1/10. Strategy of exercise prescription using an unloading technique for functional rehabilitation of an athlete with an inversion ankle sprain.STUDY DESIGN: Case study. OBJECTIVES: To demonstrate how an exercise program can be designed with specific sets, repetitions, and rest periods, and to enhance the healing process in early stages of rehabilitation when injured tissues cannot tolerate full body weight. Our goal was to enhance ankle tissue healing by reducing gravitational force through a prescriptive exercise and unloading program. BACKGROUND: This report describes a treatment method that we used to rehabilitate a collegiate soccer player with a Grade II inversion ankle sprain. This athlete sprained his ankle 6 weeks before the start of rehabilitation and was unable to participate in soccer due to persistent pain and impaired function. methods AND MEASURES: A 2-week functional training program was implemented, consisting of exercises chosen for specific task simulation related to soccer. Gravitational force was mechanically altered by suspending the subject or by supporting the subject on a variable incline plane. weight-bearing was controlled so that the subject could perform exercises without pain. The outcome measures were ankle range of motion (ROM), maximum pain-free isometric strength, vertical force during unilateral squats, and unilateral hop time and distance. RESULTS: Pain-free weight-bearing capacity increased over the 2-week course of rehabilitation and the subject was able to return to playing soccer without pain. The ratios (involved to uninvolved extremity) at time of discharge from physical therapy were 87% to 103% for ankle ROM, 75% to 93% for isometric ankle strength, 91% for unilateral squats, 88% for unilateral hop time, and 86% for unilateral hop distance. CONCLUSIONS: Return to function can be achieved in a short period by exercise that is performed with a gradual increase in pain-free weight-bearing capacity.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
2/10. weight-bearing immobilization and early exercise treatment following a grade II lateral ankle sprain.STUDY DESIGN: Case study. OBJECTIVES: To describe a protocol used in the rehabilitation of a grade II lateral ankle sprain, emphasizing brief immobilization with a removable boot, weight bearing as tolerated, and progression of early exercise. BACKGROUND: The optimum conservative treatment of severe grade II ankle sprains remains undefined. Short-term benefits of early mobilization have won favor over immobilization by casting; however, pain and ankle joint instability often linger. The timing of weight bearing as a variable that influences recovery has largely been ignored when either treatment is considered. methods AND MEASURES: The patient was a 17-year-old girl who had sustained a left ankle inversion sprain while playing high school basketball. The sprained ankle was placed in an immobilizer boot for 1 week, and weight bearing was encouraged. She received instructions for active exercise and for resistive exercise with elastic tubing. Volumetric and active range of motion measurements and gait observation provided indicators of rehabilitation progress. A digital inclinometer was used to measure active range of motion in the sagittal plane. Vertical ground reaction forces recorded with an instrumented treadmill documented gait symmetry. RESULTS: The patient responded well to the course of treatment, returning to full participation in basketball 2 weeks after the injury. The injured ankle had 29% (19 degrees) less active range of motion than the nonimpaired ankle at the beginning of physical therapy. The injured ankle also displaced 50 mL more water compared with the nonimpaired ankle at the start of treatment. Four weeks after beginning treatment, the sprained ankle had 4 degrees less active range of motion and displaced 5 mL more water compared with the nonimpaired ankle. As a college athlete, the patient has remained free of subjective complaints of ankle pain, instability, and swelling. CONCLUSION: weight-bearing immobilization combined with early exercise provided safe and effective treatment for this patient, who suffered a grade II lateral ankle sprain.- - - - - - - - - - ranking = 4keywords = motion (Clic here for more details about this article) |
3/10. Tibiofibular syndesmosis and ossification. Case report: sequelae of ankle sprain in an adolescent football player.Heterotopic ossification development within the interosseous membrane of the ankle is an uncommon occurrence after routine ankle sprains. We present a case of a high school football player who sustained a syndesmosis ankle sprain. After 4 weeks, he continued to have pain, swelling, and range of motion restriction despite being treated with cryotherapy, NSAIDs, supportive taping, and progressive rehabilitation. The radiographs revealed a heterotopic ossification within the interosseous membrane of the distal extremity. The patient was initially treated conservatively and went on to have surgical excision with an excellent result. Symptomatic patients will require definitive surgery even without frank synostosis.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
4/10. Split biceps femoris tendon reconstruction for proximal tibiofibular joint instability.Recurrent instability of the proximal tibiofibular joint is an infrequently diagnosed abnormality. We present a new technique for reconstructing the joint using a split biceps femoris tendon passed through a bone tunnel in both the proximal tibial metaphysis and fibular head. The case report is also presented. The procedure offers an anatomic reconstruction and firm stabilization. It allows normal motion of the proximal tibiofibular joint and preserves the normal mechanics of the ankle. This procedure is an excellent alternative to resection of the fibular head, transarticular arthrodesis, or pseudoarthrosis focus at the fibular head.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
