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treatment-article1

Nerve entrapment on the back of the shoulder blade

SportNetDoc

Entrapment of the suprascapular nerve.

Fabre T, Piton C, Leclouerec G, Gervais-Delion F, Durandeau A. J Bone Joint Surg Br 1999 May;81(3):414-9.

Operative release for entrapment of the suprascapular nerve was carried out in 35 patients. They were assessed at an average of 30 months (12 to 98) after operation using the functional shoulder score devised by Constant and Murley. The average age at the time of surgery was 40 years (17 to 67). Entrapment was due to injury in ten patients and no cause was found in three; 34 had diffuse posterolateral shoulder pain. The strength of abduction was reduced in all the patients. The average Constant score, unadjusted for age or gender, before operative release was 47% (28 to 53). In 25 of the patients both the supraspinatus and infraspinatus muscles were atrophied and seven had isolated atrophy of the infraspinatus muscle. The average conduction time from Erb’s point to the supraspinatus muscle and to the infraspinatus muscle was 5.7 ms (2.8 to 12.8) and 7.4 ms (3.4 to 13.4), respectively. In two patients MRI revealed a ganglion in the infraspinatus fossa and, in another, a complete rupture of the rotator cuff. The average time from the onset of symptoms to operation was ten months (3 to 36). A posterior approach was advocated. The average Constant score, after operative release, unadjusted for age or gender was 77% (35 to 91). The overall result was excellent in ten of the patients, very good in seven, good in 14, fair in two, and poor in two. The symptomatic and functional outcome in our series confirmed the usefulness and safety of operative decompression for entrapment of the suprascapular nerve.

cause-article

Nerve entrapment on the back of the shoulder blade

SportNetDoc

Suprascapular neuropathy in volleyball players.

Witvrouw E, Cools A, Lysens R, Cambier D, Vanderstraeten G, Victor J, Sneyers C, Walravens M. Br J Sports Med 2000 Jun;34(3):174-80.

BACKGROUND.
Suprascapular nerve entrapment with isolated paralysis of the infraspinatus muscle is uncommon. However, this pathology has been reported in volleyball players. Despite a lack of scientific evidence, excessive strain on the nerve is often cited as a possible cause of this syndrome. Previous research has shown a close association between shoulder range of motion and strain on the suprascapular nerve. No clinical studies have so far been designed to examine the association between excessive shoulder mobility and the presence of this pathology. AIM: To study the possible association between the range of motion of the shoulder joint and the presence of suprascapular neuropathy by clinically examining the Belgian male volleyball team with respect to several parameters.

METHODS.
An electromyographic investigation, a clinical shoulder examination, shoulder range of motion measurements, and an isokinetic concentric peak torque shoulder internal/external rotation strength test were performed in 16 professional players.

RESULTS.
The electrodiagnostic study showed a severe suprascapular neuropathy in four players which affected only the infraspinatus muscle. In each of these four players, suprascapular nerve entrapment was present on the dominant side. Except for the hypotrophy of the infraspinatus muscle, no significant differences between the affected and non-affected players were observed on clinical examination. Significant differences between the affected and non-affected players were found for range of motion measurements of external rotation, horizontal flexion and forward flexion, and for flexion of the shoulder girdle (protraction); all were found to be higher in the affected players than the non-affected players.

CONCLUSIONS.
This study suggests an association between increased range of motion of the shoulder joint and the presence of isolated paralysis of the infraspinatus muscle in volleyball players. However, the small number of patients in this study prevents definite conclusions from being drawn.

KONDITION

step4

Muscle rupture in the anterioir thigh

[Back]

Training ladder for:
MUSCLE RUPTURE IN THE ANTERIOR THIGH
(RUPTURA MUSCULI)

STEP 4
KONDITION
Unlimited: Cycling. Swimming. Running with jumping.

UDSPÆNDING
(10 min)

Lie on your back. Draw the injured leg up towards your head so that the muscles in the back of the thigh become increasingly stretched. Perform the exercise with outstretched as well as bent knee. Hold the position for 20 seconds and relax for 20 seconds before repeating. The exercise can also be performed standing with the injured leg outstretched on a chair while the upper body is bent slightly forwards.

