Antihypertensive drugs contraindicated in glaucoma glaucoma in children and youth vision correction. Treatment and rehabilitation of the knee joint for injuries of various origins Exercises for damage to the ligaments of the knee joint

Rupture of the Achilles tendon is a severe enough injury that requires an immediate visit to the doctor and, of course, surgical intervention. It is simply impossible to do without surgery for torn ligaments, so it is better to do it as soon as possible, in the first days after the injury. Today there are several methods of surgical intervention, but no matter which one the doctor chooses, the patient gets the hardest work - to behave competently and consistently during the rehabilitation period, because it depends on this how soon a person will be able to walk freely and even run, and it will also not happen whether re-injury.

Exercise therapy for rupture of the Achilles tendon in the first recovery period

Some surgeons, after removing the plaster “boot”, send the patient home with parting words: “For now, lie down, come back in a week, and I will send you to exercise therapy.” This should not happen, the injured tendon should receive loads almost immediately after the removal of the plaster cast. Another conversation is that they should be minimal, clearly defined by the doctor.

The first two weeks are the hardest. Often in this period, patients after surgery on the Achilles tendon are tormented by edema, in which case the doctor prescribes pneumomassage. It quickly gives results, removes swelling, dispersing lymph and blood. Another common complication after Achilles surgery is wound necrosis or spread of infection. Therefore, a daily thorough examination of the lower leg should be a mandatory procedure for the patient.

In order to prevent recurrence, it is necessary to attach a 4-5 cm heel to the sole. This simple action will help to avoid another injury, since in the first week after the operation the tendon is too stretched, but not firmly fused.

So, in the first two weeks, the most important thing is walking. You need to try to walk more, while relying on crutches. In the first three days, the length of the step should not exceed the length of half the foot. When walking, step on the heel and make a slow roll onto the toe, while the toes of the foot should look forward, they should not deviate to the side. If after 2-3 days the patient walks freely and confidently enough, then you can try to walk without the help of crutches. The stride length can be increased to the length of the foot. The duration of the walk in the first week should be about 15-20 minutes. At the end of the first week of rehabilitation, the heel must be removed from the heel. Now you should wear sneakers with a high, springy back.

The duration of walking should gradually increase, after one and a half weeks of training, a person should walk for 20-25 minutes without rest. Walking should be done twice a day. The length of the step by this time should be gradually increased to a length of 1.5-2 feet. If after walking the shin and ankle are very swollen, then they should be tightly rewound before starting the workout with elastic bandages or put on an elastic ankle.

You need to start walking in the exercise therapy room immediately after removing the plaster, but in the first 1.5-2 weeks, exercises should be done only while sitting or lying down. The emphasis should be on restoring dorsiflexion of the foot. Exercises are recommended not difficult: flexion of the foot, extension, rotation. Self-massage is required. First, slowly and gently knead the shin with your fingers, and then start rolling the ball with your feet. Skating should be carried out until a feeling of warmth in the foot.

Exercise therapy for rupture of the Achilles tendon in the second recovery period

If the patient does everything correctly for the first two weeks of the recovery period, then by the beginning of the third one he will be able to walk almost without difficulty for 25-30 minutes without relying on crutches, and the step length will be restored, it will become equal to the length of 3 feet.

In the exercise therapy room, now you need to do another set of exercises. Exercises in the pool are useful, because in the water there is not such a big load on the sore leg as in “dry” gymnastics, and you can safely and calmly work out the ankle. In the pool, you need to perform lifting on your toes, walking on your toes and try to run slowly.

"Dry gymnastics" should consist of semi-squats on toes, complicated walking, exercises on the step. For the first 5 days, the patient must periodically transfer the body weight to his hands, leaning on the gymnastic rail, and then only stick to it in order to keep his balance.

Exercise therapy after rupture of the Achilles tendon in the third recovery period

If 2-2.5 months after the removal of the “boot”, a person already walks for a long time without experiencing pain, walking on toes and lifting the operated leg on the toe are connected. If the patient confidently performs these exercises, then after 1.5-2 months, not earlier, you can start slow running.

You should not try to speed up the process and immediately take on heavy loads: the tendon has not yet fully recovered, and if the patient is not careful, then there is a high probability of a second rupture of the Achilles tendon!

During the treatment of ligament injuries, the knee joint is in a stationary state for a long time. At the same time, the blood supply and trophism of its tissues decreases, and partial atrophy of the muscles occurs. Rehabilitation after a knee injury is necessary to restore trophism, muscle volume and strength, and strengthen damaged ligaments.

Lack of respect for treatment leads to to re-injury to ligaments. Prolonged immobilization without subsequent exercise and development leads to the formation of dystrophy and arthrosis of the knee joint, its stiffness. These complications are accompanied by constant pain and may lead to lameness.

Therapeutic exercise (exercise therapy) after a knee injury: general training rules

In order for exercise therapy to be beneficial when spraining the ligaments of the knee joint, it is necessary to observe its basic rules:

• Regularity: the result of the exercises will appear only when they are repeated daily, 2-3 times a day.
• Gradual increase in amplitude: the degree of flexion and extension in the joint should be increased very carefully and slowly.
• Gradual increase in the number of repetitions and approaches: performing exercises for rupture of the knee ligaments, you should start with 3-4 repetitions of one exercise in the first days of rehabilitation, bring up to 10-15 repetitions by the middle of the course.
• Smoothness, no sudden movements and jerks: exercises for a knee injury should not provoke re-injury to the ligaments.
• Warm up and cool down: you need to start and end the lesson with the easiest warm-up exercises.
• Start under supervision: it is best if exercises for the knee after an injury are selected by a rehabilitation doctor who will control the correctness of their implementation at the initial stages.

