Well done everyone! You all did very well in the last case study! The hypothesis list was well thought out and clinicall navigated in accordance to what was most likely vs least likely. In these cases wear we are exploring trauma, repetitive stress/impact over an extended period of time, wirth careful consideration previous structural damage to the elbow... It's EXTREMELY hard to neglect our very basics of biomechanics.. And that is - STRUCTURE = FUNCTION If the structure is compromised, this will primarily influence (in most cases) how the surrounding active structures will support the underlying passive system (joint capsule). This man may present with what most soft tissue therapists would think as ''over active forerarm muscles'' or ''your forearm muscles are over compensating for your biceps, which could be coming from your elbow''. No! Whlst active supports do ''cop a beating'' from sports like boxing, there gets to a point where the structural stability that is supposed to provide leverage for muscles and tendons is compromised.. ''Too far too gone'' So, in saying this, my diagnosis and problem list is as follows - 1) Elbow OA (mild-mod?) ; secondary muscular overload of wrist & elbow flexors/extensors (mod/chronic) 2) Common extensor/flexor origin tendon pathology (mod/acute on chronic) ; muscular overload symptoms a/a 3) Tricep insertional tendon pathology (mod/chronic) ; muscular overload symptoms a/a 4) Olecarnon #? My first diagnosis is OA because it is clear that the structural integrity at the elbow joint capsule has been compromised enough in the past to predipose to the current severity of the irritation he is now experiencing. I've placed my soft tissue/tendon problems later, as we know these are already existing problems that have been recentky excarbated but are not primarily responsible for his symptoms. Plan of a attack? Soft tissue forerarms/triceps Dry needling - tendon focus on tricep/CEO/CFO Refer out for regenerative medicine option - PRP/?peptide therapy

Subjective Ax - 28 YO M 5-6 months ago since returning to muay thai ; high volume/intensity sessions (kicking/sparring) Client began to feel pain in anterior hip and lower back through both R & L sides C/O delayed pain at night and morning stiffness AGGS - round kick/frog stretch Objective Ax - Supine SLR - discomfort lower back (right/left - 3/10 pain) PROM hips (Flexion/IR/ER) - ''pinching sensation in EOR hip flexion/IR (R>L) MMT - discomfort in both end range/mid range hip flexion in anterior hip MRI imaging - R Hip - Linear increasd signal within the anterior/inferior labrum ; paralabral effusion noted suggestive of labral injury L Hip - Grade 2 muscular tear w/ associated haematoma with the anterior aspect of the upper thigh at the vastus medialis & rectus femoris insertion sites noted ; linear increased signal intensity within the posterior aspect of the labrum with associated minimal traces of fluid noted suggestive of nondisplaced posterior labral injury What is your diagnosis?