Stand with support from the back of a chair or the wall. Using your hand, bend the knee and draw the foot up and your knee slightly backwards so that the muscles in the front of the thigh become increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating. The exercise can also be done lying down. If you lie on your stomach you can draw the foot up by using a towel.

Lie on your side on a table. Bend one leg up under your body and let the other hang over the edge of the table so that the muscles in the outer side of the thigh become increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating. The exercise can also be done standing by placing the outstretched injured leg behind the good leg at the same time as bending over the injured leg.

Stand with one leg outstretched and the other slightly bent. Thrust your weight to the side over the bent leg so that the inner side of the opposite thigh becomes increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Lie on your back with one leg outstretched and the other bent with the foot on the other side of the outstretched leg. Draw the knee up towards the opposite shoulder so that the buttocks become increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

KOORDINATION
(5 min)

Seesaw. Balance on two legs, possibly using a hand as support against the wall, balancing subsequently on one leg without support. Look straight ahead and keep knees bent.

Stand on the healthy leg with elastic fixed around the hip. The elastic should be fixed to the wall or a wall bar. Take-off on the healthy leg and land on the leg to be trained and keep your balance. Remember that the elastic should be positioned so that it gives resistance at the moment of take-off. Change legs.

STYRKE
(40 min)

Sit on a chair with elastic around the ankle, facing the elastic. Lift the leg and slowly bend and stretch the knee.

Sit on a chair with elastic attached to the ankle. Raise the leg and slowly stretch and bend the knee.

Stand on the healthy leg with the elastic around the inside of the injured leg. Move the injured leg from side to side in a slow smooth movement. Moving the position of the elastic lower down the leg can increase the load.

Stand on the healthy leg with the elastic around the outside of the injured leg. Move the injured leg from side to side in a slow smooth movement. Moving the position of the elastic lower down the leg can increase the load.

Lie on the floor with slightly bent knees. Put the elastic under the foot and hold firmly with your hands. Stretch the knee so that the elastic is drawn tight and slowly bend the knee again.

Stand with your back against a wall with a ball or firm round cushion between the wall and your back. Slowly go down to bend your knee 90 degrees before slowly rising up again.

Stand with elastic around the hip. Step forward over one knee and hold the front foot firmly against the floor. Bend the rear leg and go forward onto your toes. Remember to change leg.

Stand with both legs on the stool with elastic around the hip. Take-off and land with feet together.

Stretching is carried out in the following way: stretch the muscle group for 3-5 seconds. Relax for 3-5 seconds. The muscle group should subsequently be stretched for 20 seconds. The muscle is allowed to be tender, but must not hurt. Relax for 20 seconds, after which the procedure can be repeated. The time consumed for stretching, coordination and strength training can be altered depending on the training opportunities available and individual requirements.

KONDITION

step3

Muscle rupture in the anterioir thigh

[Back]

Training ladder for:
MUSCLE RUPTURE IN THE ANTERIOR THIGH
(RUPTURA MUSCULI)

STEP 3
KONDITION
Unlimited: Cycling. Swimming. Running with increasing distance.

UDSPÆNDING
(10 min)

Lie on your back. Draw the injured leg up towards your head so that the muscles in the back of the thigh become increasingly stretched. Perform the exercise with outstretched as well as bent knee. Hold the position for 20 seconds and relax for 20 seconds before repeating. The exercise can also be performed standing with the injured leg outstretched on a chair while the upper body is bent slightly forwards.

Stand with support from the back of a chair or the wall. Using your hand, bend the knee and draw the foot up and your knee slightly backwards so that the muscles in the front of the thigh become increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating. The exercise can also be done lying down. If you lie on your stomach you can draw the foot up by using a towel.

Lie on your side on a table. Bend one leg up under your body and let the other hang over the edge of the table so that the muscles in the outer side of the thigh become increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating. The exercise can also be done standing by placing the outstretched injured leg behind the good leg at the same time as bending over the injured leg.