Types of exercises for knee recovery

Depending on which anatomical structures are involved, all exercises for damage to the knee joint are divided into static, statodynamic and dynamic.

Static exercises are aimed at training the ligaments that work to keep the body in a stationary position. Statodynamic exercises, in addition to ligaments, additionally involve small muscles. And dynamic fully include large, small muscles and ligaments. To start a complex of exercise therapy for the knee joint after damage to the ligaments should be from a static mode, smoothly moving to static-dynamic and dynamic. You need to finish in reverse order.

Static

This type of exercise helps to restore the knee after an injury due to muscle tension and, accordingly, a moderate tension of their tendons (ligaments) without active movements.

Exercises :

In describes the exercises that can be performed in the period from 3 months to six months after the injury. Over time, they can be complicated by using a tape expander (elastic band) or a small ball. Gymnastics with a knee sprain, performed with a ball sandwiched between the knees, additionally strengthens the internal muscles of the thigh and the internal lateral ligaments of the knee joints.

Statodynamic

In the mode of static dynamics, static exercises alternate with a dynamic change in the position of the limbs. This mode includes balance exercises that help the knee joint recover from an injury by engaging small muscle bundles from different sides.

Exercises :

dynamic

These exercises for knee injuries help to restore the range of motion of the joint, which he had before the injury.

Exercises :

Therapeutic exercise in case of rupture of the ligaments of the knee joint is carried out against the background of drug therapy. You can learn more about which drugs are used during the rehabilitation period in

Video with recovery exercises for limb development

The video shows step by step exercises for rupture of the ligaments of the knee joint after their surgical plastic surgery.

Features of gymnastics in case of rupture, sprain, bruise, dislocation

The recovery exercises proposed above for knee injuries are universal. They can be performed after a bruise, sprain, like gymnastics after a rupture of the ligaments of the knee joint. The difference is that after a bruise and sprain, you can quickly start dynamic exercises, and after surgery for ligament rupture, for the first 2-3 weeks, only passive movements in the joint, static exercises and walking on crutches are allowed.

If it has occurred, then physiotherapy exercises for a knee joint injury should be aimed at restoring its mobility and strengthening the retaining ligaments. For this, exercises with rotational movements (around the vertical axis) are additionally applied:

Exercise therapy after a rupture of the ligaments of the knee joint goes well with traditional medicine. What infusions and decoctions can be taken for ligament injuries, read.

What physiotherapy is prescribed

Rehabilitation after a rupture of the ligaments of the knee joint is carried out in a complex manner. In addition to physical therapy, massage and physiotherapy are prescribed.

Physiotherapeutic procedures are aimed at relieving swelling and pain, improving metabolic processes in the tissues of the joint.

Procedures that can be started while wearing an elastic fixation splint (orthosis):

• electromyostimulation (EMS);
• magnetotherapy;
• electrophoresis;
• phonophoresis;
• cryotherapy;
• mud treatment.

Electrical stimulation of the quadriceps muscle

Electrical stimulation of the quadriceps femoris muscle is the impact on it with a low-frequency sinusoidal current using electrodes. The main goal of electromyostimulation is to increase the volume, strength and endurance of the muscle, to return the full range of motion in the knee joint. It is used in sports medicine and as a recovery after a rupture of the ligaments of the knee joint, in particular after. For greater effect, you can simultaneously use the method of electrical stimulation and exercises to develop the knee joint after a rupture of the ligaments.

Magnetotherapy

Magnetotherapy - exposure to a joint with a constant magnetic field to relieve swelling, pain and improve oxygenation of ligaments, cartilage and bone structures. The high penetrating power of electromagnetic pulses makes it possible to influence the deep structures of the joint even through a plaster cast at the stage of immobilization.

Electrophoresis and phonophoresis

Electrophoresis - the introduction of drugs into the tissues of the joint using direct current. Electrodes (anode and cathode) are placed on two opposite sides of the knee, applying them to a tissue soaked in the medicinal substance to be injected. Physiotherapy rehabilitation after a knee ligament rupture is most often carried out with anesthetics and analgesics, as well as anti-inflammatory hormones (hydrocortisone). Such a combined effect of electrical impulses with drugs significantly accelerates recovery after a knee injury. The duration of the session and the total duration of the course are determined by the physiotherapist. During the procedure, you may feel a tingling sensation or a slight burning sensation.

IMPORTANT! Physiotherapy procedures performed using an electromagnetic field are contraindicated in patients with a pacemaker installed, as they can disrupt its operation.

Phonophoresis - the penetration of drugs to the tissues of the joint with the help of ultrasonic vibrations. Ultrasound itself dilates blood vessels and relaxes muscle tissue, stimulates regeneration and accelerates the recovery of knee ligaments after injury. With its help, Hydrocortisone, Dimexide, enzymes (hyaluronidase) and chondroprotectors are administered for cracks in the articular cartilage. What other drugs are used to restore cartilage can be found in

Cryotherapy involves cooling the surface of the body to low (from -70 degrees) and ultra-low (up to -130 degrees) temperatures using an air jet or liquid nitrogen. Rehabilitation after damage to the ligaments of the knee joint with the use of cryo-procedures is faster and more successful due to the increase in the elasticity of the connective and muscle tissues at the site of exposure to cold. Due to a sharp spasm of blood vessels and their subsequent expansion, the trophism of the tissues of the joint improves, and the aging process slows down. In addition, exposure to low temperatures helps to get rid of chronic pain after knee injuries, which is written in more detail.

