title: Rehabilitation of an elite gymnast with a type II manubriosternal dislocation.
abstract: OBJECTIVE
  This case report describes the rehabilitation of an elite, 15-year-old gymnast after a nonreduced type II manubriosternal dislocation. The rehabilitation took place in a gymnastics venue but was guided by a physician and a licensed physical therapist.
  
  
  METHODS
  The gymnast participated in a 13-week rehabilitation program for range of motion and strengthening that was based on a biomechanical hierarchy. Rehabilitation began at week 2 after injury for the lower extremities and at week 4 for the upper extremities.
  
  
  RESULTS
  By week 4, the patient began upper-extremity strengthening, and by week 6, the patient had no pain with palpation and tolerated light sternal loading. At week 9, a plain-film radiograph revealed a stable manubriosternal joint, and by week 13, the patient returned to gymnastics pain-free.
  
  
  CONCLUSIONS
  This case report shows that, after a 13-week regimen of progressive and repetitive, cyclical tensile and compressive loading, the manubriosternal joint was stable, and the elite gymnast was able to return to the sport, successfully competing in a regional competition.
authors: Department of Physical Therapy, Virginia Commonwealth University, Richmond, VA 23298, USA. pepidcoe@vcu.edu
authors: Peter E
authors: PE
authors: Pidcoe
authors: Evie N
authors: EN
authors: Burnet
mesh_terms: D000293:Adolescent; D001265:Athletic Injuries / Q000000981:diagnostic imaging / Q000534:rehabilitation*; D001696:Biomechanical Phenomena; D005260:Female; D006173:Gymnastics / Q000293:injuries*; D006801:Humans; D004204:Joint Dislocations / Q000628:therapy*; D008371:Manubrium / Q000293:injuries*; D026201:Musculoskeletal Manipulations / Q000379:methods*; D011859:Radiography; D016059:Range of Motion, Articular