Kategoriarkiv: Hip

treatment-article

_Inflammation of the bursa

SportNetDoc

Placement of intra-articular injections verified by ultrasonography and injected air as contrast medium.

Fredberg U, van Overeem Hansen G, Bolvig L. Ann Rheum Dis 2001 May;60(5):542.

Intraarticular injection of long-acting corticosteroid is a corner stone in rheumatological treatment. The injected intra-articular corticoid is more effective when the placement is correctly secured. Injection of radiographic contrast material has shown that less than half of the injections are correct placed in the joint space after blind injection. Generally, the clinical application of ultrasonographic examinations can be enhanced by contrast agents. The most common used technique is creation of microbubble contrast agents. Such agents, applied to the bloodstream, have been used for hepatic, nephrologic, cardiologic and transcranial examinations. Obviously, the risk of air embolism depends on the anatomic site of the injected air contrast. Transient ischemic attacks are described after echocardiography with air contrast and in animal models haemodynamic effects during venous air infusion can be measured. Intra-articular injection of air and subsequently lateral and posterior radiographs has shown that this technique can enhance the procedure precision. The disadvantage of this method is that the result can first be seen after the injection, and that a correction can only be made with a new injection. In the joint space the air is separated from the vascular system and when only small amounts of sterile air are used the risk of venous air embolism is neglectable. Air is a very effective contrast medium in ultrasonography. Air sonography has been used for the diagnosis of meniscus lesions in knee joints and for rotator cuff lesions in the shoulder. We expand the applicability of this method to all joints, not only for diagnostic purposes, but also for the correct placement of the needle before injection of medicine (steroid, osmium-acid, viscosupplementation): The sterile air that is contained in the capped vial with lidocain or steroid is used as contrast medium. The needle is ultrasonographic guided placed in the joint space profound for the distended capsule. When the steroid and lidocain are mixed in the syringe a small volume of air will be in the needle itself (˜ 0.05 ml). The air in the needle is clearly seen when the injection is started and will secure the correct placement of the needle. With this technique, it is not necessary to use two separate syringes and the inclination of the syringe will not cause the air to move from the needle to the bottom of the syringe. If the knee is injected, injection directly into the recess is recommended, which will make the small volume of air possible to be seen momentary. Figure 1 illustrates the ultrasonography of a MTP joint in a patient before (UL-34A) and after (UL-34B) injected air. The intraarticular air is clearly seen. We had made more than one thousand ultrasonography guided intraarticular injection without any complications. This method is easy, inexpensive, without risk and radiation and should be used routinely in rheumatology. Especially chemical synovectomy of the knee should always be guided by ultrasonography and with this technique also smaller joins can be considered for chemical synovectomy.

treatment-article

_Cartilage damage (osteochondral lesions)

SportNetDoc

“Dem bones”: osteochondral injuries of the knee.

Hinshaw MH, Tuite MJ, De Smet AA. Magn Reson Imaging Clin N Am 2000 May;8(2):335-48.

MR imaging plays a valuable role in the diagnosis and staging of osteochondral injuries of the femorotibial joint. Bone contusions may be the source of a patient’s pain, and MR imaging characteristics of certain types may help to predict which contusions might progress to more serious osteochondral lesions. MR imaging also is vital in the diagnosis of occult osteochondral fractures and in accurately classifying displaced intra-articular fractures. Although osteochondral dissecans usually is diagnosed radiographically, MR imaging is the best noninvasive test for determining if an osteochondral fragment is unstable. Unstable lesions are a treatable cause of knee pain.

complication-article2

_Anterior collateral ligament rupture

SportNetDoc

Results of reconstruction of acute ruptures of the anterior cruciate ligament with an iliotibial band autograft.

Bak K, Jorgensen U, Ekstrand J, Scavenius M. Knee Surg Sports Traumatol Arthrosc 1999;7(2):111-7.

