Kategoriarkiv: Rupture of the joint capsule

prevention-article2

Rupture of the joint capsule

SportNetDoc

The prevention of ankle sprains in sports. A systematic review of the literature.

Thacker SB, Stroup DF, Branche CM, Gilchrist J, Goodman RA, Weitman EA. Am J Sports Med 1999 Nov-Dec;27(6):753-60.

To assess the published evidence on the effectiveness of various approaches to the prevention of ankle sprains in athletes, we used textbooks, journals, and experts in the field of sports medicine to identify citations. We identified 113 studies reporting the risk of ankle sprains in sports, methods to provide support, the effect of these interventions on performance, and comparison of prevention efforts. The most common risk factor for ankle sprain in sports is history of a previous sprain. Ten citations of studies involving athletes in basketball, football, soccer, or volleyball compared alternative methods of prevention. Methods tested included wrapping the ankle with tape or cloth, orthoses, high-top shoes, or some combination of these methods. Most studies indicate that appropriately applied braces, tape, or orthoses do not adversely affect performance. Based on our review, we recommend that athletes with a sprained ankle complete supervised rehabilitation before returning to practice or competition, and those athletes suffering a moderate or severe sprain should wear an appropriate orthosis for at least 6 months. Both coaches and players must assume responsibility for prevention of injuries in sports. Methodologic limitations of published studies suggested several areas for future research.

prevention-article1

Rupture of the joint capsule

SportNetDoc

The effect of preventive measures on the incidence of ankle sprains.

Verhagen EA, van Mechelen W, de Vente W. Clin J Sport Med 2000 Oct;10(4):291-6.

OBJECTIVE.
To critically review the current data concerning the efficacy of preventive measures described in the literature, on the incidence of lateral ankle ligament injuries.

DATA SOURCES.
MEDLINE, Sportdiscus, and EMBASE were searched for papers published between 1980 and December 1998. Keywords used in the search were “prevention” in combination with “ankle,” “ankle taping,” “ankle bracing,” “orthosis,” “shoes,” and “proprioception.” Additional references were reviewed from the bibliographies of the retrieved articles.

STUDY SELECTION.
A study was included if: 1) the study contained research questions regarding the prevention of lateral ankle ligament injuries; 2) the study was a randomized controlled trial, a controlled trail, or a time intervention; 3) the results of the study contained incidence rates of lateral ankle ligament injuries as study outcome; and 4) the study met the cut-off score set for quality.

DATA EXTRACTION AND SYNTHESIS.
Two reviewers reviewed relevant studies for strengths and weaknesses in design and methodology, according to a standardized set of predefined criteria. Eight relevant studies met the criteria for inclusion and were analyzed.

MAIN RESULTS.
Overall, all studies reported a significant decrease in incidence of ankle sprains using the studied preventive measure. There was a great variety in methodology and study design between the eight analyzed studies, and every study had one or more drawbacks. Therefore, between studies only general results could be compared.

CONCLUSIONS.
The use of either tape or braces reduces the incidence of ankle sprains. Next to this preventive effect, the use of tape or braces results in less severe ankle sprains. However, braces seem to be more effective in preventing ankle sprains than tape. It is not clear which athletes are to benefit more from the use of preventive measures: those with or those without previous ankle sprains. The efficacy of shoes in preventing ankle sprains is unclear. It is likely the newness of the footwear plays a more important role than shoe height in preventing ankle sprains. Proprioceptive training reduces the incidence of ankle sprains in athletes with recurrent ankle sprains to the same level as subjects without any history of ankle sprains.

examination-article1

Rupture of the joint capsule

SportNetDoc

Rupture of the tibiofibular syndesmosis without osseous fibular injury.

Ruf W, Friedl P, Frobenius H. Aktuelle Traumatol 1987 Aug;17(4):153-6.

Within 3 years 12 injuries of the anterior fibulo-tibial ligament without fracture of the fibula were recorded prospectively. In relation to the total number of the ankle joint fractures during the same period the incidence is 3.3%. The rupture of the ligament arose in all cases from a forced eversion combined with supination or pronation of the foot. Clinical characteristics are the circumscribed painful palpation of the area of the ligament together with eversion pain of the foot. Arthrography is the most sensitive diagnostic procedure, which, however, may be avoided if the clinical situation is absolutely clear. Differential diagnosis consists mainly in the rupture of the fibulo-talar ligament including a tear of the anterior capsule of the ankle joint. Treatment should always be surgical – suture of the ligament, reinforcement of the syndesmosis by means of a positioning screw. Aftercare is functional without external fixation.