Video of local cryotherapy after injury

The video shows two methods of cryotherapy after an old knee injury: cryoair and cryocarbonic.

Ultra High Frequency Treatment (UHF)

UHF therapy is an impact on the joint with a short-wave pulsed current with a frequency of 20–40 MHz. At the same time, the effect of warming up is achieved, which has a beneficial effect on blood supply and metabolism in tissues. The maturation of collagen fibers is accelerated, which is necessary for successful recovery after a knee sprain, tear or rupture of the tendon. For the manifestation of the effect, 5–10 UHF sessions of 8–12 minutes are required.

Mud therapy (peloid therapy)

Physiotherapy for knee sprains also includes treatment with peat and sapropelic mud. It does not require special equipment, it is carried out in the form of applications, so this method can be used independently at home. To do this, the mud slightly heated in a water bath is applied to the knee and wrapped with a film, leaving for half an hour. The effect of pelotherapy is based on the high concentration of mineral substances in therapeutic mud, which are necessary for the joint at the recovery stage.

Joint injuries are divided into bruises, intra-articular fractures and dislocations. Fractures and dislocations are serious injuries, as a result of which serious functional disorders develop, sharply limiting the ability and ability to work of the victim.

bruises. The wrist, elbow, ankle and knee joints are largely damaged. With bruises of the joints (especially the knee), bleeding into the joint from ruptured vessels of the synovial membrane is often observed. In the case of an increase in the amount of fluid in the joint, puncture and the imposition of a plaster splint are indicated.

The complex treatment includes massage, LH (the main method of treatment), intra-articular injection of arteparone with a 20% glucose solution, physiotherapy, hydrocolonotherapy. LH is performed lying down and sitting, with a gradual increase in the range of motion in the joint, pace and number of repetitions. Large loads on the joint (squats, jumps) are excluded. After 2-3 weeks, exercises on simulators are connected in combination with cryomassage.

intra-articular fractures subdivided into: fractures with preservation of the congruence of the articular surfaces; fractures with a violation of the congruence of the articular surfaces, comminuted fractures, fractures-dislocations. Symptoms intra-articular fractures: sharp pain, dysfunction and deformity of the limb (change in shape, position, length). Treatment is based on three principles: comparison of fragments, keeping them in the correct position until complete consolidation (fusion) and restoration of limb functions. Methods Treatments are the same as for other fractures (conservative or operative).

dislocations- displacement of the articular ends, are divided into: complete dislocation(extensive damage to the joint capsule, tendons, ligaments and muscles) and subluxation(partial separation of articular surfaces). Symptoms of dislocations: deformity of the joint (determined visually and by palpation), pain when trying to move, dysfunction of the joint.

In case of joint damage, therapeutic physical culture is subdivided for three periods: immobilization, functional and training.

Immobilization period begins from the moment the gypsum is applied to the formation of a bone callus (in case of fractures) or the fusion of the capsule, ligamentous apparatus, etc. (in case of dislocations). Tasks this period: 1) accelerate the resorption of hemorrhage and edema; 2) improve blood, lymph circulation and metabolism in the affected segment; 3) promote the formation of callus and the healing of soft tissues; 4) prevent adhesions, muscle atrophy and stiffness in the joints.

exercise therapy used from the first days after the injury. Active and passive movements are recommended in the joints of a healthy limb and in the non-immobilized joints of an injured one, breathing and ideomotor exercises, isometric (static) exercises, first with a healthy and then with a diseased limb.

Functional period lasts from the moment immobilization is removed until partial restoration of function. Tasks: 1) completion of the regeneration of the damaged area; 2) reduction of muscle atrophy and stiffness in the joint; 3) increase in muscle strength; 4) restoration of the function of the damaged limb. exercise therapy: general developmental exercises; special exercises for the damaged segment, first - in light conditions (with help, on a smooth surface and in water), then - gradually expand (large range of motion, with resistance, with gradually increasing loads); passive, active and active-passive movements. The duration of classes is 1.5-2 hours 2-3 times a day.

Training period starts from the moment of restoration (but not complete) of the function of the damaged segment. Tasks of this period: 1) finally restore the functions of the damaged segment and the whole organism as a whole; 2) adapt the patient to household and production loads; 3) in case of impossibility of complete restoration of the function, to form the necessary compensation. exercise therapy: general developmental exercises, special exercises: to increase the volume and strength of muscles in the area of ​​damage, to restore motor actions (domestic, industrial), to normalize walking (in case of damage to the lower extremities).

