Lower Leg, Ankle and Foot

Fullreturnshouldbewhentheathleteseemstobepainfree

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Unformatted text preview: uld be placed in short leg cast in slight plantarflexion, and non­weight bearing for 5 – 6 weeks • Surgery may be necessary if conservative treatment is not successful, to prevent a reoccurrence Subluxation and Dislocation of the Peroneal Tendons the Rehabilitation Progression • Following surgery, the athlete should be placed in a non­weight bearing short leg cast for ~ 4 weeks • Aggressive rehabilitation should begin after removal of the cast • The rehabilitation is similar compared to ankle fractures, with increased emphasis on increasing the strength of the peroneals • Eversion exercises should be concentrated on throughout the rehabilitation Subluxation and Dislocation of the Peroneal Tendons the Return to Play Guidelines • May return to full activity after ~ 10 to 12 weeks as tolerated • Normal strength, ROM, and neuromuscular control should be regained prior to RTP Tendonitis Tendonitis Mechanism of Injury • Typically an overuse injury • Can be related to biomechanical errors, poor footwear, acute trauma to the tendon, tight heel cords, changes in training surface, or changes in the training program Rehabilitation Concerns/Progression • • Common areas for tendonitis to occur in the lower leg, ankle, and foot are the tibialis anterior, tibialis posterior, and peroneals In the early phases of rehabilitation, exercises should be used to increase circulation to the area The increased circulation of the lymphatic system will facilitate removal of waste and by­products of the excessive inflammation, along with increased nutrition to the healing tendon Tendonitis Tendonitis Rehabilitation Concerns/Progressions • Exercises should also limit the amount of atrophy, which can occur with disuse, as well as minimize loss of strength, proprioception, and neuromuscular control • The rehabilitation should incorporate techniques in which concentrate on reducing inflammation (rest, therapeutic modalities, anti­inflammatory medications) • The use of orthotics and taping may also be helpful in reducing stress on the tendons if biomechanical errors are present • The rehabilitation should be slow and controlled, as opposed to traditional sports medicine rehabilitation, which is considered to be aggressive Tendonitis Tendonitis Return to Play Guidelines • Sufficient rest should be allowed in order to insure the best healing for the inflamed tendons • Full return should be when the athlete seems to be pain free Excessive Pronation and Supination Supination Mechanism of Injury • Excessive pronation (pes planus) or supination (pes cavus) at the subtalar joint typically occurs due to some structural or functional deformity in the foot or leg (forefoot and rearfoot varas, forefoot valgus) • Overuse injuries occure due to excessive pronation and supination Rehabilitation Concerns • The main objective of treatment is to correct the faulty biomechanics due to the structural deformity • An accurate biomechanical analysis should be conducted in order to identify the deformities causing compensatory movements, which lead to injury • Most cases of faulty biomechanics can be resolved with the use of orthotics Excessive Pronation and Supination Supination Re...
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