Stand with one leg outstretched and the other slightly bent. Thrust your weight to the side over the bent leg so that the inner side of the opposite thigh becomes increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Lie on your back with one leg outstretched and the other bent with the foot on the other side of the outstretched leg. Draw the knee up towards the opposite shoulder so that the buttocks become increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

KOORDINATION
(5 min)

Seesaw. Balance on two legs, possibly using a hand as support against the wall, balancing subsequently on one leg without support. Look straight ahead and keep knees bent.

Stand on the healthy leg with elastic fixed around the hip. The elastic should be fixed to the wall or a wall bar. Take-off on the healthy leg and land on the leg to be trained and keep your balance. Remember that the elastic should be positioned so that it gives resistance at the moment of take-off. Change legs.

STYRKE
(40 min)

Sit on a chair with elastic around the ankle, facing the elastic. Lift the leg and slowly bend and stretch the knee.

Sit on a chair with elastic attached to the ankle. Raise the leg and slowly stretch and bend the knee.

Stand on the healthy leg with the elastic around the inside of the injured leg. Move the injured leg from side to side in a slow smooth movement. Moving the position of the elastic lower down the leg can increase the load.

Stand on the healthy leg with the elastic around the outside of the injured leg. Move the injured leg from side to side in a slow smooth movement. Moving the position of the elastic lower down the leg can increase the load.

Lie on the floor with slightly bent knees. Put the elastic under the foot and hold firmly with your hands. Stretch the knee so that the elastic is drawn tight and slowly bend the knee again.

Stand with your back to the wall with your weight on both feet. Slowly go down and bend the knee to 90 degrees, and slowly rise again.

Go forward on the injured leg until the knee is bent to max. 90 degrees. Stand up on the same leg and return to the starting position.

Stretching is carried out in the following way: stretch the muscle group for 3-5 seconds. Relax for 3-5 seconds. The muscle group should subsequently be stretched for 20 seconds. The muscle is allowed to be tender, but must not hurt. Relax for 20 seconds, after which the procedure can be repeated. The time consumed for stretching, coordination and strength training can be altered depending on the training opportunities available and individual requirements.

KONDITION

step2

Muscle rupture in the anterioir thigh

[Back]

Training ladder for:
MUSCLE RUPTURE IN THE ANTERIOR THIGH
(RUPTURA MUSCULI)

STEP 2
KONDITION
Unlimited: Cycling with a weak load. Swimming. Jogging.

UDSPÆNDING
(10 min)

Lie on your back. Draw the injured leg up towards your head so that the muscles in the back of the thigh become increasingly stretched. Perform the exercise with outstretched as well as bent knee. Hold the position for 20 seconds and relax for 20 seconds before repeating. The exercise can also be performed standing with the injured leg outstretched on a chair while the upper body is bent slightly forwards.

Stand with support from the back of a chair or the wall. Using your hand, bend the knee and draw the foot up and your knee slightly backwards so that the muscles in the front of the thigh become increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating. The exercise can also be done lying down. If you lie on your stomach you can draw the foot up by using a towel.

Lie on your side on a table. Bend one leg up under your body and let the other hang over the edge of the table so that the muscles in the outer side of the thigh become increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating. The exercise can also be done standing by placing the outstretched injured leg behind the good leg at the same time as bending over the injured leg.

Stand with one leg outstretched and the other slightly bent. Thrust your weight to the side over the bent leg so that the inner side of the opposite thigh becomes increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Lie on your back with one leg outstretched and the other bent with the foot on the other side of the outstretched leg. Draw the knee up towards the opposite shoulder so that the buttocks become increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

KOORDINATION
(5 min)

Seesaw. Balance on two legs, possibly using a hand as support against the wall, balancing subsequently on one leg without support. Look straight ahead and keep knees bent.

STYRKE
(45 min)

Sit on a chair with elastic around the ankle, facing the elastic. Lift the leg and slowly bend and stretch the knee.

Sit on a chair with elastic attached to the ankle. Raise the leg and slowly stretch and bend the knee.

Stand on the healthy leg with the elastic around the inside of the injured leg. Move the injured leg from side to side in a slow smooth movement. Moving the position of the elastic lower down the leg can increase the load.