Exercise therapy for intra-articular fracture of the surgical neck of the humerus. There are the following varieties: driven in fracture (peripheral fragment wedged into the central one); abduction (abduction) fracture and abduction (adductor) fracture. Treatment: with these fractures, a bean-shaped roller is inserted into the axillary region, which is fixed behind the neck and torso with a gauze bandage. The forearm is placed at an angle of 35–45 0 in the elbow joint on a serpentine Drewing bandage (a wide gauze bandage quilted with cotton), wrapped in a double round around the lower third of the forearm, wrist joint and hand.

exercise therapy: In the first period(10-14 days) physical exercises begin 1-2 days after the injury. General developmental and breathing exercises are performed from the initial sitting and standing position with a slight inclination towards the injured arm. Special exercises: flexion and extension of the wrist in the wrist joint, circular movements of the hand, flexion and extension of the forearm in the elbow joint, abduction and adduction of the shoulder with a small amplitude, reduction and extension of the shoulder blades, isometric exercises for the deltoid muscles, circular movements of the sore arm with torso inclinations in side of the injured limb.

Second period(3-4 weeks), its tasks: to increase the range of motion in the shoulder joint and muscle strength. Special exercises of the second period: 1) swing movements with a small amplitude with straight arms in different directions from the starting position, standing with the body tilted forward, arms lowered (4–6 times); 2) slight inclinations towards the injured limb; slow flexion (until pain appears) in the elbow joint; 3) abduction - adduction of the shoulder (6-8 times); 4) flexion in the elbow joints with abduction of the shoulders until the chin and forehead touch; 5) exercises with a gymnastic stick.

Tasks of the third period: restoration of full range of motion in the shoulder joint, increase in muscle volume and strength. Physical exercises of this period are: exercises with objects (sticks, maces), with weights (dumbbells), with resistance (expanders), exercises on simulators. Recommended therapeutic swimming and exercises in the pool, exercises in the hangings and emphasis. Occupational therapy (ironing, laundry, window cleaning, etc.) can be widely used.

Exercise therapy for dislocations in the shoulder joint. Depending on where the head of the humerus has shifted during dislocation, there are anterior (more often), lower and posterior dislocations of the shoulder. All dislocations are accompanied by stretching and rupture of the articular bag, sharp pains, deformity of the shoulder joint and lack of movement in it. Treatment: after reduction of the dislocation under anesthesia, the limb is immobilized for 3–4 weeks with a Dezo bandage or a plaster splint.

Exercise therapy is carried out in 3 periods, the technique coincides with exercise therapy for a fracture of the surgical neck of the shoulder.

Exercise therapy for habitual dislocation of the shoulder (PVP). PVP is a severe lesion of the shoulder joint, which is a complication of primary traumatic dislocation. It occurs due to improper reduction or an incomplete period of rehabilitation. Most of all PVP is associated (68%) with sports activities (wrestling, volleyball, basketball, etc.). Treatment: The only effective treatment for PVP is surgery.

First period rehabilitation lasts about a month. His tasks: 1) stimulate regeneration processes; 2) stimulate the contractility of the muscles surrounding the shoulder joint; 3) maintain overall performance.

exercise therapy. General developmental exercises for a healthy arm, legs, torso, breathing exercises are carried out. Special exercises are included for the hand of the operated hand with a carpal expander, a tennis ball. After the disappearance of pain (5–7 days after surgery), isometric tension of the muscles of the shoulder girdle is activated (initially for 1–2 s, and then 5–7 seconds). Conducted from 3 to 5 sessions during the day, lasting 45 minutes at the beginning and gradually brought up to 2 hours.

Second period begins on average 1 month after surgery and lasts up to 3-4 months after it. The operated arm is suspended on a scarf to prevent stretching of the shoulder joint capsule. Tasks: 1) strengthening of the stabilizing muscles and other muscle groups of the shoulder joint; 2) restoration of mobility in the shoulder joint in all planes; 3) restoration of general performance.

Physical therapy classes are held in the pool, exercise therapy room or gym. Classes in the pool last up to 40 minutes at a temperature of 26–28 0 C. While the range of motion in the shoulder joint remains limited, you should swim on your side, rowing with a half-bent and slightly brought to the body arm. In the future, crawl and breaststroke should be used. Dosage of swimming from 10 to 20 min.

Dynamic exercises are carried out for the injured limb on a smooth surface and in water. Then (after 5–7 days) active dynamic and static exercises are carried out at a slow pace. Later, dynamic exercises are performed with additional weights, starting from 0.5–1 kg.

To restore general performance during the second period, daily training is used on a bicycle ergometer or on the run, on a rowing machine with a pulse of 150–160 beats / min, lasting 30–40 minutes. The total duration of all classes is up to 4-5 hours a day.

Third period starts from 3–4 months and lasts up to 6 months after surgery. Tasks: 1) restoration of the full amplitude of not only active, but also passive movements along all axes; 2) restoration of maximum strength of the muscles of the shoulder girdle; 3) restoration of general working capacity and restoration of specific skills (domestic and professional).

All exercises used in this period can be divided into three groups:

Local strength exercises for the muscles of the shoulder girdle;

Imitation and special preparatory exercises aimed at developing flexibility, agility and strength;

General developmental exercises and exercises that increase overall endurance.

The total duration of classes per day is 5-5.5 hours.

Elbow joint injuries divided into bruises, intra-articular fractures and dislocations.

To intra-articular injuries of the elbow joint include fractures of the distal end of the humerus and proximal epiphyses of the bones of the forearm. Treatment intra-articular fractures without displacement of fragments is carried out by fixing the joint with a plaster splint for 1-3 weeks. With T- and Y-shaped fractures, operative reposition of fragments is performed with their fixation with knitting needles, screws or screws, followed by the application of a plaster cast for up to 3 weeks.

