BACKGROUND: The mechanism of injury and the conservative rehabilitation of the ulnar collateral ligament of the elbow (UCL) are well studied and reported in overhead athletes, while research on gymnastic athletes is sparse. Evidence suggests exercise as the mainstay in UCL injury rehabilitation. With this report, we aimed to provide a complete rehabilitation protocol following a partial UCL tear of an acrobatic athlete, where exercise and adjunct treatments, such as manual therapy, were used in a progressive staged rehabilitation.
METHODS: A 16-year-old female acrobatic athlete was diagnosed with partial tear of the anterior band of UCL. The rehabilitation included progressive exercise loading in conjunction with manual therapy for 10 sessions in 8 weeks. Pain, UCL special tests, the Disabilities of Arm, Shoulder and Hand Score Questionnaire (DASH), and the Upper Limb Functional Index (ULFI) were assessed and administered at baseline and at 3, 6, 10 weeks, and 3 months.
RESULTS: Improvement in all outcome measures was noted at the 3-month follow-up indicating a substantial reduction in pain and disability, and an increase in stability of the elbow joint. Return to training was achieved at 8 weeks from the initial visit, while return to sport at the pre-injury level was achieved at 3 months.
CONCLUSIONS: Progressive exercise loading along with the addition of manual therapy is an effective intervention for the rehabilitation and return to sport following a partial UCL tear. A progressive staged rehabilitation guideline for acrobatic athletes with UCL injuries has been provided to be used and guide clinical practice.
METHODS: Level IV.

A 34-year-old male with a 9+ year history of right sided abdominal pain, associated diarrhea and a diagnosis of irritable bowel syndrome was referred for physical therapy and chiropractic care at a multidisciplinary primary care clinic. Multiple evaluations by various providers resulted in multiple tests and numerous medications without substantial relief in symptoms. Five physical therapy visits and three sessions of chiropractic care resulted in 90% improvement in subjective pain report and 60-70% reduction in diarrhea frequency. At a 6 month follow up phone visit, his symptoms had continued to decrease. While limited as a case study, this report may illustrate a potential somatovisceral relationship and subsequent reduction in gastrointestinal symptoms that can be addressed with conservative care.

UNASSIGNED: Developmental dysplasia of the hip (DDH) is a common musculoskeletal disorder in newborns, ranging from mild dysplasia to complete dislocation. Early detection and intervention are crucial for managing DDH. However, in some cases, standard orthopedic treatments such as the Pavlik harness fail, and alternative approaches are needed. Our study explores the possibility that manual therapy, specifically the Mézières-Bertelè Method (MBM), could be beneficial in cases of DDH that are resistant to conventional treatments.
UNASSIGNED: We present a case of a 20-month-old female who had been suffering from persistent DDH (Graf\'s type IIIC on the left), pain and limping, despite previous conventional treatments, including the Pavlik harness. The patient received daily MBM sessions for six months, followed by maintenance sessions every two months.
UNASSIGNED: After undergoing the MBM treatment, the patient showed clinical improvements, such as normal neuromotor development and restored hip joint parameters. We observed normal walking and running abilities, and X-ray parameters returned to normal levels. The patient sustained positive outcomes during long-term follow-up until the age of 7.
UNASSIGNED: The MBM manual therapy was used to treat a challenging case of DDH resistant to conventional treatment. This case report suggests a possible correlation between manual therapy and improved outcomes in resistant DDH and highlights the potential relevance of addressing the inherent musculoskeletal components of the condition.

The purpose of this case is to describe an outpatient treatment course using previously published systemic manual therapy protocol to treat a 65-year-old patient who, after prolonged COVID-related intubation, presented with polyneuropathy, organ failure and other residuals.
A single-subject case study.
Review of clinical records and follow-up interview.
The patient identified problem scale (PIP) had improved from a high score of 52 to 11; QUICKDASH score improved from 68 to 16. All individual problems had either resolved or remained at a minimal level and the patient had generally returned to his prior level of function including return to work.
It appears that Despite factors such as age, length of ICU stay, length of symptoms before initiation of physical therapy, and complicated hospital stay including multiple organ failure, after receiving physical therapy consists of the systemic manual therapy protocols, the patient rapidly improved during the outpatient episode.

(1) Background: Chronic pelvic pain represents a prevalent condition afflicting women. Research has highlighted the presence of psychological distress and sexual dysfunction in these individuals. Regrettably, myofascial pelvic pain often goes unnoticed and untreated despite its integral role in chronic pelvic pain. (2) Methods: By employing a longitudinal case series design, we studied eighteen women afflicted with chronic pelvic pain. Over a 12-week period, these participants underwent 15 sessions of myofascial therapy. Data encompassing sociodemographic particulars, the Hospital Anxiety and Depression Scale, the Medical Outcomes Study Short Form 12 questionnaire, and the Female Sexual Function Index were collected at baseline, 12 weeks post-intervention, and again at the 24-week mark. (3) Results: After a span of 12 weeks subsequent to the intervention, the participants demonstrated noteworthy enhancements (p < 0.001) in their depression and anxiety scores, their overall Mental Component scores in the Medical Outcomes Study Short Form 12, as well as sexual function. Importantly, these gains were sustained at the 24-week juncture post-therapy. (4) Conclusions: The findings stemming from our prospective case study underscore the potential utility of myofascial therapy for women grappling with chronic pelvic pain. This form of intervention yields significant advancements in alleviating anxiety, depression, health-related quality of life, and sexual function.