Stand on the healthy leg with the elastic around the outside of the injured leg. Move the injured leg from side to side in a slow smooth movement. Moving the position of the elastic lower down the leg can increase the load.

Go up and down from the stool. Go up with alternating right and left legs.

Lie on the floor with slightly bent knees. Put the elastic under the foot and hold firmly with your hands. Stretch the knee so that the elastic is drawn tight and slowly bend the knee again.

Stretching is carried out in the following way: stretch the muscle group for 3-5 seconds. Relax for 3-5 seconds. The muscle group should subsequently be stretched for 20 seconds. The muscle is allowed to be tender, but must not hurt. Relax for 20 seconds, after which the procedure can be repeated. The time consumed for stretching, coordination and strength training can be altered depending on the training opportunities available and individual requirements.

KONDITION

step1

Muscle rupture in the anterioir thigh

[Back]

Training ladder for:
MUSCLE RUPTURE IN THE ANTERIOR THIGH
(RUPTURA MUSCULI)

STEP 1
The indications of time after stretching, coordination training and strength training show the division of time for the respective type of training when training for a period of one hour. The time indications are therefore not a definition of the daily training needs, as the daily training is determined on an individual basis.

KONDITION
Unlimited: Cycling with a weak load. Swimming. Running in deep water.

UDSPÆNDING
(10 min)

Lie on your back. Draw the injured leg up towards your head so that the muscles in the back of the thigh become increasingly stretched. Perform the exercise with outstretched as well as bent knee. Hold the position for 20 seconds and relax for 20 seconds before repeating. The exercise can also be performed standing with the injured leg outstretched on a chair while the upper body is bent slightly forwards.

Stand with support from the back of a chair or the wall. Using your hand, bend the knee and draw the foot up and your knee slightly backwards so that the muscles in the front of the thigh become increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating. The exercise can also be done lying down. If you lie on your stomach you can draw the foot up by using a towel.

Lie on your side on a table. Bend one leg up under your body and let the other hang over the edge of the table so that the muscles in the outer side of the thigh become increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating. The exercise can also be done standing by placing the outstretched injured leg behind the good leg at the same time as bending over the injured leg.

Stand with one leg outstretched and the other slightly bent. Thrust your weight to the side over the bent leg so that the inner side of the opposite thigh becomes increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Lie on your back with one leg outstretched and the other bent with the foot on the other side of the outstretched leg. Draw the knee up towards the opposite shoulder so that the buttocks become increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

KOORDINATION
(5 min)

Seesaw. Balance on two legs, possibly using a hand as support against the wall, balancing subsequently on one leg without support. Look straight ahead and keep knees bent.

STYRKE
(45 min)

Sit on a chair with elastic around the ankle, facing the elastic. Lift the leg and slowly bend and stretch the knee.

Lie on your back with a ball or firm round cushion under both feet. Roll the ball backwards and forwards in a steady pace while lifting your backside.

Sit on a chair and lift the knee to a horizontal position. Hold for 1 minute, lower the leg to approx. 45 degrees for 30 seconds. Lower again to the starting position.

Sit on a chair with the injured leg on a stool or similar. Lift the leg above the stool with the foot flexed at a maximum, and hold the position for 10 seconds, followed by 10 seconds rest. The exercise should be repeated for approx. 3 minutes.

Stand on the healthy leg with the elastic around the inside of the injured leg. Move the injured leg from side to side in a slow smooth movement. Moving the position of the elastic lower down the leg can increase the load.

Stand on the healthy leg with the elastic around the outside of the injured leg. Move the injured leg from side to side in a slow smooth movement. Moving the position of the elastic lower down the leg can increase the load.

Stretching is carried out in the following way: stretch the muscle group for 3-5 seconds. Relax for 3-5 seconds. The muscle group should subsequently be stretched for 20 seconds. The muscle is allowed to be tender, but must not hurt. Relax for 20 seconds, after which the procedure can be repeated. The time consumed for stretching, coordination and strength training can be altered depending on the training opportunities available and individual requirements.

treatment-article

Muscle rupture in the anterioir thigh

SportNetDoc

Complete quadriceps tendon ruptures.

