A weekend warrior basketball player came into our clinic reporting chronic ankle sprains over the past several years of his left ankle that restrict his play. Over the past two years he has given up on basketball as running, and cutting activities reproduce pain. He is also an avid fisherman and walks the banks of creeks and rivers throughout Idaho. However, balance and chronic instability is a continual problem with his function with fishing. His question was: “Should I consider some type of surgery or can PT help me get back to the things I love?” Our response is to try PT first!
Presentation:
The patient presented in our office for his first visit walking with mild chronic swelling on the outside of the ankle, mildly excessive motion at the left ankle and weakness. He was having pain at with running, jumping and cutting activities and was limited with balance on the left foot. While his pain was his number one struggle with walking inclines or on uneven ground.
Treatment:
PT started with a clinical examination of his foot and ankle. The exam identified the main problems and gave us the prioritized list for his care. From there, treatment is focused on reducing the pain and inflammation, gradually restore full pain free motion and strengthen the ankle musculature and retraining responses for balance and stability. Running and hill climbing on our Alter G treadmill at 75% weight bearing did not reproduce pain. Therefore, we used this as his baseline and improved over the next 6 weeks.
Alter G (Anti-Gravity Treadmill):
The Alter G Treadmill system is a revolutionary technology in rehabilitation that was originally developed for NASA. The treadmill uses a force plate under the belt to measure the patient’s weight and then an air pressure system to unweight the patient from 5%-90%. The first time a patient is on the Alter G they feel like they are walking or running on air. Therapeutically there are so many forces that can be alleviated with the Alter G to create a pain-free experience. Then, during the rehabilitation process, the patient can gradually ‘add gravity’ back into the equation without adding pain as strength and motion return to normal.
Bibliography:
These studies collectively underscore the versatility and effectiveness of the AlterG Anti-Gravity Treadmill in various rehabilitation contexts, offering valuable insights for clinicians and researchers.
- “Role of Antigravity Training in Rehabilitation and Return to Sport After Running Injuries”
Authors: Heather K. Vincent, Aimee Madsen, Kevin R. Vincent
Journal: International Journal of Sports Physical Therapy, 2022
Abstract: This paper reviews the biomechanical and metabolic effects of BWS treadmill training, focusing on its use in rehabilitating injured runners. Findings indicate that antigravity treadmill training reduces cadence, ground reaction forces, and joint range of motion while increasing stride duration and ground contact time. Clinical case studies demonstrate its effectiveness in conditions such as osteochondral defects and stress reactions. - “The Effect of Anti-Gravity Treadmill Training for Knee Osteoarthritis Rehabilitation on Joint Pain, Gait, and EMG”
Authors: Hyeong-Dong Kim, Hyeon-Seon Jeong, et al.
Journal: Medicine, 2019
Abstract: This case report investigates the impact of anti-gravity treadmill training on patients with knee osteoarthritis. Findings suggest improvements in joint pain, gait parameters, and electromyographic activity, supporting its use as a rehabilitation modality for this condition. - “Anti-Gravity Treadmill Rehabilitation Improves Gait and Muscle Atrophy After Total Knee Arthroplasty: A Randomized Controlled Trial”
Authors: Yusuke Osawa, et al.
Journal: Clinical Rehabilitation, 2021
Abstract: This randomized controlled trial assesses the efficacy of anti-gravity treadmill rehabilitation post-total knee arthroplasty. Results demonstrate significant improvements in gait and reduction in muscle atrophy compared to conventional rehabilitation methods. - “Effect of Speed and Gradient on Plantar Force When Running on an AlterG Treadmill”
Authors: James R. Hannah, et al.
Journal: BMC Sports Science, Medicine and Rehabilitation, 2021
Abstract: This research examines how varying speed and incline on an AlterG treadmill affects plantar forces during running. The study provides insights into optimizing rehabilitation protocols to manage musculoskeletal loading. - “Anti-Gravity Treadmill Training Leads to Superior Improvements in Gait Speed and Endurance in Stroke Patients”
Authors: S. K. Ng, et al.
Journal: Stroke, 2015
Abstract: This abstract presents findings on the benefits of anti-gravity treadmill training in stroke rehabilitation, highlighting significant enhancements in gait speed and endurance compared to traditional methods.
Return to Sport Testing…Are you ready?
After 6 weeks of intense ankle rehabilitation, the patient was able to progress from hill intervals at 75% weight bearing to 100%. Our basketball player was able to return to running and sports activities after years of being on the sidelines. He was able to hike inclines and the uneven ground of riverbed without pain or limitation.
Proactive Action:
No matter what surgical situation you find yourself in, there is a better way to get back to life than through the help of Superior Physical Therapy. Click and make an appointment or call 208-233-2248 to get in with a Board-Certified Doctor of Physical Therapy and get better faster in Pocatello, American Falls, Fort Hall, Idaho Falls and Rexburg. Our rehab specialists are ready to get you back in the game!
Sincerely,
Bart McDonald, MPT, ECS, FMSK
President of Superior Physical Therapy