5/10. chiropractic care of a patient with vertebral subluxations and unsuccessful surgery of the cervical spine.OBJECTIVE: The chiropractic care of a patient with vertebral subluxations, neck pain, and cervical radiculopathy after a cervical diskectomy is described. CLINICAL FEATURES: A 55-year-old man had neck pain and left upper extremity radiculopathy after unsuccessful cervical spine surgery. INTERVENTION AND OUTCOME: Contact-specific, high-velocity, low-amplitude adjustments (i.e., Gonstead technique) were applied to sites of vertebral subluxations. rehabilitation exercises were also used as adjunct to care. The patient reported a decrease in neck pain and left arm pain after chiropractic intervention. The patient also demonstrated a marked increase in range of motion (ROM) of the left glenohumeral articulation. CONCLUSION: The chiropractic care of a patient with neck pain and left upper extremity radiculopathy after cervical diskectomy is presented. Marked resolution of the patient's symptoms was obtained concomitant with a reduction in subluxation findings at multiple levels despite the complicating history of an unsuccessful cervical spine surgery. This is the first report in the indexed literature of chiropractic care after an unsuccessful cervical spine surgery.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
6/10. A new consideration in athletic injuries. The classical ballet dancer.The professional ballet dancer presents all of the problems of any vigorous athlete. The problems include osteochondral fractures, fatigue fractures, sprains, chronic ligamentous instability of the knee, meniscal tears, impingement syndrome, degenerative arthritis of multiple joints and low back pain. attention to minor problems with sound conservative therapy can avoid many major developments and lost hours. Observations included the extraordinary external rotation of at the hip without demonstrable alteration in the hip version angle and hypertrophy of the femur, tibia and particularly the second metatarsal (in female dancers). Careful evaluation of the range of motion of the extremities, serial roentgenographic examination, and systematic review of previous injuries, training programs and rehearsal techniques have been evaluated in a series of cases to provide the basis for advice to directors and teachers of the ballet.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
7/10. Distal tibiofibular synostosis and late sequelae of an ankle sprain.The late sequelae of an ankle sprain is described in the form of an acquired tibiofibular synostosis. A synostosis can result in loss of dynamic motion between the tibia and fibula, which may create decreased and painful ankle motion. A case report and surgical procedure is presented.- - - - - - - - - - ranking = 2keywords = motion (Clic here for more details about this article) |
8/10. Lunotriquetral sprains.Injuries to the ulnar side of the carpus have not been well defined. Lunotriquetral (LT) sprains have only recently been described and are often unrecognized. They usually occur from hyperextension: and twisting of the wrist. Symptoms include pain, weakness, limitation of motion, and a "click" with lateral motions. The sprain may be associated with dorsal subluxation of the ulnar head and supination of the carpus. physical examination discloses point tenderness, laxity, and often a snap over the LT joint. Dorsopalmar manipulation of the triquetrum on the lunate demonstrates crepitus and laxity. A radiocarpal arthrogram is helpful in confirming the diagnosis. Palmar-flexion instability patterns represent a more extensive continuation of this injury, which then may be termed an LT dissociation. Treatment with adequate immobilization for acute injuries appears to be useful if the diagnosis is established early. Chronic sprains may require stabilization of the LT joint by ligament repair, reconstruction, or LT fusion. Associated injuries, such as carpometacarpal (CMC) or hamulus fractures, have been noted. Results of treatment have varied considerably and depend in part on the severity and chronicity of the condition at the time of recognition.- - - - - - - - - - ranking = 2keywords = motion (Clic here for more details about this article) |
9/10. Tibiofibular synostosis and recurrent ankle sprains in high performance athletes.Recent evidence points toward a weight bearing and dynamic stabilizing function of the distal fibula in ankle joint mechanics. When fibular rotation and translation are restricted, ankle pain during weight bearing and push off often (but not always) results. The case histories of six professional athletes with distal tibial synostosis resulting from internal rotation-inversion injury confirm recent reports of ankle disability resulting from restriction of fibular motion, but suggest that there may be many patients with this lesion who are not disabled. Two patients with incomplete synostosis were asymptomatic, and one with complete synostosis had only occasional pain after vigorous exercise.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
10/10. Tibiofibular synostosis: a cause of ankle disability.A syndrome of ankle pain on weight-bearing while running due to post-traumatic ossification of the tibiofibular ligament is described. Pain is caused by failure of normal downward and lateral motion of the fibula. Treatment consists of complete excision of the synostosis, followed by cast immobilization for 3 weeks.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
| | Next -> |