Case Studies

Case Study: Ben K

Rugby Union Injury to Left Ankle

Assessment & Clinical Diagnosis
Severe strains to the Peroneii and Extensor mechanisms, the anterior talofibular ligament (ATFL), and thecalcaneofibular ligament (CFL) Graded II – III.

These structures being injured when Ben's foot was plantar-flexed and  forcefully inverted.  He also had a strain to the medial compartment in the form of severe tenderness to the soleus insertion along the tibia.

Incident
Towards the last quarter of the game fly half Ben K launched a kick from the 22, to clear for touch.  Ben K is right footed.  The ball was kicked whilst he was “airborne”.  His left foot was therefore first to return to ground.  His left foot was in a plantar flexed position and in effect he hit the ground toes first.  His body weight then caused his tibia to rotate and the ankle to invert and give way beneath him causing an extreme torsion at the lateral ankle.  From the touchline it actually appeared that the tibia may have fractured.

Meds in the form of paracetamol and ibuprofen were prescribed. 

Physiotherapy
Physiotherapy was commenced on 11th September, Ben’s left ankle having being immobilised for two days, during which time he carried out the I.C.E routine. 

Physio initially consisted of a combination of manual and electrical modalities (ultra sound and interferential therapy) to decrease the pain and reduce the considerable swelling.  Specific taping and bandaging was applied to support and compress.  The continuation of the self-help protocols was stressed. 

I discussed the use and the benefits of high dose collagen as a supplement to speeding the healing process of his soft tissue injuries and Ben agreed to the trial.

He was seen again at my clinic two days later on the 13th.

Swelling was sufficiently reduced as to enable a meaningful assessment and clinical diagnosis of physio continued as above and Ben was supplied with Xenca Collagen Revitalise Powder and instructed to take a high dose of 8 grams in the form of 2 teaspoons twice a day.  Personal exercise and treatment protocols were maintained.

Ben continued physio twice per week and was off crutches 7 days post injury.  He began confident full weight bearing by 10 days and started a proprioreceptive rehabilitation programme on the 26th September only 18 days post injury.

On the 4th October (only 26 days post injury) examination revealed that there was zero swelling and the sensitivity to palpation was minimal in the anterior and posterior compartments.  The lateral ligament was still tender to deep pressure but other than that full Range of Motion was restored.   Ben was confident in terms of stability and balance and as such I was able to conduct a plyometric type test programme on the pitch which included sprints, shuttles, explosive start stop exercises and a variety of functional activities. 

No pain or dysfunction was experienced.  Ben has declared himself fit for a full training session and optimistically for the game this weekend the 6th October, less than 1 Calendar month post injury and only missing two games.

He will be monitored through training and playing with ongoing treatment, rehabilitation and protective taping and is being encouraged to continue to take the Xenca Collagen for a further month to maintain tissue healing and to avoid chronic onset symptoms.

In my opinion and within my 30 year experience of physiotherapy this has been a rapid recovery given the nature and severity of the original injury. 

Although there is no specific evidence in terms of scientific testing of Ben's healing, it is fair to anecdotally conclude that the use of the Xenca Collagen in his treatment plan has contributed significantly to his early recovery.

Ray Bramford, Physiotherapist
MCSP SRP. Dp RG&RT. SRP (HPC)
www.spsclinics.co.uk

Case Study: Dan Smith - World Champion IFBB Wheelchair Pro Bodybuilder

About Dan Smith
In October 2006 I had an accident at work which left me paralysed from the waist down and wheelchair bound, I spent the next 6 months in the National Spinal unit at Stoke Mandeville receiving intense rehabilitation.

After 6 months I came home in March 2007 and had a very up and down year dealing with the wheelchair, when finally my mate dragged me back to the gym mid-2008.

When I started back at the gym a friend of mine (Paul Smith), who runs the local bodybuilding UKBFF (UK Bodybuilding and Fitness Federation) South Coast show every April, set me the challenge of getting back into shape for his show in April 2009 to do a guest spot. I trained extremely hard. With this new challenge I had been given I was determined not to let him or myself down.

2009 came and my guest spot got me a full standing ovation and made me feel amazing and extremely emotional.

That was it. I had the bug!

A week later I got a call from Paul Smith asking me if I wanted to guest spot at the British Finals in October 2009. I immediately said yes and was over the moon with the invite from the UKBFF.

The guest spot at the UKBFF British Finals was amazing. What followed was even better. I was invited to compete in the first ever Wheelchair World Championships in Poland in November 2009.