Migraine is the second most debilitating condition affecting a significant portion of the general population, particularly young adults under 50. Despite extensive research, the etiology of migraine remains diverse and often multifactorial, with limited clarity on the specific underlying pathogenic processes. Consequently, the treatment of migraine lacks a mechanism-based approach. We present the case of a young female patient suffering for 8 years of chronic migraine and tension-type headaches. The manual therapy techniques successfully released the muscular tensions, considerably improving her quality of life in terms of pain and emotional well-being.

UNASSIGNED: Most people with lower-limb loss (PLL) have musculoskeletal conditions and range-of-motion and muscle performance impairments. Such impairments limit potential for functional movement but can be reduced with manual therapy. Manual therapy, however, is rarely used for PLL. This case demonstrated how integrating manual therapy, exercise, and functional training led to lasting benefits for one low functioning PLL.
UNASSIGNED: A 54-year-old woman more than 1 year after transtibial amputation due to peripheral artery disease presented with multiple comorbidities and yellow flags. Her function remained limited to the Medicare K-1 household walking level with slow gait speed <0.25 m/s. Treatment included four weekly sessions each beginning with manual therapy, followed by exercise and functional training.
UNASSIGNED: After 1 month, performance-based strength, balance, walking speed, and physical activity increased. She advanced to the K-2 limited community walking level and maintained her functional level without further treatment after 3 months.
UNASSIGNED: Improvements maintained without treatment expanded upon research that lacked follow-up and excluded K-1 level walkers. Marked improvement after only four sessions was noteworthy since exercise protocols require ≥4 sessions.
UNASSIGNED: Manual therapy followed by exercise and functional training may optimize movement potential and contribute to improving strength, balance, gait, and physical activity among PLL.

Carpal tunnel syndrome is the most common neuropathy affecting the upper limb. Several therapeutic approaches are used to treat this syndrome, including conservative treatment, often used as the first line treatment. We here report the case of a 61-year-old female patient, presenting to the Department of Clinical Neurophysiology of the Specialty Hospital, Rabat, with moderate and bilateral carpal tunnel syndrome with sensory loss confirmed by electroneuromyography (ENMG). Manual therapy, including bilateral median nerve neurodynamic mobilization, was performed. Patient´s outcome was marked by disappearance of nocturnal numbness and follow up ENMG showed a marked improvement in nerve conduction parameters. Based on this positive result, neurodynamic mobilization of the median nerve may be considered as a possible approach for the conservative treatment of carpal tunnel syndrome.

UNASSIGNED: The purpose of this case study was to report the chiropractic management of a teenage athlete who had chronic pain after a lateral ankle sprain.
UNASSIGNED: A 15-year-old male patient presented with persistent ankle pain due to an inversion sprain while playing soccer approximately 8.5 months prior. Emergency department records noted a left lateral ankle sprain, including the anterior talofibular ligament, calcaneofibular ligament, and posterior talofibular ligament. The examination revealed ankle tenderness upon palpation, limited active and passive dorsiflexion range of motion, restricted talocrural joint posterior glide, and moderate lateral compartment muscular hypertonicity.
UNASSIGNED: Chiropractic management included high-velocity, low-amplitude chiropractic ankle manipulation and education on home-based ankle dorsiflexion stretching. After 4 treatments, the athlete returned to unencumbered athletic participation. Follow-up evaluation at 5 months revealed no pain or functional complaints.
UNASSIGNED: This teen athlete\'s chronic pain from a lateral ankle sprain resolved with a short course of chiropractic manipulation coupled with home-based stretching.

Patients who have undergone cervical surgery may present pain and dysfunction in the upper limb, which is often referred to as failed neck surgery syndrome. Little is known about the effects of an exercise program plus manual therapy in the treatment of prolonged neuropathic pain of the upper quadrant in a patient with failed neck surgery.
A 66-year-old woman consulted for neuropathic pain and dysfunction during grasping activities, as a result of failed neck surgery after 12 months. Clinical, functional, and electromyographic measurements were recorded at baseline and after treatment. The patient underwent a treatment for six weeks based on manual therapy for the upper limb and cervical spine and an exercise program for the scapular muscles, rotator cuff and wrist extensor muscles.
Positive clinically significant changes were observed in the Neuropathic Pain Questionnaire (DN4) (baseline = 7 points; post-treatment = 4 points), Neck Disability Index (NDI) (baseline = 36; post-treatment = 18 points), QuickDASH (baseline = 78; post- treatment = 32 points), Upper Limb Neurodynamic Test 1 (ULNT-1) (baseline = 75°; post- treatment = 42°) and grip strength (GS) (baseline = 23 kgf; post-treatment = to 32 kgf). Improvements in the surface electromyographic (sEMG) activity of the upper trapezius (UT), infraspinatus (IS) and radial wrist extensors (RWE) muscles also seemed to occur after treatment.
Treatment helped relieve neuropathic pain, decrease neck disability, and improve general upper limb function.