Therapy of ankle injuries

There is no single, accepted algorithm for the treatment of ankle injuries, so the physician must intuitively decide which therapy to use depending on the severity of the injury and the functional needs of the patient.

Rehabilitation and physiotherapy after a ruptured ligament

A torn ligament is not fatal, but it is an uncomfortable injury that requires long rehabilitation, patience, and a lot of attention.

It's impossible to be immune to tendon injuries. A real scourge can hit anyone, but athletes, dancers, circus people and ballet dancers are particularly at risk.

The constant pressure on their ligaments causes micro-tears and painful symptoms that are easily treated with numbing ointments. However, over time, this leads to a thinning of the tape material, and the risk of a complete tear then increases.

Injuries often occur with sudden movements. When there is excessive stress on a joint strained by the speed of the task at hand.

In some cases, the tear is even accompanied by the separation of a small part of the bone. In particularly severe cases, a fracture may occur.

Depending on the severity of the injury, three types are distinguished:

1. Microfracture or slight tendon strain. Everyone has experienced this at least once in their life. However, sometimes this injury is not felt at all and does not cause discomfort.
2. Partial ligament tear. The function of the joint is limited, but the ability to work is preserved. Pain sensations are present and the joint reacts to external influences.
3. Complete tendon rupture. Distortion of the joint area, hematoma formation, bruising and inability to perform normal joint activities are characteristic.

While full rehabilitation after a first-degree ligament tear takes anywhere from two days to two weeks, the second and third points are more difficult.

Important! If you suspect a ligament tear, you should remain calm and immobilize the joint until it is examined by a doctor. Never try to straighten a sprain or treat a fracture yourself! This often leads to a worsening of the condition and hinders further recovery.

Physiotherapy recommendation after a ruptured ligament

Once the tear has been diagnosed by a specialist, either surgical or conservative treatment will be prescribed. Regardless of the method chosen, physical therapy is always prescribed to improve tissue healing.

Therapeutic exercises are very popular in ligament injury rehabilitation. This type of rehabilitation is considered one of the most effective, in no way inferior to other forms of rehabilitation:

LFK is prescribed by a specialist and performed under medical supervision.

Important! The exercises are divided into small blocks with gradually increasing loads. In general, there are complexes for a week of rehabilitation after a ruptured ligament. Don't skip the steps on your own, even if the burden seems manageable! This often leads to re-injury.

Physiotherapy exercises for ankle fractures

Rehabilitation therapists at Yusupov Hospital begin physical therapy for broken ankles when the leg is in a cast. During this time, the injured limb must not bear any weight. The aim of physical therapy is to improve blood circulation in the injured limb. Initially, patients will do the exercises every other day, later every day. While the leg is in the cast, the patient can do various exercises. Stand against a wall or chair with your good leg, lean on your arms for balance, and perform side-to-side movements. Begin by moving the injured leg to the side with an inhale, then an exhale with a forward motion that crosses over to the sound leg. From the same starting position, perform a side leg swing. Swing the sore leg up as high as you can, hold it for a few seconds, and then lower it back down. Do this exercise 10-15 times. Without changing the starting position, raise the knee until the thigh is parallel to the floor. Stay in this position for a few seconds, then lower your leg. The exercise is performed for 30 seconds. Stand on the sound leg and support yourself with your hands on a wall, lift your leg backwards. Raise the injured leg up as high as possible. Then pause for a few seconds and return to the starting position. Don't bend your lower back when doing this exercise.

Physical therapy after an ankle fracture

Once the cast is removed, rehabilitation therapists at Yusupov Hospital provide rehabilitation services for patients with a broken ankle. First, electromagnetic therapy is performed to restore blood and lymph circulation and reduce swelling. Physical therapy for the ankle fracture is then prescribed. Since the patient will initially not be able to do without support, an elbow brace should be purchased. The balanced support prevents hyperextension of the arm and makes it easier for the patient to move. After 2 weeks, the patient gradually gives up the crutch. The remaining crutch can be relieved with therapeutic exercises. Gymnastics with an ankle fracture is the way to full recovery. The joint must be effectively loaded after a long period of static storage. In the rehabilitation clinic, the patient performs physiotherapy exercises under the guidance of experienced physiotherapists. When recommending physical therapy after an ankle fracture, the rehabilitation therapists at the Yusupov Hospital are guided by the following principles: first, the range of motion of the ankle must be restored, and then it must be fully loaded when walking.

