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Rehabilitation of an Elite Gymnast With a Type II Manubriosternal Dislocation

PE Pidcoe, PT, DPT, PhD, is Associate Professor, Department of Physical Therapy, Virginia Commonwealth University, Richmond, VA 23298 (USA)
EN Burnet, PT, DPT, is Graduate Assistant, Department of Physical Therapy, Virginia Commonwealth University

Address all correspondence to Dr Pidcoe at: pepidcoe{at}vcu.edu

Background and Purpose: This case report describes the rehabilitation of an elite, 15-year-old gymnast after a nonreduced type II manubriosternal dislocation. The rehabilitation took place in a gymnastics venue but was guided by a physician and a licensed physical therapist.

Case Description: The gymnast participated in a 13-week rehabilitation program for range of motion and strengthening that was based on a biomechanical hierarchy. Rehabilitation began at week 2 after injury for the lower extremities and at week 4 for the upper extremities.

Outcomes: By week 4, the patient began upper-extremity strengthening, and by week 6, the patient had no pain with palpation and tolerated light sternal loading. At week 9, a plain-film radiograph revealed a stable manubriosternal joint, and by week 13, the patient returned to gymnastics pain-free.

Discussion: This case report shows that, after a 13-week regimen of progressive and repetitive, cyclical tensile and compressive loading, the manubriosternal joint was stable, and the elite gymnast was able to return to the sport, successfully competing in a regional competition.