Of course I said yes, I wanted to go for the experience and to meet other wheelchair bodybuilders like me. I went and to my shock I won making me the first Wheelchair Amateur IFBB World Champ. I could not stop crying. The emotions and the UKBFF Team who came along were incredible and I now had some lifelong friends from the trip.

In 2010 I turned pro and I'm now a full time IFBB Wheelchair Pro Bodybuilder.

As a wheelchair bodybuilder my arms and joints get used constantly, they ache with mild pain so the use of Xenca Revitalise Collagen has helped massively with a heaped teaspoon twice a day.

http://www.dansmith-uk.com/

Case Study: Terry Brady

Injury to Left Hand, Accident with Electric Circular Saw

Assessment & Clinical Diagnosis
The circular saw had cut through tissue and tendons across the left hand, cut across the second and then first fingers severing the artery in the second finger. This required nerve grafts in first finger and the removal of a tendon from the first finger. It was considered unlikely by both the surgical and after-care team that useful feeling, sensation and movement would return.

Incident
During a bathroom refurbish, the next job was the straightforward 'boxing in' the pipes. Whilst cutting a piece of wood, secured in a work bench, the electric circular saw hit a knot of wood, kicked back and cut across the left hand, palm and fingers. The spray of blood up the wall from an artery being cut made it immediately obvious that it was a very serious injury.

The hand was immediately wrapped in a bath towel and a fast car to the nearest A&E unit followed. The A&E trauma doctors administered morphine and quickly X-rayed to confirm no serious bone damage. Due to the nature of the injury an emergency ambulance transfer to a more specialist trauma centre took place.

Following further examination and monitoring, an operation was scheduled for the early hours of the next morning. A specialist surgeon and plastic re-constructive consultant operated for 7 hours on the hand in an attempt to repair and connect damaged tissue. A fibreglass cast was made to fit, immobilise and protect the hand and fingers for the next 3 months!

Considerable pain relief medication was administered including anti-biotics for infection. Some x12 pure collagen hydrolysate capsules (400mg each) were taken commencing the day after the operation and every day after for some 5 months, then reduced to a maintenance dosage. 

Physiotherapy
Mobilisation of the hand had to wait for the wounds to heal and the external stitches to be removed. Light physiotherapy commenced after 4 weeks, initially weekly removing the cast and utilising a ball of clay in the palm for only 15 minutes, then replacing the cast.

As the general healing improved the finger & hand flexion was monitored and the hand was slowly stretched out over a period of 2-3 months. The wound itself was massaged daily to assist with flexibility and minimise tough scar tissue. This procedure took some 5 months prior to discharge from physiotherapy. Altogether, the hand moves well and much of the sensation has returned but some numbness will always be present.

The physiotherapist was fully aware that collagen hydrolysate was orally ingested throughout the recovery period.

On completion of physiotherapy the NHS team confirmed that “We didn’t expect you to have any feeling at all after your accident”.

Patients Comment's
I am extremely grateful to the A&E department at Wigan Hospital for their quick action minimising the risk of further damage to my hand and the use of morphine to help with the immense pain, which also helped to stop the constant shaking. They had the common sense to realise that they needed the help of the specialist Plastic Surgeons based at Whiston Hospital.

The day after my operation I started taking at least 12, 400mg, collagen capsules daily to help the soft tissue healing process. After a week or so although I was still in some pain, I didn’t need the painkillers as often as recommended (not clock watching for my next dose of painkillers). In fact, I got through the rehabilitation period with not many painkillers at all, not even finishing the course, and I think it’s thanks to the collagen!

The physiotherapist saw me 6 days after the operation. I was shocked at seeing my hand for the first time since my accident. The fingers and hand were so swollen I thought it would never heal. But with careful expert physiotherapy and home physiotherapy exercises we began to see improvements. As the swelling went down, my hand and fingers were stretched open and were straightening. Each visit to the physiotherapist resulted in the splint being altered to accommodate my fingers and help to get them back to their previous normal position.

I remember telling my physiotherapist that I felt foolish for having this injury, to which she replied “Don’t worry, I see about 3 of you hand injury patients like this a week; mostly injured by bench saws, grinders and circular saws!”

I firmly believe that taking approximately 5g of collagen hydrolysate daily helped my injury heal quicker than anyone thought possible. It helped the tendons and ligaments and the wound itself. Some 5 months after the accident, after my discharge from the physiotherapist I reduced the collagen capsules to the maintenance dose of 3 per night.

I'm fortunate, my scarring is minimal due to the collagen repairing the wound, funnily enough my nails have grown thicker and stronger.

I continue to use the collagen capsules.