Saphenous Neuropathy Following Medial Knee Trauma

Timothy L. Pendergrass, Josef H. Moore

Patients are frequently referred to physical therapy for musculoskeletal injuries. These injuries range from muscle strains to ligament ruptures and bone avulsion fractures. On occasion, what first may appear to be a common musculoskeletal injury can actually develop unexpected sequellae. It is imperative that the physical therapist continue to treat the patient while observing for signs and symptoms that would indicate changes to the initial diagnosis. Reevaluations include examining the progress of the patient and modifying or redirecting interventions.

This is a case report of a patient referred from his primary care physician to physical therapy 6 weeks after suffering a common musculoskeletal injury (diagnosed by the physician as a hamstring muscle contusion). The patient was later determined by a neurologist, and confirmed by a neurosurgeon, to have developed a saphenous neuropathy. Saphenous neuropathy is an uncommon syndrome, accounting for less than 1% of adult patients presenting with lower-extremity pain. True diagnosis is often delayed due to the rarity of the syndrome and the reliance on clinical presentation. Optimal treatment is not known but usually requires injection of local anesthetics with steroids or a surgical nerve release/decompression.

It is important for physical therapists to understand and recognize the signs and symptoms of a saphenous neuropathy. This syndrome is not reported often and can be overlooked or misdiagnosed as it develops. It is equally important for physical therapists to understand their involvement in the primary care team. In that capacity, physical therapists have the opportunity to interact with and refer to other providers. It is important to assimilate the findings of these other care providers as well as the information gathered during initial and follow-up evaluations in the clinic.

J Orthop Sports Phys Ther. 2004; 34(6):328-334. doi:10.2519/jospt.2004.1269

Key Words: saphenous neuropathy, knee, primary care

Improvement in Sit-up Performance Associated With 2 Different Training Regimens

Richard E. Baxter, Josef H. Moore, Timothy L. Pendergrass, Todd A. Crowder, Shannon Lynch
Study Design: Factorial experimental design. Objective:To compare the outcomes of 2 different abdominal muscular fitness training regimens on sit-up performance across sex and abdominal muscular fitness level. Background: Researchers suggest that the curl-up, when compared to the sit-up, optimizes the challenge to the abdominal muscles while minimizing shear and compressive forces on the lumbar spine. Although researchers have compared curl-ups and sit-ups in many ways, a comparison of sit-up performance after training programs involving curl-ups and sit-ups has not been investigated. Methods and Measures: One hundred two active, healthy, college-aged subjects participated in this study. After stratification based upon maximal 2-minute sit-up performance during the orientation session, subjects were randomly assigned to either a training group using curl-up exercise, a training group using sit-up exercise, or a control group. Maximal 2-minute sit-up test performance was measured before and after a 6-week training program. Data were analyzed utilizing an ANOVA model. Significant interactions or main effects were analyzed utilizing Tukey’s Honestly Significant Difference Test. Level of significance for all testing was at a = 0.05. Results: The sit-up training group improved significantly (P<0.05). No significant difference in sit-up performance was noted for the curl-up or control groups after the 6-week training program. No statistically significant difference in improvement was noted between sex of subject and level of abdominal muscular fitness of subject. Conclusions: Short-term sit-up training with the Modified Kersey Method in this population significantly improved a maximum 2-minute sit-up test performance. Curl-up training utilizing the same method did not result in improvement in the number of sit-ups performed in 2 minutes. Specificity of training provides the primary explanation for our findings.

J Orthop Sports Phys Ther. 2003;33(1):40-47.

Keywords: abdominal muscular fitness, curl-up, strength training

Journal of Orthopaedic & Sports Physical Therapy - Timothy L. Pendergrass, PT, DSc, SCS, ATC

Saphenous Neuropathy Following Medial Knee Trauma

Improvement in Sit-up Performance Associated With 2 Different Training Regimens