As a physical therapist for the Sports Medicine Program at Texas Children’s Hospital West Campus, I see many pediatric and adolescent patients with chronic sports-related injuries. When we evaluate, diagnose and treat these athletes, our team uses an interdisciplinary approach to tailor every treatment plan, which allows us to meet the patient’s individualized needs and ensure the best possible outcomes.
When I first met my patient, Agnes Gonzalez, in July 2020, a knee injury caused her extreme pain. As a collegiate rower, Agnes, with the support of athletic trainers at her university, helped push her through the winter rowing season. Despite limiting her physical activity to allow her knee enough time to heal, the pain got progressively worse to the point where performing the simplest daily activities were unbearable.
“The pain was very debilitating,” Agnes said. “It was during the start of the COVID-19 pandemic when the pain began to impact my daily life and my athletic career. Simple things like walking, getting out of a chair or going up stairs were difficult. My knee pain improved gradually after my physician, Dr. Jorge Gomez, referred me to the Sports Medicine Clinic at West Campus where I had physical therapy.”
Unlike other young athletes I have worked with, Agnes was a unique patient in that she was a competitive rower. We hadn’t seen many patients involved in competitive rowing as a sport. To develop the most effective treatment plan for Agnes’ case, I began researching her sport so I could tailor her physical therapy to mimic the same motions used in rowing in order to strengthen the muscles around her knee.
The first plan of action was to treat her knee pain. She was very sensitive to light touch; just touching the outside of her knee was painful, so we needed to get that under control. She began biomechanical exercises to increase her range of motion and improve the control of her body when she moves so she could resume her normal activities free from pain. To complement her physical therapy, we used trigger point dry needling, which involves inserting a thin needle directly into muscle tissue, zeroing in on the trigger points that can cause pain and poor movement quality in the muscles, tendons and joints around her knee. This approach alleviated her knee pain and resulted in improved function.
Once her knee pain was under control, we incorporated strength building into Agnes’ therapy sessions using a new, cutting-edge approach called blood flow restriction therapy. A Velcro cuff connected to an air hose was placed around Agnes’ leg to restrict blood flow to the muscles surrounding her injured knee. When a certain amount of blood flow is restricted, it deprives muscle tissues of oxygen and metabolically stresses those muscles. The muscles respond as though the person is lifting heavy weights when no heavy weights are lifted at all. When Agnes was in a painful state and she couldn’t handle lifting heavy weights to get stronger, we used blood flow restriction therapy to help get her muscles strong and improve her movement in a pain-free way. This therapy has benefited Agnes on her road to recovery.
“Dr. Gomez and my physical therapist Rob were phenomenal,” Agnes said. “They paid attention to detail, they made sure they covered all of the bases, and developed a treatment plan to help my knee so I could heal at 100 percent. Besides helping me physically get better, their “we are going to get there” mentality helped me break the mental barriers of frustration during my recovery process. I’ve had physical therapy at other places, but the care I received at Texas Children’s was exceptional. Everything I thought I knew about physical therapy was thrown out the window thanks to the wonderful team I got to work with.”
After five months in physical therapy, Agnes is doing exceptionally well. She recently got clearance from Dr. Gomez and has successfully completed her therapy with us. Agnes will head back to college next month where she will resume classes and prepare for winter training camp with her rowing team.
Our Sports Medicine and Sports Physical Therapy team combined a thorough understanding of this athlete's unique situation with advanced therapy treatments to solve a problem that had been very frustrating for her. Through this treatment approach, Agnes is now able to return to collegiate rowing.
Click here to learn more about our Sports Medicine team at Texas Children’s Hospital West Campus and our use of advanced technology to rehabilitate young athletes and help them return to competition.