Friday, April 5, 2019

Achilles Tendon Sprain Case Study

Achilles T end upon Sprain Case Study delineate Lani ThompsonAge 26Sex FemaleOccupation MerchandiserHeight 179Weight77.8, BMIDiet intricateFamily She lives with her partner, no kids.Medical History No history of Hypertension, Cardiovascular, Diabetics mellitus, pulmonary or any continuing disease. floorwear A comfortable, properly fitted tushwear should be used. Avoid High heels.Daily activities Usually she goes to Gym thrice in a week, occasionally she goes for swimming.BalanceMuscle performance No muscle wasting.Posture peripheral measurementAlignment There is no difference in alignment while she walks.History Lani Thompson is a hockey and rugby player. About 4 months back, while she was bringing up rugby she had a accountability articulatio talocruralis sprain. The Incident was happening around 7 in the night. Soon after she was shifted to the hospital and consulted with the doctor. On the aforesaid(prenominal) day she had underg unmatchable several investigations and exa minations, including X-Ray and ultrasound. No evidence of any fracture on the x-ray and was diagnosed as an Achilles muscularity sprain. Initial 2 weeks she was in a brace, subsequently she started articulatio talocruralis junction occasion joint make fors. Later she patternd with Theraband and had started physi other(a)apy intercession for 2 weeks, eventually continued her exercises at home.Past Medical History She has never been hospitalized for any chronic diseases. No history of Diabetes mellitus, Hypertension, Heart diseases, Asthma, Hepatitis, Sexually transmitted diseases or Tuberculosis.She regularly takes medications for depression/anxiety and for contraception. medicinal drug Venlafaxine, Quitiepine and a contraceptive pill.Surgical Intervention No surgical interference.Gait pattern Altered, limping of right stagecoach.Range of Motion (ROM) Normal on left side, right ankle ROM is slightly altered, No muscle stiffness.Palpation No tenderness or any abnormalities. Anatomy of the Ankle joint The ankle joint mainly consists of two joints, the subtalar and the avowedly ankle joint. The subtalar joint comprises three get up, the tibia, the fibula and the talus. The mechanism of the ankle joint is very complex. True ankle is responsible for the up and down drives of the foot. The subtalar joint is po amazeioned under the true ankle joint and consists with two bones, the calcaneus and the talus. This joint is responsible for the side to side movement of the foot. The joint is covered with a cartilage know as articular cartilage. The articular joint is lubricated with synovial fluid.Many ligaments connect the ankle bones together, they are anterior fibular ligament, which attaches the fibula to the tibial bone. The second ligament is known as the askant collateral ligament, which connects calcaneus bone with the fibula and the tibial bone and the third one is deltoid ligament, it connects calcaneus and the talus bones together to the tibia.Many sinews attach the muscles of the lower limb and the bones of the ankle, they are the Achilles, the flexor hallicus longus, the flexor digitorium, the peroneal tendons, the posterior tibialis and the anterior tibialis tendons. Among these tendons the Achilles tendon is considered to be the strongest tendons in the human body. It is located at the posterior of the arm and connects the calcaneus bone to the gastrocnemius ,solens and plantarius muscles. The Achilles tendon is about six inches long and can withstand around four time of body pack during walking and almost eight times while tally.Achilles Tendonitis It is the inflammation of the calcaneus tendon.Over use of the tendon causes pain and stiffness, for instance running up hill or climbing up stairs.Achilles Rupture asdf..Exercises root 1 ExerciseEvertion/ Invertion isometric exercises.Evertion This exercise can be performed by placing the wound foot co boundinous to a door or the leg of a table and gradually push extreme ly to the lateral side of the foot.Inversion This exercise can be done by placing the medial aspect of the foot to any fixed objects much(prenominal) as a table leg or a door, then(prenominal) to push gently outward in for two to three seconds.Evertion/Invertion with an exercise bandEvertion The guest has to sit and fix the leg immediately, with the help of an elastic band One end of the elastic band is attach to a table leg and other to the foot and then gradually turns the foot outwards.Invertion Rotate the foot inwards by reversing the position of the band .The movement of the foot should be apart from the leg of the table.The client can proceed to the assembly two exercises, if he tolerates to do group one exercise.Group 2 exercisesGastrocnemius stretch The patient has to bend forward