KONDITION

STEP4

Rupture of the joint capsule

[Back]

Training ladder for:
RUPTURE OF THE JOINT-CAPSULE AT THE FRONT OF THE ANKLE JOINT
(RUPTURA TRAUMATICA LIGAMENTI PEDIS)

STEP 4
KONDITION
Unlimited: Cycling. Swimming. Running with directional change.

UDSPÆNDING
(10 min)

Stand with the injured leg stretched backwards with the toes facing front. Slowly bend the knee so that the calf muscles become increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Stand with the injured leg outstretched with the ankle joint bent up against the wall. Press your abdomen against the wall so that the calf muscles become increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Stand on the good leg while gaining support on the wall with the hand on the same side. Bend the knee of the injured leg and draw the heel towards the buttocks. Take hold of the big toe side of the foot and draw slowly upwards so that the ankle joint is stretched to the maximum and drawn slightly outwards so that increased stretching is experienced on the inside of the shin bone. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Stand on the good leg while gaining support from the wall with the opposite hand. Bend the knee of the injured leg and draw the heel towards the buttocks. Take hold of the little toe side of the foot and draw slowly upwards so that the ankle joint is stretched to the maximum and drawn over the good leg so that increased stretching is experienced on the outer side of the shin bone. Hold the position for 20 seconds and relax for 20 seconds before repeating.

KOORDINATION
(15 min)

Stand on the leg to be trained. Take-off and land on the same leg.

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 injured leg with your upper body bent forwards at 90 degrees. Lift the good leg in a straight line behind you. When you feel comfortable with the exercise, it can be made more difficult by closing your eyes.

STYRKE
(35 min)

Sit on the floor. Tip the foot up and down with elastic under the forefoot so that the elastic becomes taut.

Sit on the floor. Tip the foot up and down with elastic on top of the forefoot so that the elastic becomes taut.

Sit on the floor. Tip the foot from side to side with elastic on the outer side of the foot, without moving the knee.

Sit on the floor. Tip the foot from side to side with elastic on the inner side of the foot, without moving the knee.

Stand behind a chair. Rise slowly up on tiptoe and go down again.

Up and down from the stool with load. Tie elastic around the hip and go up on the stool in a slow movement. The elastic should be fastened to the wall.

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

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.

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

Stand with feet together. Using the ankle joint to take off, hop approx. 5 cm and land on both feet. The exercise should be done on one leg when you are able to do it without discomfort using both legs.

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

Rupture of the joint capsule

[Back]

Training ladder for:
RUPTURE OF THE JOINT-CAPSULE AT THE FRONT OF THE ANKLE JOINT
(RUPTURA TRAUMATICA LIGAMENTI PEDIS)

STEP 3
KONDITION
Unlimited: Cycling. Swimming. Running straight ahead (without directional change).

UDSPÆNDING
(10 min)

Stand with the injured leg stretched backwards with the toes facing front. Slowly bend the knee so that the calf muscles become increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Stand with the injured leg outstretched with the ankle joint bent up against the wall. Press your abdomen against the wall so that the calf muscles become increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Stand on the good leg while gaining support on the wall with the hand on the same side. Bend the knee of the injured leg and draw the heel towards the buttocks. Take hold of the big toe side of the foot and draw slowly upwards so that the ankle joint is stretched to the maximum and drawn slightly outwards so that increased stretching is experienced on the inside of the shin bone. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Stand on the good leg while gaining support from the wall with the opposite hand. Bend the knee of the injured leg and draw the heel towards the buttocks. Take hold of the little toe side of the foot and draw slowly upwards so that the ankle joint is stretched to the maximum and drawn over the good leg so that increased stretching is experienced on the outer side of the shin bone. Hold the position for 20 seconds and relax for 20 seconds before repeating.

KOORDINATION
(15 min)

Stand on the leg to be trained. Take-off and land on the same leg.

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 injured leg with your upper body bent forwards at 90 degrees. Lift the good leg in a straight line behind you. When you feel comfortable with the exercise, it can be made more difficult by closing your eyes.

STYRKE
(35 min)

Sit on the floor. Tip the foot up and down with elastic under the forefoot so that the elastic becomes taut.

Sit on the floor. Tip the foot up and down with elastic on top of the forefoot so that the elastic becomes taut.

Sit on the floor. Tip the foot from side to side with elastic on the outer side of the foot, without moving the knee.

Sit on the floor. Tip the foot from side to side with elastic on the inner side of the foot, without moving the knee.

Stand behind a chair. Rise slowly up on tiptoe and go down again.