• Toes are extended sideways and entire foot rotated away from hips as far as possible;
• Alternately raising the legs to a right angle in the hip joints (do not bend the lower limbs, but pull the socks towards you);
• Raise the straight injured limb at the right angle of the hip joint while flexing and straightening the foot and toes with weight.

In addition to LFC exercises, rehabilitation therapists at Yusupov Hospital also offer massage to patients with ankle fractures. The injured leg should be bandaged from the toe to the knee joint with an elastic bandage or Class I compression stockings should be worn. Compression garments should be removed at night and during physical therapy of ankle fractures. During this recovery period, physiotherapy treatments such as magnetotherapy, electrophoresis and ozokerite are used in the rehabilitation clinic to treat patients after an ankle fracture.

Rehabilitation after a torn knee ligament

Rehabilitation after a knee ligament tear begins with the patient's admission to the hospital. With the right treatment plan, knee joint function can be restored as quickly as possible. If the patient is diagnosed with a complete rupture of ligaments with instability of the knee joint, other damage to the joint or the surrounding tissues, the traumatologist will recommend surgery. In other cases, surgery is not required.

The patient is prescribed painkillers intramuscularly (ketorolac) or for oral administration. Ointments, creams and gels with an analgesic component are used. Cold compresses or cryotherapy are placed on the knee. A splint or orthosis may be prescribed to immobilize the lower limbs. The lower limb must not be hyperextended.

If a vessel was injured during the injury, blood can accumulate in the knee joint cavity. To remove this, the trauma surgeon inserts a needle into the lateral part of the knee under local anesthesia and removes the accumulated fluid. If necessary, medicinal solutions are injected into the joint. Patients use an ointment to repair the torn ligament in the foot.

The treatment of patients with torn ligaments in the knee joint is supplemented by modern physiotherapeutic methods:

A senior physiotherapist at the Yusupov Hospital conducts individual therapy exercises. At the first stage of rehabilitation (within 1-7 days after the injury), patients perform all exercises with both feet 3-4 times a day with 10 approaches. Don't exercise when you're in pain. For rehabilitation after a cruciate ligament rupture, patients are offered the following exercises

• flexion and extension of the knee (in rehabilitation after a cruciate ligament rupture, the exercises should be performed with low resistance, and the difficulty of the exercises should not be increased hastily);
• static stretching of the muscles in the front of the thigh (quadriceps) to stimulate blood flow and increase tension;
• Rocking the foot forwards, backwards and sideways - helps maintain strength in the lower leg muscles and stimulates blood circulation;
• Walking without full support of the injured leg with the help of crutches, a cane, or a brace.

Gymnastics for the ankle after a ligament tear

Rehabilitation after a torn ligament in the ankle is carried out by the specialists of the Yusupov Hospital. The duration of rehabilitation depends on the severity of the injury and the patient's personal characteristics. The course of rehabilitation takes place in 3 stages:

• the use of physiotherapy and massage – starting immediately after the acute phase, on the second or third day after the injury, using phonophoresis and electrostimulation in combination with massage of the ankle, calf muscle and knee area;
• physical therapy with first passive and then active exercises that permanently decongest the joint, reduce the risk of muscle atrophy, and promote primary ankle mobility;
• a final phase in which the load is gradually increased to the maximum, allowing the muscles to regain their natural tension and the joint its normal range of motion.

Rehabilitation is also essential after ankle surgery. Rehabilitation therapists at Yusupov Hospital select a set of exercises that will help reduce swelling as quickly as possible, develop normal mobility of the ankle, and strengthen ligaments to reduce the risk of re-injury.

