RESUMO
The plantaris muscle is often dismissed as a small, vestigial muscle, however an injury to this structure should actually be included in differential considerations of the painful calf. Injury to the plantaris on its own, or in association with concurrent injuries of the knee can present a diagnostic challenge to the manual practitioner. This review discusses the diagnosis, imaging, and evidence based management of this tiny, but important muscle of the lower limb.
RESUMO
BACKGROUND: The presence of painful coxa saltans (snapping hip) can be a debilitating injury for a competitive athlete, hindering both training, and performance. Considering the various potential etiologies, it often poses a diagnostic and management dilemma for health care practitioners and the success of treatment is often dependent on the practitioner's precise understanding of the cause. Although it is suggested by various authors that conservative therapy should be attempted before considering surgical management, little is known in terms of the most effective modes of manual therapy that should be attempted. CASE PRESENTATION: A case of chronic, external coxa saltans in a 16 year old competitive dancer treated with Active Release Techniques(R) is presented. The clinical presentation, differential diagnosis, management and rehabilitation of the case are discussed. CONCLUSION: Active Release Techniques, or ART, is a soft tissue treatment method that focuses on relieving tissue tension via the removal of fibrosis/adhesion that develops in tissue that is overloaded with repetitive use. In this case of external coxa saltans, the underlying cause of the condition was increased tissue tension leading to increased friction of the proximal Iliotibial band (ITB) complex over the greater trochanter. Utilizing ART resulted in a complete resolution of this athlete's symptoms and may be a good treatment option for external coxa saltans.