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.

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