Once the integrity of the ligaments is restored, general seated exercises are performed, such as: B. Breathing exercises with gradual rotation of the arms and tilting of the body in combination with diaphragmatic breathing. This puts you in a good mood and increases overall body tension, which is important in the recovery process. Therapeutic physiotherapy is started 3 to 4 days after the injury. The main goal is to reduce the swelling of the ankle, develop the necessary flexibility of the ligaments and strengthen the muscles that control the ankle.

The patient performs the exercises of the first group while sitting:

ankle fracture and healing

In this case, the doctor prescribes treatment after the patient takes an X-ray. The examination serves to determine the nature of the injury and to determine the time when the patient can begin active exercise.

If the patient has an ankle fracture without complications and the cast has been removed, he can play sports 14-15 days after the cast is applied.

If the lateral malleolus is dislocated, an X-ray examination is carried out before the load is applied. If there is no improvement, the patient must be operated on.

After such a fracture, rehabilitation is essential.

• conducting exercises to aid in the development of the ankle;
• perform massages;
• consumption of foods that accelerate the healing process of the injured limb;
• Always wear a bandage to support the injured limb.

If the exercises are chosen correctly, there will be no complications.

Massage and self-massage

Can be performed on the 2nd or 3rd day after the cast is applied.

• They improve metabolic processes, blood circulation, lymph flow and innervation in the injured limb;
• accelerate the regeneration of bones and soft tissues;
• help relieve tension and reduce the risk of muscle wasting;
• to relieve swelling.

The massage can be performed by a specialist or by the patient himself. During the treatment, the patient can massage the foot and lower leg in gentle circular movements. The limb should be massaged for 10-15 minutes. A total of 15-20 sessions are required.

The massage relaxes the muscular walls of the blood vessels, increases their lumen and improves the flow of blood and nutrients to the injured limb. The massage also improves the nutrition of bone calluses, venous valves and lymphatic vessels in the lower limbs. This will help the patient eliminate pain and swelling.

Remember: if the patient is wearing a plaster cast, he can only be massaged on open areas of the body.

Stroking, rubbing, kneading and vibrating movements are used.

• Lower back;
• Thigh. movement from knee to groin;
• lower leg. movement from ankle to knee;
• Foot. Movement from toe to ankle.

Remember: massage both the back and front of the foot.

When the cast has been removed, a gentle massage of the patient can be performed. As a rule, suction massage is performed by lifting the limbs.

However, it should be noted that not all groups of people can receive a massage.

For example, it is not allowed if the patient has:

How to treat the ankle after a fracture

Recovery requires the help of a doctor, but speedy recovery is possible only with the patience and determination of the patient himself. For the first week, try to get around with the help of crutches and a walker. The patient must understand that this is necessary, and he wants to return to normal life as soon as possible.

By the end of the week, you can begin to gently wiggle your toes on the injured leg. You should also try different leg movements: bending and stretching, knee and hip exercises.

Gradually, the child will learn to sit up straight in bed and raise their legs. If it is already easy, you can start a series of exercises to activate the muscles and tendons of both legs. Absolutely necessary:

• picking up and carrying objects scattered on the floor with toes (pencils, small stones, beads);
• roll a ball (stick, bottle) with your feet;
• bending forward and backward while flexing and straightening the ankle;
• rotate the feet (imitate the rotation of a bicycle pedal)
• In the supine position, perform a scissors punch of appropriate amplitude
• flex and straighten the foot, extending the toe as much as possible;
• Rotate your feet in different directions (this exercise can be done standing, rotating your feet alternately, or sitting, rotating both feet).

Whenever possible, therapeutic walking should also be performed on tiptoe and heel, sideways, half-crouch and backwards (carefully!).

A numbing ointment can be applied for pain, but if the discomfort is severe or even unbearable, do not exert yourself and consult a doctor as this could be a sign of complications.