In the first period, physical therapy exercises include movements in the joints of the injured arm, free from plaster, ideomotor exercises, muscle contractions under plaster. Make the most of your injured hand in self-care.

The second period includes special exercises for the damaged joint (gypsum is removed during classes). A variety of movements are performed with the fingers and in the wrist joint, pronation and supination of the forearm, flexion and extension in the elbow joint. All exercises should not cause pain. Exercises for the injured hand should be carried out in warm water (34–36 0 C) and under light conditions (a table with a smooth surface).

The third period is appointed with good consolidation of the fracture and a satisfactory range of motion. Physical exercises of this period are: exercises with objects (sticks, maces), with weights (dumbbells), with resistance (expanders), exercises on simulators. Recommended therapeutic swimming and exercises in the pool, exercises in the hangings and emphasis. Occupational therapy (ironing, laundry, window cleaning, etc.) can be widely used.

Dislocations in the elbow joint. Dislocations occur: both bones of the forearm (posterior, anterior, outward, inward, divergent dislocation); dislocation of one radius (anterior, posterior, outward); dislocation of one elbow.

Treatment. The posterior dislocation is reduced under anesthesia. Next, the elbow bent at an acute angle is immobilized with a back plaster splint for 7 days, after which therapeutic exercises are prescribed, combining it with thermal procedures. After reduction of the anterior dislocation, the forearm is unbent to an obtuse angle, fixed with a posterior plaster splint with the supinated forearm for 10–12 days.

exercise therapy consists of two stages: absolute immobilization period and relative immobilization period(the limb is temporarily released from the plaster splint for exercise therapy). With simple dislocations, the period of absolute immobilization lasts 3-4 days, relative - 14-15 days.

In the first period(starts from the 2nd day after the splint is applied) against the background of general developmental and breathing exercises, active movements in the joints free from immobilization, ideomotor exercises, isometric muscle tension of the shoulder and forearm are used. Recommended rhythmic tension and muscle relaxation due to flexion-extension movements in the fingers. Passive exercises and carrying weight with a sore hand are contraindicated. During the day, it is recommended to give the injured limb an elevated position to reduce swelling, pain and prevent stiffness. LH classes are held 2-3 times a day. The duration of classes in the first 2-3 days is 10-15 minutes, in the future - 20-30 minutes.

The task of exercise therapy of the second period- gradual restoration of joint mobility and normalization of the function of the muscular apparatus of the limb. Therapeutic gymnastics is carried out under a number of conditions: the patient performs all exercises from lightweight starting positions; only active movements are used; the amplitude of movements should contribute to the stretching of tense muscles without pain; avoid passive movements, weights and massage of the elbow joint.

Lateral ligament injuries of the knee(partial and complete rupture of the lateral ligament). With a partial rupture of the lateral ligaments, a deep posterior splint is applied for 3-4 weeks. With a complete rupture, surgical treatment is indicated, after which a plaster cast is applied to the middle third of the thigh for 2–3 weeks. Therapeutic exercise is carried out with the classic three periods.

Cruciate ligament injury(incomplete and complete rupture) - a more severe injury to the knee joint. With an incomplete rupture of the cruciate ligaments, a plaster cast is applied to the middle third of the thigh for 3–5 weeks. With a complete rupture, an operative replacement of the cruciate ligaments with a lavsan tape or other material is carried out.

In the first period (1–2 days after the operation), RG exercises include both exercises for a healthy leg and exercises for the operated limb: movements of the fingers, in the ankle and hip joints. Partial weight-bearing on the leg is allowed 3-4 weeks after surgery. Exercise therapy in the second and third periods corresponds to exercises for fractures of the femur.

Injuries to the menisci of the knee require surgical treatment and subsequent long period of rehabilitation (up to 4-5 months). The first stage of exercise therapy (up to 3–4 weeks after the operation): from the 2nd day, LT is carried out in the ward (20–30 minutes), from the 7th–10th day in the hall (45–60 minutes). From the 3-4th day, walking with crutches without support is allowed (3-4 weeks). LH classes are performed only lying down and sitting. Much attention is paid to classes in a warm pool (from 10–12 days after the operation), lasting 30 minutes.

The second period of exercise therapy (from 3–4 weeks to 2–2.5 months after surgery). Walking on crutches is allowed, lightly stepping on the operated leg (from the 4–5th week). Further, in the absence of pain, the victims begin to walk without crutches. Special exercises to restore normal gait. Further training in walking (the duration is gradually brought to 45–60 minutes, the pace increases from 80 to 100 steps per minute). Trainings are held in the pool lasting up to 45 minutes. In the hall, general developmental and strength exercises are performed for 1–1.5 hours a day of medium and high intensity (pulse 140–150 beats / min).

The third (training) period lasts from 2–2.5 months to 4–5 months after the operation. Starting from the 2nd month after the operation, the patient trains in fast walking, then slow running is included in the training, with a gradual increase in the speed of movement.

Arthrosis- chronic diseases of the joints. Symptoms: rapid onset of fatigue in the joint, dull or aching pain, hypoxia and circulatory disorders. In the future, the pain becomes constant and makes it impossible to exercise.

The objectives of rehabilitation are to improve blood and lymph circulation in the joint (joints) of the limb, achieve relaxation of tense muscles, improve metabolism in the tissues of the musculoskeletal system, eliminate (reduce) pain, and accelerate tissue regeneration processes.