Forty patients with an acute complete tear of the anterior cruciate ligament (ACL) underwent primary reconstruction with an iliotibial band autograft after median 15 (range 0-90) days. Objective and functional evaluation was performed after median 37 (range 24-87) months by two independent observers using the International Knee Documentation Committee (IKDC) knee evaluation form, the Lysholm knee function score, and the Tegner activity score. During the observation period 5 patients sustained an ACL tear in the contralateral knee, and 1 patient (2.5%) sustained a graft rupture and underwent re-reconstruction. For the remaining 34 knees the Lysholm score at follow-up was median 100 (range 84-100, mean 97 [+/- 4]), all patients scoring excellent (n = 28) or good (n = 6). Three patients (9%) had more than 3 mm side-to-side difference in anteroposterior laxity. All 4 ligament failures occurred in patients operated on within the first 2 weeks after the injury. Twenty-six patients (76%) returned to the same level of activity as prior to the injury. Of 8 who dropped to a lower activity level, only one ascribed this to problems with the operated knee, meaning that 26 of 27 (96%) returned to their desired level of activity. According to the overall IKDC evaluation, 14 patients (40%) had a normal knee (A), 13 (37%) had a nearly normal knee (B), 5 (14%) had an abnormal knee (C), and 2 (9%) had a severely abnormal knee (D). Ten patients (25%) had the staples removed due to local irritation, and further 6 (15%) had local symptoms from the tibial staples. The harvest site gave 8 (20%) patients cosmetic complaints, but all graded this as slight, and 3 (8%) had slight pain during activity from the lateral muscular hernia. In selected individuals performing vigorous knee activities, autologous reconstruction of acute ACL disrupted knees with a combined internal and external iliotibial band transfer demonstrates excellent results after median 3 years. The failure rate is comparable to other techniques.

treatment-article

_Anterior collateral ligament rupture

SportNetDoc

Revision ACL reconstruction using autogenous patellar tendon graft.

Eberhardt C, Kurth AH, Hailer N, Jager A. Knee Surg Sports Traumatol Arthrosc 2000;8(5):290-5.

This retrospective study examined revision anterior cruciate ligament reconstruction using a bone-tendon-bone autograft of the patellar ligament. We followed up 44 patients (mean age 27.9 years) for an average of 41.2 months. Clinical examination with the Lachmann and pivot shift tests showed clearly improved stability; KT-1000 arthrometer measurements had a mean difference of 3.5 mm in side-to-side comparison. The evaluated knee scores were significantly improved (P<0.01); the median Lysholm score was 85 and the median Tegner activity score 5.0 at follow-up. In the IKDC ranking system 75.0% of knees were rated normal or nearly normal (grades A and B). According to a modified Fairbank scale, progression of radiographic signs of osteoarthritis was noted in 36.4%. There was a significant difference (P<0.05) in progression of radiographic signs of osteoarthritis between patients with major (grades III, IV) versus minor (grades I, II) lesions of the articular cartilage surface and between knees with versus without extensive synovitis due to previous synthetic graft reconstruction (P<0.05). Revision anterior cruciate ligament reconstruction using an autogenous patellar tendon graft shows good results with improved knee function compared to the prerevision status and is in line with various operative techniques described in the literature. Progression of osteoarthritis must be expected in patients with major lesions of the articular cartilage surface and knees with long-term extensive synovitis due to previous anterior cruciate ligament reconstruction using synthetic grafts.

KONDITION

week15+

_Anterior collateral ligament rupture

Training ladder for:
 RUPTURE OF THE ANTERIOR CRUCIATE LIGAMENT
(RUPTURA LIGAMENTUM CRUCIATUM ANTERIUS)

Uge 15 +
The following exercises can only be considered as a supplement to the guidelines furnished by the doctor which performed the operation. Specific precautions are necessary as the operation can be complicated. The training must not bring about swelling or pain in the knee.
KONDITION
Unlimited: Cycling. Swimming. Running.

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
(10 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):

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.

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.

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.

Lie on your back with a ball or firm round cushion under the injured leg. Lift your backside up from the floor and stretch the healthy leg. Hold the position for a few seconds.

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 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.

KONDITION

week13-15

_Anterior collateral ligament rupture

Training ladder for:
 RUPTURE OF THE ANTERIOR CRUCIATE LIGAMENT
(RUPTURA LIGAMENTUM CRUCIATUM ANTERIUS)

Uge 13-15
The following exercises can only be considered as a supplement to the guidelines furnished by the doctor which performed the operation. Specific precautions are necessary as the operation can be complicated. The training must not bring about swelling or pain in the knee.
KONDITION
Cycling with raised saddle. Swimming (Backstroke). Light 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
(10 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 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.

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):

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.

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.

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.

