Scaphoid Fracture
A comprehensive overview of a non-displaced scaphoid fracture in a baseball player
Fibroblastic Repair Phase:
During this phase scar formation referred to as fibroplasia begins within the first few hours after injury and can last as long as 4-6 weeks. During the fibroblastic repair phase many signs and symptoms that are shown during the inflammatory response phase start to subside. The formation of the delicate connective tissue is called granulation tissue which occurs with the breakdown of the fibrin clot. Granulation tissue consists of fibroblasts, collagen and capillaries. During this phase the athlete should start to work on muscle strength, muscle endurance, muscle speed, muscle power, neuromuscular control, integrated coordinate movements, agility, cardiovascular endurance.
Exercises:
Putty: Athlete can squeeze putty in their hand for 30secs. Athlete should do 3 sets of squeezing the putty.
Rice Bucket: Athlete can stick their hand in a rice bucket and do CW and CC circles in the rice for 45secs. Athlete should do 3 sets of each.
Neuromuscular Control Exercises:
1. Slide board: Athlete can be use a slide board to regain neuromuscular control. The slide board helps the athlete with joint awareness and proprioception. The athlete is to put booties on his/her hands and do CC and CW circles. Athlete should do 3x30sec for each.
2. Double/Single Arm Balance on a Wobble Board: Athlete should start out double arm balance and then progress to single arm balance. A progression can also be made for the AT to add perturbations. Double arm balance should start out at 3x45sec and then progress with the athlete as it gets easier.
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Isotonic Exercises:
1. Wrist Extensions: Athlete is to stabilize their arm in a pronated position on the table with just their hand hanging off. Athlete should then have a free weight in their hand/wrist (can start out at 1lb and slowly increase the weight as the athlete gets stronger). With their hand/wrist hanging off the table the Athlete is then to lift their wrist up to the ceiling. Athlete should do 3x20.
2. Wrist Flexion: Athlete is to stabilize their arm in a supinated position on the table with just their hand/wrist hanging off. Athlete should have a free weight in their hand (can start out at 1lb and slowly increase the weight as the athlete gets stronger). With their hand/wrist hanging off the table the athlete is to flex their wrist. Athlete should do 3x20.
3. Pronation/Supination with Hammer: Athlete can do pronation and supination exercises with a weighted hammer in their hand. Athlete is to stabilize their arm on the table and have their/hand wrist hanging off of it. Athlete should do 3x15.
Plyometric Exercises:
1.Throwing a Weighted Ball into a Mini Tramp: This is to be done as fast at the athlete can. Athlete should do 3x15.
2.Throwing a Weighted Ball Sideways into a Mini Tramp: This is should be done as fast as the athlete can. Athlete should do 3x15.
3.Throwing a Ball Overhead at a Partner: Athlete should do 3x15.
Goals:
Short Term Goals: Increase Pain free ROM Wrist Extension to 50-60 degrees, Wrist Flexion to 60-70 degrees.
Long Term Goals: Increase Cardiovascular Endurace, Increase Muscle Strength, Increase Muscular Endurance, Being able to throw a ball and swing a bat with no pain.