Comprehensive rehabilitation includes intra-articular administration of drugs, diet therapy, drug therapy, cryomassage, massage, vibromassage, hydrotherapy, exercise therapy.

LH in water (with special belts and cuffs on the ankle joints) allows you to unload the joint by training the muscles of the lower extremities. They are especially effective in deforming arthrosis. Weightlifting, jumping, wrestling are undesirable. Overloading is not recommended.

During an exacerbation of the disease- LG in I.p. lying down, general developmental exercises, exercises with rubber bandages, massage, treatment by position are included.

In the subacute period include LH in the pool, stretching exercises, with rubber shock absorbers, cryomassage. There should be no pain during exercise.

During the period of remission it is important to normalize the function of the joint by means of exercise therapy: lying down, with an elastic bandage, with dumbbells, swimming, training on simulators, hydrocolonotherapy, mud applications, position treatment. Exercises for the muscles of the back and abdominals are included (to compensate for static disorders in the spine).

The muscles of the outer group are most often damaged, since they are responsible for the most frequent movements - bending the foot in the direction of the sole and turning it inward.

Ligament ruptures account for 10% of the total number of ankle injuries. Why is it happening?

Causes of an ankle ligament tear

1) Sports injuries when jumping and running.

Sharp movements of a large radius, simultaneously loading the lower limb, most often lead to rupture of the ligaments or damage to the outer muscle group of the joint.

2) Sports injuries of fans of winter sports: skiing, snowboarding, figure skating.

A sharp movement of a limb around its axis with a full load on it instantly leads to injury to the external, less often internal, muscle group of the ankle.

3) Household injuries when slipping on a flat wet surface, unsuccessful falls, “tucking” the legs when stepping over, and the like.

4) Garden work, in particular digging, leads to a significant load on the muscles of the ankle, the fibers of which gradually stretch and break, especially if this type of activity is unusual.

However, you must agree that the aching pain in the foot after digging up the beds and the sharp pain after falling on the ski slope are not the same thing, although they have the same name.

Therefore, there are different types and degrees of damage.

Types of ankle ligament ruptures are classified according to the degree of damage to the fibers:

• Damage of the 1st degree, in everyday life referred to as "stretching", characterizes the deformation of a small number of muscle fibers of one group, most often external;
• Injury of the II degree is often called a partial rupture of the ligaments, it characterizes the traumatization of a significant number of fibers of the external and internal groups of muscles of the ankle;
• Damage of the III degree is an extensive injury to the muscle fibers of all groups, that is, a complete rupture of the ligament. A complication of this degree of damage may be the detachment of the ligament from the place of its attachment with the subsequent loss of its functions;

Symptoms of a Torn Ankle Ligament

What characterizes each degree of damage?

Not so much painful as unpleasant sensations during the load on the injured limb, fast walking, running, going up and down the stairs;

Absence of discomfort at rest;

Barely noticeable redness and slight swelling at the bend of the ankle joint on the forefoot;

II degree manifests itself more painfully:

Intense sharp pains even when walking slowly on a flat surface;

Bright red color of the lower leg at the junction with the foot;

Swelling of the joint, making it impossible to wear shoes;

The pain does not subside when the limb does not move;

The desire of the victim to limit or exclude movement;

Redness of the entire joint, reaching the middle of the lower leg;

Hematomas, hemorrhages at the site of maximum injury;

Bruising on the ankle and lower leg;

Severe unbearable pain;

Impossibility of movement even if desired or necessary;

When the foot is torn off from the place of attachment, it hangs, continuing the shin, while it is impossible to stand on the foot.

Diagnosing a foot ligament tear is simple:

The doctor analyzes visual symptoms;

Identifies the affected group of ligaments with a simple flexion-extension test of the foot;

In difficult cases, an x-ray is needed;

With the most severe degrees of injury, computed tomography is prescribed to assess damage to muscle fibers, the integrity of the articular bag, cartilage and small bones of the joint;

Ankle tear treatment

I degree injuries or sprains occur at home.

It consists in providing a gentle regimen, applying a fixing bandage from an elastic bandage, applying anti-inflammatory and anti-edematous ointments and gels to the damaged surface.

The first two days following the injury, the use of warming compresses and ointments is unacceptable.

On the contrary, cooling ointments are used:

They do not reduce the surface temperature of the skin, but through analgesics, anticoagulants, menthol, alcohol and essential oils, they cool and anesthetize the injury site.

These ointments can not be rubbed, you need to apply them with light movements without pressure.

The absorbability of gels is higher than that of ointments!

Ointments for pain relief and inflammation:

Which are well absorbed, do not warm up, but cool the place on which they are applied.

Use them for compresses on painful areas, changing every 3-4 hours.

A slightly injured joint, provided that it is securely fixed, does not need to be completely immobilized.

Walking is acceptable and even necessary, but on condition that there is no complete support on the ankle joint and foot.

For walking during this period, you can use a cane or crutches.

Treatment with Natural Remedies for Mild Ankle Sprains

Natural products are used as lotions and compresses.

To relieve edema, you can use compresses from natural milk or vodka, the edema is removed in a maximum of 2 days.

A dense layer of bandage is wetted in milk or vodka and wrapped around the ankle joint.

It is covered with polyethylene, then with a layer of cotton wool or warm fabric (woolen is better), bandage is good, but not too tight and lasts 6-8 hours.