Lie on your back with a ball or firm round cushion under the injured leg. Lift your backside up from the floor and stretch the healthy leg. Hold the position for a few seconds.

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.

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.

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

week10-12

_Anterior collateral ligament rupture

Training ladder for:
 RUPTURE OF THE ANTERIOR CRUCIATE LIGAMENT
(RUPTURA LIGAMENTUM CRUCIATUM ANTERIUS)

Uge 10-12
The following exercises can only be considered as a supplement to the guidelines furnished by the doctor which performed the operation. Specific precautions are necessary as the operation can be complicated. The training must not bring about swelling or pain in the knee.
KONDITION
Unlimited: Cycling with raised saddle. Swimming (Backstroke). 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
(10 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 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
(40 min):

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

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.

Lie on your back with a ball or firm round cushion under both feet. Raise your backside up from the floor and hold your feet on the ball. Hold the position for a few seconds.

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.

Lie on your back with a ball or firm round cushion under the injured leg. Lift your backside up from the floor and stretch the healthy leg. Hold the position for a few seconds.

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 on the good leg with the elastic around the inner side of the injured leg above the knee. Move the injured leg from side to side in a slow movement.

Stand on the good leg with the elastic around the outer side of the injured leg above the knee. Move the injured leg from side to side in a slow movement.

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

week7-9

_Anterior collateral ligament rupture

Training ladder for:
 RUPTURE OF THE ANTERIOR CRUCIATE LIGAMENT
(RUPTURA LIGAMENTUM CRUCIATUM ANTERIUS)

Uge 7-9
The following exercises can only be considered as a supplement to the guidelines furnished by the doctor which performed the operation. Specific precautions are necessary as the operation can be complicated. The training must not bring about swelling or pain in the knee.
KONDITION
Unlimited: Cycling with raised saddle. Swimming (Backstroke). 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.

KOORDINATION
(10 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):

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.

Lie on your stomach on the floor with your arms above your head and with outstretched legs. Lift right arm and left leg together, changing to lift left arm and right leg together.

Lie on your back with a ball or firm round cushion under both feet. Raise your backside up from the floor and hold your feet on the ball. Hold the position for a few seconds.

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.

Lie on your back with a ball or firm round cushion under the injured leg. Lift your backside up from the floor and stretch the healthy leg. Hold the position for a few seconds.

Stand on the good leg with the elastic around the inner side of the injured leg above the knee. Move the injured leg from side to side in a slow movement.

Stand on the good leg with the elastic around the outer side of the injured leg above the knee. Move the injured leg from side to side in a slow movement.

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

week4-6

_Anterior collateral ligament rupture

Training ladder for:
 RUPTURE OF THE ANTERIOR CRUCIATE LIGAMENT
(RUPTURA LIGAMENTUM CRUCIATUM ANTERIUS)

Uge 4-6
The following exercises can only be considered as a supplement to the guidelines furnished by the doctor which performed the operation. Specific precautions are necessary as the operation can be complicated. The training must not bring about swelling or pain in the knee.
KONDITION
Unlimited: Swimming (Backstroke). 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.

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.

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.

KOORDINATION
(10 min):

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

Stand on your toes with bent knees. Place your weight forward on the toes and keep your balance.

STYRKE
(40 min):

Pull yourself forward on a chair by use of your heel against the floor. Increase the resistance by having someone hold the chair.

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.

Lie on your stomach on the floor with your arms above your head and with outstretched legs. Lift right arm and left leg together, changing to lift left arm and right leg together.

Lie on your back with a ball or firm round cushion under both feet. Raise your backside up from the floor and hold your feet on the ball. Hold the position for a few seconds.

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.

Lie on your back with a ball or firm round cushion under the injured leg. Lift your backside up from the floor and stretch the healthy leg. Hold the position for a few seconds.

Lie on the floor with the injured leg. Press the leg against the floor and tip the foot up. Hold the position for approx. 10 seconds. You have to feel a stretching of the anterior thigh. Rest for approx. 10 seconds. Repeat the exercise for approx. 3 minutes.

Stand on the good leg with the elastic around the inner side of the injured leg above the knee. Move the injured leg from side to side in a slow movement.

Stand on the good leg with the elastic around the outer side of the injured leg above the knee. Move the injured leg from side to side in a slow movement.

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.