laser therapy for treatment. For electroacupuncture... Osteopuncture at 100 Hz at the base and head of the metatarsal to cross the fracture ? 30 Hz across the ankle joint at GB 40 and above the sustentaculum tali? Are MPs relevant here?
15 weeks. Should I avoid altogether? CC: ankle pain - recovering from surgery repairing broken tibula and fibula.
CC: Groin Pain?
Patient complains of pain not in the groin but next to it. No burning, no sharp pain, pain increased with walking or rotation of the knee internally and externally. There was a big tear near the groin but it is healed.
Hip Flexion slows as getting above 90 degrees but stays straight with lifting and does not rotate to the lateral side with lift. Patient winces once the angle of tension is above 90 degrees.
What i have done so far:
- Needling towards pelvic bowl to release hip flexion and extend range to 120 degrees easily
- TFL and Adductors showed tension with Rotation of Knee and range was below 45 degrees rotation with internal/external rotation so we released it.
Pain is improved and range is improved but there is still tension in the areas of GB27/28 area that leads down to the L/ side crease outside of the genitals.
He has had this issue in the past and it resolved for a while. I am unsure what is actually happening here or how I could assess this further.
I ...
