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Lower Leg, Ankle and Foot

Jointstiffness abnormalgaitpattern atrophy

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Unformatted text preview: and Fibular Fractures Tibial Mechanism of Injury: • Direct blow • Indirect blow Through a combined rotatory or compressive force Rehabilitation Concerns: • Immobilization is almost always the case Leads to functional deficits to proximal and distant joints surrounding injured area. Joint stiffness Abnormal gait pattern atrophy • Depending on severity could lead to postsurgical considerations Incisions Hardware placed within bone Tibial and Fibular Fractures Tibial Rehabilitation Progression: • Determine weight­bearing status • ROM deficits should be addressed immediately with AROM, passive stretching and joint mobilizations. • Isometric strengthening and progress to isotonic once ROM is back to normal • Gait training • Strengthening exercises In other joints surrounding such as hip and knee • Balance and proprioception • Eventually moving toward functional, sports specific exercises Tibial and Fibular Fractures Tibial Return to play guidelines: • • • • Full ROM Full strength Normal walking, jogging, running Ability to successfully pass functional testing Compartment Syndromes Compartment Mechanism of Injury: • • • Occurs secondary to direct trauma to the area Medical emergency Athlete will complain of a deep aching pain, tightness and swelling of involved compartment Rehabilitation Concerns: • Depending on severity could lead to postsurgical considerations, all dependent upon specific compartment injured Incisions Muscular atrophy Compartment Syndromes Compartment Rehabilitation Progression • Decrease postsurgical pain and swelling RICE • Flexibility exercises • Weight bearing will progress as ROM improves • Gait training • AROM Open kinetic chain Closed kinetic chain Compartment Syndromes Compartment Return to play guidelines Full ROM Full Strength No gait deviations with walking, jogging and running • Completed progressive and functional testings • • • Muscle Strains Muscle Mechanism of Injury: • Commonly due to a sudden ballistic movement Gastrocnemius Rehabilitation Concerns: • Edema Attention needs to stay focused on the compression and elevation of the lower extremity to avoid edema Can limit ROM and prolong process if not aware • Light stretching NOT overstretching • Can future injury athlete and prolong process Muscle Strains Muscle Rehabilitation Progression: • • Reduction of pain Reduction of swelling RICE AROM of foot and ankle in all planes Standing calf stretching and strengthening exercises • Plyometric activities • • Muscle Strains Muscle Return to play guidelines Full ROM of foot and ankle Gastrocnemius strength and endurance that are equal to the uninvolved side • Ability to walk, jog, run and hop without compensation • Successful completion of functional testing • • Medial Tibial Stress Syndrome Medial Mechanism of Injury: • Excessive pronation Primary cause • Overuse Rehabilitation Concerns: • Must include a physicians referral to rule out any type of stress fractures • Taping Anti­pronation tape jobs Orthotics • Improper shoe ware Medial Tibial Stress Syndrome Medial Rehabilitation Progression: • Running or jumping activities may need to be completely eliminated • Pool workouts for cardiovascular fitness • Gastrocnemius and soleus stretching • Ice and E­stim Reduce inflammation Moderate early stages of pain • As improvement begins: General stretching of ankle Using Theraband...
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