The article presents the case study of a foot injury treatment of BBTS volleyball player with high power laser therapy and ultrasound therapy.
Characteristics of the player:
- Age: 22 years
- Height: 210 cm
- Weight: 110 kg
- Position: middle blocker
Description of the injury:
During a volleyball game the player jumped to block (at the wing), collided with another player, landed on one leg outside the court and injured his foot. Despite strong pain, the player continued to play in the game.
Diagnosis and physical examination
The palpatory examination revealed painfulness in the area of the first MTP joint, significant reduction of its mobility, difficulties in putting weight on it and in locomotion.
Ultrasound diagnosis – sprain of the first metatarsophalangeal joint of the left foot. The image shows exudate, trauma to the joint capsule and collateral ligament.
USG examination 2 weeks after the injury:
Therapy
The intense, three-week-long rehabilitation involved:
Day: 1 – 4
- cryotherapy,
- STADIOPASTA compresses (algae extract),
- magnetotherapy,
- lymphatic drainage of the foot.
Day: 5 – 14
- high power laser therapy with ASTAR POLARIS HPS (analgesic, anti-inflammatory effect),
- cryotherapy,
- magnetotherapy,
- claw therapy,
- ultrasound therapy,
- transverse massage of the scar,
- hydro massage,
- manual therapy,
- isometric exercises of the foot and shank muscles.
Day: 15 – 21
- high power laser therapy with ASTAR POLARIS HPS (analgesic, biostimulation effect),
- ultrasound therapy,
- transverse massage of the scar,
- manual therapy,
- hydro massage, exercises in water,
- exercises to strengthen the muscles of the big toe,
- cardio training.
Day: 22 – 28
- exercises to strengthen the muscles of the big toe,
- cryotherapy,
- functional training.
High power laser therapy (ASTAR POLARIS HPS) applied on the first MTP joint.
| Treatment | Dose 808 nm / 980 nm [J/cm2]: | Output power 808 nm / 980 nm [W]: | Radiation mode 808 nm / 980 nm: | Frequency 808 nm/ 980 nm[Hz]: | Duty factor 808 nm/ 980 nm [%]: | Treatment area 808 nm/ 980 nm [cm2]: |
| I | 10 / 10 | 3 / 3 | Pulse/pulse | 60/60 | 25 / 25 | 20 |
| II | 10 / 10 | 3 / 3 | Pulse/pulse | 60/60 | 25 / 25 | 20 |
| III | 10/ 10 | 3 / 3 | Pulse/pulse | 60/60 | 25 / 25 | 20 |
| IV | 15 / 15 | 4 / 4 | Pulse/pulse | 60/60 | 25 / 25 | 20 |
| V | 15 / 15 | 4 / 4 | Pulse/pulse | 3000/3000 | 25 / 25 | 20 |
| VI | 15 / 15 | 4 / 4 | Pulse/pulse | 3000/3000 | 30 / 30 | 20 |
| VII | 15 / 15 | 4 / 4 | Pulse/pulse | 3000/3000 | 30 / 30 | 20 |
| VIII | 15 / 15 | 4 / 4 | Pulse/pulse | 2500/2500 | 30 / 30 | 20 |
| IX | 20 / 20 | 4 / 4 | Pulse/pulse | 2500/2500 | 30 / 30 | 20 |
| X | 20 / 20 | 5 / 5 | Pulse/pulse | 2500/2500 | 40 / 40 | 20 |
| XI | 20 / 20 | 5 / 5 | Pulse/pulse | 2500/2500 | 40 / 40 | 20 |
| XII | 20 / 20 | 5 / 5 | Pulse/pulse | 700/700 | 40 / 40 | 20 |
| XIII | 20 / 20 | 5 / 5 | Pulse/pulse | 2200/2200 | 40 / 40 | 20 |
| XIV | 30 / 30 | 6 / 6 | Pulse/pulse | 700/700 | 50 / 50 | 20 |
| XV | 30 / 30 | 6 / 6 | Pulse/pulse | 2200/2200 | 50 / 50 | 20 |
| XVI | 30 / 30 | 6 / 6 | Pulse/pulse | 700/700 | 50 / 50 | 20 |
| XVII | 30 / 30 | 6 / 6 | Pulse/pulse | 700/700 | 50 / 50 | 20 |
Ultrasound therapy with 1 cm2 US head (PhysioGo)
| Treatment | Power [W/cm2] | Duty factor [%] | Duration [min] | Method |
| I | 0,5 | 20 | 5 | labile |
| II | 0,5 | 20 | 5 | labile |
| III | 0,5 | 20 | 5 | labile |
| IV | 0,5 | 20 | 5 | labile |
| V | 0,7 | 20 | 5 | labile |
| VI | 0,7 | 20 | 6 | labile |
| VII | 0,7 | 50 | 6 | labile |
| VIII | 0,7 | 50 | 6 | labile |
| IX | 1 | 50 | 6 | labile |
| X | 1 | 50 | 6 | labile |
| XI | 1 | 75 | 6 | labile |
| XII | 1 | 75 | 7 | labile |
| XIII | 1,2 | 75 | 7 | labile |
| XIV | 1,2 | 75 | 7 | labile |
| XV | 1,2 | 75 | 8 | labile |
| XVI | 1,2 | 75 | 8 | labile |
| XVII | 1,2 | 75 | 8 | labile |
The use of laser therapy – results
The rehabilitation process with the use of high power laser therapy allowed to shorten the recovery time from planned 6 weeks to 3-4 weeks (the beginning of the volleyball season). Four weeks after the injury, the player trained intensively with the first MTP joint stabilized by the means of kinesiology taping. The player’s return to active practice was supported by adequate preventive training.