(Kiosk 2) A PM&R Perspective on the Volleyball Paralympian: A Case Report

Case Diagnosis: This case report delineates a five-year span of rehabilitation needs in a Paralympic Volleyball athlete with a below knee amputation.

Case Description or Program Description: 52-year-old US Paralympic volleyball male athlete with a past medical history of left below knee amputation from a motorcycle collision and PTSD, who over the last five years presented with a variety of musculoskeletal complications including bilateral knee pain, low back pain, hamstring strain, and a traumatic brain injury with temporary memory loss, vision changes, chronic folliculitis, and balance issues.

Setting: Outpatient VA Clinic

Assessment/Results: The athlete was seen at least bi-annually by physiatry, prosthetics, therapy services. After a mild traumatic brain injury during play, he followed-up with polytrauma physiatry clinic and was referred to speech therapy for continued and successful memory compensatory strategies. As for the patient’s knee pain, degenerative changes of the left patella on the residual limb and tricompartmental osteoarthropathy on the right knee, most significant in the medial and patellofemoral compartments, were seen on imaging. A medial unloading DJO OA Full Force knee orthotic was used for the intact right leg. Patient was also fitted for a left below knee suction suspension prosthesis with posterior mount for running/volleyball. Pain management was multimodal with complementary medicine, including acupuncture and chiropractic care, which provided good relief of neck and back pain. Chronic folliculitis of the residual limb was managed with topical antifungals and aggressive hygiene. Hamstring strain was treated with conservative treatment, including physical therapy, with complete resolution of symptoms. Patient received daily strength and conditioning from the US Paralympic volleyball trainer.

Discussion (relevance): To our knowledge, little has been written about the short and long-term injuries and implications of Paralympic volleyball athletes.

Conclusions: As this Paralympic athlete demonstrates comprehensive care of the Paralympic Volleyball athlete requires a multidisciplinary approach with physiatrists, prosthetists, physical therapists, occupational therapists, speech therapists, and trainers.