treating the athlete
To The Bone Treating a stress fracture can test the patience of even the most experienced athletic trainer. This twopart article provides a double dose of rehab secrets.
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By Summer McKeehan
n more than a decade of working with the Duke University women’s basketball team, I’ve treated stress fractures in bones ranging from the metatarsal to the navicular. Last year, I got a lesson in just how “stressful” these injuries can be while rehabbing a player with a persistent injury to her tibia. Our starting center, junior Elizabeth Williams, was diagnosed with a tibial stress fracture in her right lower leg as she neared the end of her freshman year. Over the next 14 months, our medical and coaching staffs worked hard keep her on the court and avoid surgery. We did so—Elizabeth earned All-America honors her sophomore season—by using every resource at our disposal and implementing some creative rehab ideas. Elizabeth came to Duke with no history of bone injury, shin splints, or any other lower-leg problem. In fact, she hardly spent any time in an athletic training room until March 2012. At our first practice in between the Atlantic Coast Conference Tournament and the NCAA Tournament, Elizabeth walked into the athletic training room complaining of pain in the middle of her right shin. She said she’d been experiencing it for three weeks but hadn’t said anything, hoping it was nothing and would go away on its own. She told me the pain would come and go frequently during practice, and she often felt it just after practice ended. Upon examination, I found a visible and palpable lump over the middle of her anterior tibia bone. The area was extremely sore to the touch, as was the medial ridge of the tibia. An X-ray showed a stress fracture in the right tibial shaft, and an MRI found periostitis along the medial ridge of the tibia. Alison Toth, MD, the Director of the Duke Women’s Sports Medicine Program and our Team Physician, determined that it would be safe for Elizabeth to play in the NCAA Tournament if she felt she could cope with the pain. Elizabeth committed to playing through the pain but her game time would have to be limited and she’d likely have to sit out most practices, so we had to ask her coaches if they were okay with this. After receiving their go-ahead, we started working on a treatment plan. Summer McKeehan, MS, ATC, LAT is Associate Athletic Trainer for women’s basketball at Duke University, where she has been on staff since 2001. She has also served as the athletic trainer for the USA Basketball Women’s U18 and U19 National Teams. She can be reached at: summer@duaa.duke.edu.
TR AINING-CONDITIONING.COM Timothy Sofranko
T&C MARCH 2014
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