Up and down from the stool with load. Tie elastic around the hip and go up on the stool in a slow movement. The elastic should be fastened to the wall.

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

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.

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

STEP2

Rupture of the joint capsule

[Back]

Training ladder for:
RUPTURE OF THE JOINT-CAPSULE AT THE FRONT OF THE ANKLE JOINT
(RUPTURA TRAUMATICA LIGAMENTI PEDIS)

STEP 2
KONDITION
Unlimited: Cycling. Swimming. Light running straight ahead (without directional change) on a smooth surface.

UDSPÆNDING
(10 min)

Stand with the injured leg stretched backwards with the toes facing front. Slowly bend the knee so that the calf muscles become increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Stand with the injured leg outstretched with the ankle joint bent up against the wall. Press your abdomen against the wall so that the calf muscles become increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Stand on the good leg while gaining support on the wall with the hand on the same side. Bend the knee of the injured leg and draw the heel towards the buttocks. Take hold of the big toe side of the foot and draw slowly upwards so that the ankle joint is stretched to the maximum and drawn slightly outwards so that increased stretching is experienced on the inside of the shin bone. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Stand on the good leg while gaining support from the wall with the opposite hand. Bend the knee of the injured leg and draw the heel towards the buttocks. Take hold of the little toe side of the foot and draw slowly upwards so that the ankle joint is stretched to the maximum and drawn over the good leg so that increased stretching is experienced on the outer side of the shin bone. Hold the position for 20 seconds and relax for 20 seconds before repeating.

KOORDINATION
(15 min)

Stand on one leg. Play the ball up against the wall.

Stand on one leg on the floor or a mattress. Look straight ahead and keep the knee slightly bent.

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
(35 min)

Sit on the floor. Tip the foot up and down with elastic under the forefoot so that the elastic becomes taut.

Sit on the floor. Tip the foot up and down with elastic on top of the forefoot so that the elastic becomes taut.

Sit on the floor. Tip the foot from side to side with elastic on the outer side of the foot, without moving the knee.

Sit on the floor. Tip the foot from side to side with elastic on the inner side of the foot, without moving the knee.

Stand behind a chair. Rise slowly up on tiptoe and go down again.

Up and down from the stool with load. Tie elastic around the hip and go up on the stool in a slow movement. The elastic should be fastened to the wall.

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

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

STEP1

Rupture of the joint capsule

[Back]

Training ladder for:
RUPTURE OF THE JOINT-CAPSULE AT THE FRONT OF THE ANKLE JOINT
(RUPTURA TRAUMATICA LIGAMENTI PEDIS)

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. Swimming. Running in deep water.

UDSPÆNDING
(10 min)

Stand with the injured leg stretched backwards with the toes facing front. Slowly bend the knee so that the calf muscles become increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Stand with the injured leg outstretched with the ankle joint bent up against the wall. Press your abdomen against the wall so that the calf muscles become increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Stand on the good leg while gaining support on the wall with the hand on the same side. Bend the knee of the injured leg and draw the heel towards the buttocks. Take hold of the big toe side of the foot and draw slowly upwards so that the ankle joint is stretched to the maximum and drawn slightly outwards so that increased stretching is experienced on the inside of the shin bone. Hold the position for 20 seconds and relax for 20 seconds before repeating.

Stand on the good leg while gaining support from the wall with the opposite hand. Bend the knee of the injured leg and draw the heel towards the buttocks. Take hold of the little toe side of the foot and draw slowly upwards so that the ankle joint is stretched to the maximum and drawn over the good leg so that increased stretching is experienced on the outer side of the shin bone. Hold the position for 20 seconds and relax for 20 seconds before repeating.

KOORDINATION
(10 min)

Stand on one leg on the floor or a mattress. Look straight ahead and keep the knee slightly bent.

STYRKE
(40 min)

Sit on the floor. Tip the foot up and down with elastic under the forefoot so that the elastic becomes taut.

Sit on the floor. Tip the foot up and down with elastic on top of the forefoot so that the elastic becomes taut.

Sit on the floor. Tip the foot from side to side with elastic on the outer side of the foot, without moving the knee.

Sit on the floor. Tip the foot from side to side with elastic on the inner side of the foot, without moving the knee.

Stand on a soft surface. Rise slowly up on tiptoe and go down again.

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

Sit with a ball under the foot. Roll the ball backwards and forwards and from side to side.

Stand on both legs. Tip the toes on the leg to be trained upwards and down again, whilst having the heel firmly on the floor during the exercise.

Sit on a chair. Keep the heel firmly on the ground and tip the toes up.

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.