Rougraff BT, Reeck CC, Essenmacher J. Orthopedics 1996 Jun;19(6):509-14.

Forty-four patients with 53 quadriceps tendon ruptures were studied retrospectively with an average follow up of 67.2 months (range: 24 to 155). The type of repair was not associated with differences in functional outcome, patient satisfaction, range of motion, or isokinetic testing. Patients with a delay in surgical treatment in comparison to those immediately repaired had significantly worse functional results (P < .05), lower satisfaction scores (P < .05), and lower isokinetic data for both the injured and uninjured extremities, however, their range of motion and comparative extensor power results were nearly identical. On reviewing all patients, the ultimate range of motion was within an average of 2 degrees of the uninjured side in nearly all patients. Based on the results of this study, all surgical methods can be expected to give comparable results as long as treatment is begun within 1 week of the injury. Regaining range of motion comparable to the uninjured side was not a problem in this series despite a delay in treatment.

examination-article

Muscle rupture in the anterioir thigh

SportNetDoc

Ultrasonography as a diagnostic tool in cases of quadriceps tendon rupture.

Mahlfeld K, Mahlfeld A, Kayser R, Franke J, Merk H. Ultraschall Med 1999 Feb;20(1):22-5. Published erratum appears in Ultraschall Med 1999 Apr;20(2):69.

AIM.
Determination of the reliability of ultrasonography as a diagnostic tool for rupture of the quadriceps tendon and for follow-up after surgical repair.

METHOD.
11 patients (12 tendons) with a clinical suspicion of quadriceps tendon rupture were studied with ultrasonography in two planes.

RESULTS.
In 9 cases we were able to confirm the results of the clinical examination using ultrasonography. In 2 cases we did not find a rupture of the quadriceps tendons.

KONDITION

step4

Muscular bleeding in the anterior thigh

[Back]

Training ladder for:
MUSCULAR BLEEDING IN THE ANTERIOR THIGH
(HÆMATOMA MUSCULI)

STEP 4
KONDITION
Unlimited: Cycling. Swimming. Running with jumping.

UDSPÆNDING
(10 min)

Lie on your back. Draw the injured leg up towards your head so that the muscles in the back of the thigh become increasingly stretched. Perform the exercise with outstretched as well as bent knee. Hold the position for 20 seconds and relax for 20 seconds before repeating. The exercise can also be performed standing with the injured leg outstretched on a chair while the upper body is bent slightly forwards.

Stand with support from the back of a chair or the wall. Using your hand, bend the knee and draw the foot up and your knee slightly backwards so that the muscles in the front of the thigh become increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating. The exercise can also be done lying down. If you lie on your stomach you can draw the foot up by using a towel.

Lie on your side on a table. Bend one leg up under your body and let the other hang over the edge of the table so that the muscles in the outer side of the thigh become increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating. The exercise can also be done standing by placing the outstretched injured leg behind the good leg at the same time as bending over the injured leg.

Stand with one leg outstretched and the other slightly bent. Thrust your weight to the side over the bent leg so that the inner side of the opposite thigh becomes increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Lie on your back with one leg outstretched and the other bent with the foot on the other side of the outstretched leg. Draw the knee up towards the opposite shoulder so that the buttocks become increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

KOORDINATION
(5 min)

Seesaw. Balance on two legs, possibly using a hand as support against the wall, balancing subsequently on one leg without support. Look straight ahead and keep knees bent.

Stand on the healthy leg with elastic fixed around the hip. The elastic should be fixed to the wall or a wall bar. Take-off on the healthy leg and land on the leg to be trained and keep your balance. Remember that the elastic should be positioned so that it gives resistance at the moment of take-off. Change legs.

STYRKE
(40 min)

Sit on a chair with elastic around the ankle, facing the elastic. Lift the leg and slowly bend and stretch the knee.

Sit on a chair with elastic attached to the ankle. Raise the leg and slowly stretch and bend the knee.

Stand on the healthy leg with the elastic around the inside of the injured leg. Move the injured leg from side to side in a slow smooth movement. Moving the position of the elastic lower down the leg can increase the load.