Lotions from onion gruel with table salt (can be iodized).

Two medium onions are crushed in a meat grinder (the juice is preserved), a tablespoon of salt is added, stirred, laid out between layers of gauze and applied to the injured ankle during the day 5-6 times for 1-1.5 hours.

Healing occurs after days.

The victim can return to life in a normal rhythm, but at first it is better to avoid excessive loads (jogging, jumping, going up and down stairs).

Second-degree injuries also often occur at home.

But the damaged joint in the hospital or emergency room is preliminarily fixed with a plaster splint, which provides the joint with complete immobility.

Of the medicines after removing the splint, anesthetic ointments with anti-inflammatory and anti-edematous effects are prescribed:

Complete the treatment with warming ointments:

To accelerate the healing of seriously injured fibers, physiotherapy procedures are prescribed:

UHF (electric field treatment)

Warm relaxing baths

Treatment can take up to three weeks.

Grade III injuries will most likely require hospitalization.

Strong painkillers are used to relieve severe pain.

To remove blood and joint fluid from the joint cavity, a puncture is performed, this prevents infection of the joint and its inflammation, and novocaine injected during the puncture helps relieve pain for a period of a day.

With a complete rupture of the ligaments of the lower leg and foot, immobilization is required, for which the joint is securely fixed with a plaster cast for 3-4 weeks.

The attending physician individually selects medicines for treatment, exercises for physiotherapy exercises and physiotherapy procedures.

Rehabilitation treatment or rehabilitation

After reducing pain and swelling, a course of physiotherapy is prescribed, which may include:

electrophoresis with calcium

Phonophoresis with hydrocortisone

The course of treatment with healing mud

Physiotherapy procedures restore the structure of muscle fibers, accelerate their nutrition and growth, fusion with each other.

They increase the density of muscle mass and restore its elasticity, accelerate metabolic processes inside the joint.

Complete recovery of a severe rupture of the ligaments occurs in 2-3 months.

The simplest exercise therapy exercises after ankle sprain

1. Sitting, slowly and freely move your toes for 2-3 minutes with breaks;
2. Stand up, rise slightly on your toes, slowly and smoothly lower yourself onto your heels;
3. Walk slowly, turning your heels inward 3-5 meters;
4. Walk slowly, turning your heels outward 3-5 meters;

Prevention of ankle sprains

An ankle sprain can be avoided if:

Rarely, but confidently wear shoes with heels;

For sports activities, wear shoes that properly support the ankle joint;

Engage in exercises and physical education in order to strengthen the muscles and ligamentous apparatus of the joints;

In order for the fusion of the ligaments and the restoration of the joint to proceed quickly, correctly and to exclude the long-term consequences of the injury, it is necessary to strictly adhere to all the requirements of the rehabilitation course.

A serious attitude to each type of treatment will lead to a complete restoration of the joint and a physically fulfilling life!

Recovery after an ankle ligament tear

Ankle ligament injuries are the most common injury that can occur while on vacation or playing sports. In 70% of cases, ligament rupture occurs in individuals who have previously received a sprain. This is due to the fact that frequent sprains (especially in athletes) lead to instability of the ankle, which means that it increases the risk of injury and osteoarthritis in the future.

In most cases, ligament rupture occurs when the leg is tucked inward. In this case, the load on the external ligaments of the joint increases many times over. At the time of rupture of the ligaments, small fragments of bones can come off. In the most severe cases, the injury is accompanied by a fracture of the bones that form the joint.

Classification

Symptoms of an ankle ligament injury

• Sharp pain in the joint, inability to step on the foot.
• Visible joint deformity.
• Hematomas under the skin of the ankle.
• The injury was caused by a fall from a height or a collision with something heavy, such as an accident.
• Pain and swelling increase.

First aid

• Rest - it is necessary to remove the load from the injured leg as much as possible. It is advisable not to step on it for two days.
• Cold - to reduce swelling, you need to apply an ice pack or a cold compress for up to 4 times a day.
• Compression – Applying a pressure bandage or splint will also greatly reduce swelling.
• Elevation - the elevated position of the limb (for example, on a chair) stimulates the lymphatic drainage effect and microcirculation, and therefore reduces swelling.

Diagnostics

To establish the diagnosis, it is necessary to consult a traumatologist, x-rays.

Treatment for torn ankle ligaments

After examination, the traumatologist will determine the severity of the injury and prescribe treatment.

• Rest, cryotherapy (cold compresses), elevated position. Constant wearing of a splint or orthosis.
• Painkillers orally (tablets, such as Diclofenac) and topically (ointments, such as Voltaren).

With the accumulation of blood in the joint cavity (hemarthrosis), a puncture (puncture) will be performed, during which all the accumulated fluid will be removed. It is impossible to refuse the procedure, as this will lead to a deterioration in the condition, significantly increase the rehabilitation time, and increase the risk of inflammation (arthritis).

Physiotherapy

The first three days, the simplest exercises are performed 3 times a day, 10 sets each.

• Static tension of the muscles of the foot and lower leg.
• Active movements of the toes and in the knee joint.

After 3-7 days (depending on the severity of the injury), the following exercises are connected.

