INTEGRATED REHABILITATION PHYSIOTHERAPY WITH PELVIC FLOOR EXERCISES IN TAEKWONDO ATHLETE WITH BREATHING DISORDER IN EFFORTS – A CASE DESCRIPTION

R. Kafri¹, M. Cal’e Benzoor¹, G. Dar²

¹Wingate Institute, Institute of Physiotherapy, Ribstein Center for Sports Medicine and Research, Netanya, Israel, ²University of Haifa, Department of Physical Therapy, Faculty of Social Welfare & Health Sciences, Haifa, Israel

Background: Athletes engaged in intense activity, need a respiratory system that will allow them to maintain this level of intensity. A respiratory disorder associated with physical exertion, beyond impaired achievement, can be life threatening. The diaphragm, although a major respiratory muscle, is attached to the pelvic floor through soft tissue in the peritoneal membrane envelope. The anatomical connection and coordination between them, should allow for proper respiratory function. The paucity of literature on the relationship between the two systems in general (among achievement athletes in particular), as well as regarding treatment for athletes with a respiratory disorder, brings about the need to discuss the issue.

Purpose: To examine and describe the rehabilitative process in a taekwondo athlete who suffered from chronic vocal cord disorders.

Methods: A taekwondo athlete with vocal cord disorder for 4 years arrived at the physiotherapy clinic. The athlete had symptoms of suffocation and shortness of breath during exertion. Imaging tests showed no significant findings. Intense sporting activities were found as challenging. Physical examination showed normal neck and upper back active movement while sitting, and limitation of passive end of head movement during laying down.In a passive examination of the diaphragm while laying on her back, pain was produced on the left side and a little on the right. When pressing on the connection of the diaphragm to the bones of the chest, she reported sensitivity which was like the pain she felt during the effort of a match. When she was asked to count slowly to 10 continuously, at the number 3 she stopped and inhaled air to continue counting.
Nine treatments were performed in combination with pelvic floor rehabilitation for 3 months, once every two weeks. The treatments included: learning to control pelvic floor muscles for contraction and relaxation, controlling the ability to releasing air and combining manual therapy and exercise to improve mobility of shoulder blades, neck, chest and pelvic floor.

Results: Improvement was noticed at the second session already, in which the athlete managed to count to 5, 4th session- to 7 and 9th session easily up to 10. At the same time as the progress in the ability to relax the diaphragm and allow for an easy release of air, the pain and limitation of head movement decreased. Upon her return to sports, she continued self-practice of relaxation and reported that the symptoms did not return. She competed in the European Championship and won a bronze medal.

Conclusions: Due to the paucity of literature in the biomechanical and therapeutic aspect, in respiratory disorders in athletes, we found importance in presenting a case treated at the Physiotherapy Institute of Achievement Sports at the Wingate Institute, and in the approval of the athlete.

Implications: Pelvic floor rehabilitation must be an integral part of rehabilitation in general and in athletes in particular during rehabilitation program for several disorders.

Funding acknowledgements: No

Keywords:
Sport
Pelvic floor
Vocal cord disorders

Topics:
Sport & sports injuries
Pelvic, sexual and reproductive health
Orthopaedics

Did this work require ethics approval? No

Reason: In the abstract, the results of the athlete's treatment are presented within the framework of the existing treatment known in the literature. The patient approved the publication of the results for the purpose of improving the treatment of athletes suffering from the presented problem.