Stand on the healthy leg with the elastic around the outside of the injured leg. Move the injured leg from side to side in a slow smooth movement. Moving the position of the elastic lower down the leg can increase the load.

Lie on the floor with slightly bent knees. Put the elastic under the foot and hold firmly with your hands. Stretch the knee so that the elastic is drawn tight and slowly bend the knee again.

Stand with your back against a wall with a ball or firm round cushion between the wall and your back. Slowly go down to bend your knee 90 degrees before slowly rising up again.

Stand with elastic around the hip. Step forward over one knee and hold the front foot firmly against the floor. Bend the rear leg and go forward onto your toes. Remember to change leg.

Stand with both legs on the stool with elastic around the hip. Take-off and land with feet together.

Stretching is carried out in the following way: stretch the muscle group for 3-5 seconds. Relax for 3-5 seconds. The muscle group should subsequently be stretched for 20 seconds. The muscle is allowed to be tender, but must not hurt. Relax for 20 seconds, after which the procedure can be repeated. The time consumed for stretching, coordination and strength training can be altered depending on the training opportunities available and individual requirements.

KONDITION

step3

Muscular bleeding in the anterior thigh

[Back]

Training ladder for:
MUSCULAR BLEEDING IN THE ANTERIOR THIGH
(HÆMATOMA MUSCULI)

STEP 3
KONDITION
Unlimited: Cycling. Swimming. Running with increasing distance.

UDSPÆNDING
(10 min)

Lie on your back. Draw the injured leg up towards your head so that the muscles in the back of the thigh become increasingly stretched. Perform the exercise with outstretched as well as bent knee. Hold the position for 20 seconds and relax for 20 seconds before repeating. The exercise can also be performed standing with the injured leg outstretched on a chair while the upper body is bent slightly forwards.

Stand with support from the back of a chair or the wall. Using your hand, bend the knee and draw the foot up and your knee slightly backwards so that the muscles in the front of the thigh become increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating. The exercise can also be done lying down. If you lie on your stomach you can draw the foot up by using a towel.

Lie on your side on a table. Bend one leg up under your body and let the other hang over the edge of the table so that the muscles in the outer side of the thigh become increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating. The exercise can also be done standing by placing the outstretched injured leg behind the good leg at the same time as bending over the injured leg.

Stand with one leg outstretched and the other slightly bent. Thrust your weight to the side over the bent leg so that the inner side of the opposite thigh becomes increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Lie on your back with one leg outstretched and the other bent with the foot on the other side of the outstretched leg. Draw the knee up towards the opposite shoulder so that the buttocks become increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

KOORDINATION
(5 min)

Seesaw. Balance on two legs, possibly using a hand as support against the wall, balancing subsequently on one leg without support. Look straight ahead and keep knees bent.

STYRKE
(40 min)

Sit on a chair with elastic around the ankle, facing the elastic. Lift the leg and slowly bend and stretch the knee.

Sit on a chair with elastic attached to the ankle. Raise the leg and slowly stretch and bend the knee.

Stand on the healthy leg with the elastic around the inside of the injured leg. Move the injured leg from side to side in a slow smooth movement. Moving the position of the elastic lower down the leg can increase the load.

Stand on the healthy leg with the elastic around the outside of the injured leg. Move the injured leg from side to side in a slow smooth movement. Moving the position of the elastic lower down the leg can increase the load.

Lie on the floor with slightly bent knees. Put the elastic under the foot and hold firmly with your hands. Stretch the knee so that the elastic is drawn tight and slowly bend the knee again.

Stand with your back to the wall with your weight on both feet. Slowly go down and bend the knee to 90 degrees, and slowly rise again.

Go forward on the injured leg until the knee is bent to max. 90 degrees. Stand up on the same leg and return to the starting position.

Stretching is carried out in the following way: stretch the muscle group for 3-5 seconds. Relax for 3-5 seconds. The muscle group should subsequently be stretched for 20 seconds. The muscle is allowed to be tender, but must not hurt. Relax for 20 seconds, after which the procedure can be repeated. The time consumed for stretching, coordination and strength training can be altered depending on the training opportunities available and individual requirements.