Exercises to strengthen muscles after a broken leg

You should regularly do exercises that will help you quickly strengthen your muscles and regain proper balance while walking. It's a good idea to start with the help of your doctor or an LFC trainer, who will review the execution of the exercises and explain exactly how to move your ankle after a fracture.

With a ball

The patient holds a special ball – a physical therapy ball – against a wall with their lower back. Keep your feet and torso forward. Squat down slightly to keep the ball from tipping over. The knees should be bent so that they form a right angle (90°).

On the platform

Stand on an unstable surface, the sound leg should be slightly bent at the knee. In the beginning you just have to learn to keep your balance. Once you master this, you can pick up the ball and throw it against a wall without losing your balance and catch it. This exercise activates the stabilizing muscles and restores balance.

Jump

Jump along a line on the floor with each foot. Land on either side of the line with each jump. This strengthens the thigh muscles, balance and coordination. The ease with which this occurs can be used to assess the development of the joint after an ankle fracture.

On a roll

Take turns standing on this roll while moderately swinging your other leg back and to the side. For stability, bend the leg slightly on the roller, but keep it straight. A loop of elastic webbing attached to the bottom of the wall can be used. This is placed around the leg that is swinging.

Alternatively, you can simply stand on the leg and balance using the elastic loop on the other leg. The legs should be loaded alternately.

Following the doctor's recommendations and one's own willingness and perseverance, mobility of the joint will be fully restored in a relatively short time.

Instead of a summary

In conclusion, I would like to say a few words about being overweight. If a person, e.g. in bad weather or ice, falls unfortunate, the weight of the trunk and upper limbs 'press' on the injured leg. The greater the load, the more serious the injury can be! If possible, try to get rid of the extra weight. Take care of yourself and stay healthy!

Ormed

Physiotherapy recommendation after a foot fracture

Rehabilitation after a foot fracture has the following goals for the patient

• restoring mobility of the foot;
• activation of ligament and muscle tone in the area of injury;
• strengthening the base of the ankle;
• elimination of puffiness and activation of metabolic processes;
• Return to normal gait.

• Therapeutic physiotherapy – a set of physical and gymnastic exercises;
• Massage;
• orthopedic shoes, splints;
• a drinking cure (at least two liters per day).

Therapeutic exercise is recommended from day one of injury and continued for several months until full recovery.

exercise sets

Therapeutic techniques for rehabilitation after a foot fracture at home include morning exercises, standing exercises, range of motion exercises, and sitting exercises.

Morning gymnastics is a so-called hygiene exercise that should be carried out immediately after waking up. They consist of three parts. The first part should be performed in bed - bending and spreading fingers, turning outwards and inwards, circular movements. This is followed by a self-massage with a cream or ointment.

General exercises performed in the morning:

• successive raising on the toes and lowering on the heels;
• knees of one leg bent, hands resting on wall; other leg pulled back on tiptoe; Calf muscle and Achilles tendon are tense;
• Feet, parallel to each other, roll from outside to inside;
• Knees raised to chest, ankle extended;
• Side lunges with torso turned to one side.

• Toes are flexed so foot is on outside;
• rolling from heel to toe;
• Half squat, with simultaneous rolling of feet left and right;
• Squat, lift heels off the floor.

These exercises are performed in 2 sets of 10-15 times.

• Jumping in place: feet apart and back together;
• Walking backwards;
• Walk on all fours
• Jump up alternately with the right and left foot;
• Jog.

You can also knead the injured foot while sitting:

• A tennis ball is rolled back and forth with the foot;
• Pick up a cloth or towel with your toes
• The towel wraps around the ankle and pulls it towards you;

Do I need rehabilitation so badly?

Targeted correction of orthopedic injuries is only the first step on the road to recovery. And to achieve the ultimate goal, every trauma patient needs professional rehabilitation. To be effective and safe, it requires expert help, comprehensive care, and an individual approach.