and push the wall with his hands. The injure leg should be placed just behind the other foot, keeping the foot firmly to the floor for about 30 seconds.Soleus Stretch Place the non injured fo ot behind the injured foot and bend the other knee joint. The heel should be raised while stretching.Weight standing exercises The client should stand on the floor with the affected leg and bend the other leg, so that the whole body weight should bear on the injured leg for 30 seconds and then lift the heel up and down.Injured leg stand with a clothThe client is asked to stand on a 2inches thick cloth with the injured leg for 30 seconds.The client can proceed to the group three exercises, if he tolerates to do group two exercises.Group 3 exercisesLateral step and bound exercise.This exercise is performed by placing a folded wipe on the floor and to stand beside the wipe and client steps on the folded towel. Other foot should be placed firmly on the floor. Repeat the same exercise with other leg. As the pain allows, cast up the repetitions and speed accordingly.Hop exercise It is performed by placing a folded towel on a floor and the client is asked to stand beside the towel and bound over the folded towel and to rest on the other foot. Then remove the entire exercise with the other leg.As the pain allows, slowly raise the speed and hops.RehabilitationRange of movementStretching of the calf muscle When the patient will be able to sand comfortably with an injured leg, he is asked to move back the injured foot and move the hip gradually forward, so that the calf muscle is stretched. Hold for 20 seconds and repeat for at least 2 times per day.Alphabet paternity The patient has to write alphabets with his greater toe at least 2 times per day.Balance cooking exercises By holding a fixed object firmly with one hand and stand on a single leg, keeping the other knee folded. Repeat the same with the other foot as well. As the patients balance improves, he is encouraged to repeat the same exercise with eyes shut.GOALSShort term kind 1 and 2Improve joint range of motion and flexibilityIncrease ankle strengthGain normal gait patternProgressive Proprioception and m otor coordinationLong term Phase 3 and 4Improve cardiovascular enduranceReturn to complete sports activityRehabilitation political program involvesStretching of the calf muscle and around the ankle muscleStrengthening exerciseDeep rub down techniquesCardiovascular endurance exerciseAgility trainingPhase 1 T o meet range of motionStretching-Calf plantar fascia stretchSit on the floor with leg extended and knees straightLoop a towel around the affected leg and grip the end of towel on each hand.Affected leg should be in straight and pull the towel near the bodyHold the position as same for 30 seconds and relaxRepetition 3 to 5Calf muscle stretchingOpen kinetic chain exercise toe curlsmarble pickupsFour-plane surgical tubing exercisesSub maximal Isokinetics in short arcStrengthening exerciseplantar flexion exercises with TherabandInversion and eversion exercise isometric exerciseFlexibilityGrade 1 and 2 mobilizationAlphabet ROMProprioceptiveStork standingSingle plane tilt boardBiome chanical ankle platform system in non-partialWeight thrill position.Cardiac endurance exercisePool therapy unmoving cycling.PHASE 2StretchingAchilles stretches in sitting and standing positionsOpen kinetic chain exercise full arc ISO kineticsClose kinetic chain exerciseShuttle squatsHeel raisesToe raisesTubing lunge stepsProprioceptionWobble board workWalking on uneven popBiomechanical ankle platform system with partialCardiac endurance trainingTreadmill StairmasterPHASE 3Program in this phase should be considered according to theStrength and progression of the client.The program involves dynamic and operating(a) tolerance of the patient.Start up with increase weight bearing force on the ankle jointStretching of Achilles tendon in a supinated positionEccentric heel drop with knee straightEccentric heel drop with knee bentLunges and squatsStep upsSide step ups with weight bearingTo focus on lateral stability up and down sideways movementBack pedalling exerciseCaricosPlyomettric dr illsProprioceptionLadder drill Net orb throwing and catching with Standing on the affected leg moving to catch the ball and return to land on the same leg.Four square hopping drillsAgility trainingShuttle running with changing the directionZigzagging or figure of 8 runsPhase 4 functional rehabilitation activities such as tip toe walking.Polymeric progressions hopping, bounding, depth jumps and box drillsSport-specific trainingUnstable surface trainingStationary cross country skierEnsure normal plantar to dorsiflexion strength ratios and muscle balance overcareful increase in training regimens

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