• degenerative changes
• Formation of muscle, tendon and joint contractures
• bleeding into the joint cavity
• muscle wasting (atrophy)
• Fracture healing, deformity
• septic or infectious inflammation
• post-traumatic arthritis
• ankylosis (immobility)
• disability

duration of the rehabilitation phase

The duration of the rehabilitation treatment largely depends on the type and severity of the injury (between 2 weeks and 2 years). At the same time, the main indicators of performance are: elimination or reduction of residual consequences, stabilization of impaired functions as much as possible, achievement of an optimal level of physical activity and work capacity.

A prerequisite for a successful recovery is the earliest possible integration of the recommended rehabilitation measures into the treatment process. The time is determined individually, taking into account the state of health, age and functional capacity.

Split Step Lung

Standing, shoulder-width apart, take a big step forward and pause. In this extended position, with one foot in front and the other behind, bring the front knee forward and the back knee to the floor and lunge. Keep your back straight. Make sure both knees are bent at 90 degrees. Return to the center. Repeat 5 times, then switch front and back legs.

First, stand with your feet shoulder-width apart. Take a large step forward, pushing the front knee forward and the back knee toward the floor. Lower both knees to a 90 degree angle. Press on the heel of the front foot and slide it up. Then, on the opposite side, take another step forward and repeat the same movement. Repeat 5 steps with each leg.

Side lunge

Start standing. Take a big step to the right with your right foot, keeping both feet pointed forward. Support yourself with your right buttock while bending your right knee over your right ankle. Squat down on your right side, keeping your left leg straight. Press your right heel down to bring your right foot back to center. Then repeat the exercise on the left side. Repeat the exercise 5 times on each side.

Diagnostic arthroscopy

Diagnostic arthroscopy is a modern, safe technique that allows for quick recovery and reduced morbidity. prevent ligament damage, impingement syndrome and arthrofibrosis of the ankle.

Chronic pain syndrome as a complication of treatment after ankle fracture requires a comprehensive approach. After verification of the diagnosis, arthroscopic exposure of the ankle with resection of the pathological tissue and debridement of the ankle structures is possible, arthroscopic irrigation..

After mechanically removing the 'obstacle' and sources of pain and flushing the joint with saline solution, it is necessary to prescribe an appropriate medication. saline flush, it is extremely important to prescribe appropriate drug therapyto create favorable conditions for the reconstruction of the articular structures.

In order to achieve this, it is advisable to meet the need for hyaluronic acidwhich plays a role in the hydration of protein molecules that affect the elasticity and flexibility of cartilage, and the chondroprotectors.

The high concentration of viscoelastic hyaluronic acid provides the necessary padding and lubricating effect, which has a positive effect on the regeneration process of the joints.

Proper rehabilitation

The basis for optimal results is the continuity between the orthopedic trauma surgeon and the rehabilitation therapist.

After correct diagnosis, surgical treatment and proper drug therapy, the inpatient phase can be completed, but treatment must be continued on an outpatient basis - all patients are recommended to get one All patients are recommended to complete a graded rehabilitation program during both the acute phase and the phase of recovery of movement and function.

Rehabilitation aims to maintain and increase the range of motion achieved in the ankle and is also necessary to prevent the development of relapse.

Since there is no algorithm and no uniform protocol, the treatment often depends on the decision of the individual doctor. Careful verification of the diagnosis, minimally invasive surgical treatment in a single surgical session with resection of pathologic tissue in the ankle to eliminate mechanical causes that limit movement, and removal of metal fixation devices are essential for optimal results.

In the early postoperative period, the following measures should be taken

• appropriate drug therapy to restore the damaged structures of the joint,
• local injections of hyaluronic acid, one of the most important elements in restoring range of motion in the ankle.

Only a comprehensive approach can solve such a complex problem.

• Injury to the ankle.
• Massage for flat feet.
• Lift your heels off the floor during the squat.
• Treatment of torn ligaments in the ankle.
• Injury to the ligaments of the ankle.
• dislocation of the ankle.
• The ankle bruise is where the picture is taken.
• Partial tear of the ligaments of the ankle.