• Rise on toes.
• Pulling an object towards you. You need to hook the leg of the chair with your toes and pull it towards you. Over time, you should switch to performing exercises with weighting (an object on a chair, a coffee table).
• Walking. Up to 2 hours a day on a flat surface at a pace that is comfortable for you.
• To strengthen the muscles of the lower leg and foot, it is necessary to perform stretching exercises. Static stretch. You will need an expander (rubber band). Turning the leg inward (pronation) and outward (supination), plantar and dorsiflexion of the foot are performed with overcoming the resistance of the expander.

The purpose of the exercises is to improve blood circulation in the limbs, maintaining muscle tone.

Before starting gymnastics, be sure to warm up. Never exercise through pain, it can only worsen the condition of the joint and ligaments.

Physiotherapy

• UHF therapy. The use of ultra-high frequency alternating currents during the procedure stimulates the expansion of blood vessels, enhances regenerative and metabolic processes.
• Ultrasound. The achieved effect of micromassage improves blood and lymph metabolism, has analgesic and anti-inflammatory effects. After ultrasound, the skin absorbs ointments and creams better, which also enhances the result of drug treatment.
• Paraffin therapy can be prescribed already in the first hours after the injury. It has anti-inflammatory, analgesic effect, actively stimulates metabolic processes.
• Diadynamic therapy. The alternation of currents of different frequencies gives an analgesic effect.
• Magnetotherapy improves blood circulation, reduces swelling.
• Massage is carried out in courses below.
• water procedures. At the first visits to the pool, it is better to limit yourself to performing physical therapy exercises in the water. After a while, you can swim in a comfortable style for up to 30 minutes a day.
• Balneotherapy (mud baths).

It is advisable to follow a diet rich in protein and calcium. For the speedy restoration of joint function, it is recommended to take vitamin complexes and nutritional supplements (glucosamine and chondroitin).

Prevention of torn ankle ligaments

1. Be sure to warm up before exercising and stretch after your workout.
2. Wear an elastic bandage if your ankle is unstable.
3. Buy good shoes with quality foot support: the right size, solid heel, comfortable toe, hard arch support, low heel.

Given the prevalence of injury to the ankle ligaments, measures to restore their normal functioning include a wide range of manipulations. However, it should be remembered that rehabilitation without exercise therapy and physiotherapy is impossible.

7 Treatments for Ankle Sprain Rehabilitation

The joints of the lower extremities are subjected to increased loads. Rupture of connective tissues in the ankle can be obtained during sports, when falling or walking around the city. Unintentional bending of the foot or slipping of the heel from a high heel is fraught with dislocation, sprain, fracture. Tendons between the calcaneus, fibula, and talus are usually injured.

Timely treatment and rehabilitation after an ankle sprain will fully restore the anatomical functions of the joints and stabilize the foot. The fibers of the tissues grow together in 3 weeks and acquire their former elasticity.

• degradation of the peroneal muscles caused by displacement of the intervertebral discs;
• anatomical defect in the structure of the upper part of the foot;
• age changes.

Classification of injuries

An ankle sprain is accompanied by pain symptoms, which manifest themselves depending on the degree of damage. Signs of pathology are nonspecific and can be observed with bruises, dislocations or fractures, therefore, informative diagnostic methods are needed to draw up a clinical picture.

Differentiate 3 degrees of sprains:

• I is characterized by slight damage to the fibers (up to 15%) with full preservation of mobility. The violation is accompanied by a slight swelling in the lower part of the lower leg, discomfort when walking.
• In II, most of the connective tissue is injured. There is aching pain, subtle swelling, hematoma. Functions are partially preserved, but the mobility of the leg is limited.
• In stage III, a complete rupture of the ligament is observed. This causes a sharp pain up to loss of consciousness, an attack of nausea, dizziness. An extensive bruise forms on the ankle.

Stretching is not life-threatening, but requires treatment and a course of physical therapy, otherwise in the future the problem will become chronic, and the risk of re-injury will increase. Complications are fraught with abrasion of the articular cartilage, the appearance of arthrosis.

Health care

Before prescribing therapy, the severity of the injury is established. The doctor tests the leg for mobility, if necessary, prescribes an x-ray. In difficult cases, to assess damage to the joint capsule, cartilage and muscle fibers, CT is performed, arthrography is prescribed.

1. To eliminate pain and swelling.
2. Removal of blood in case of hemorrhage into the joint capsule.
3. Resuscitation of motor functions.

With a slight sprain of the ankle ligaments, an elastic bandage in the form of a figure eight is sufficient. A bandage is wrapped around the foot and the lower part of the ankle, an ice compress is applied. In case of pathology of the external tissues, the foot is turned with the sole outward. If the internal fibers are damaged, it is directed inward to give the correct shape. Sprain of the tibiofibular ligaments forces to relieve tension from the damaged area by bending the foot. From the moment of injury, the bandage is worn for 2 months. It keeps the joint in the correct position and prevents repeated ruptures.

To enhance microcirculation and lymphatic drainage, the leg is placed on a high pillow. Pain is relieved with menthol preparations (Chloroethyl). With the help of anticoagulants, esters, signs of stretching quickly disappear. A day later, thermal procedures are carried out. Subjective symptoms are relieved with analgesics and ointments.

With severe damage to the ligaments, hospitalization is offered. A plaster splint is applied to the ankle for 20 days. To remove blood from the joint cavity and prevent inflammation, a puncture with novocaine blockade is performed.

After removing the plaster for a certain period, warming and decongestants for external use are prescribed - Finalgon, Menovazin. Surgical intervention is required if the rupture is complicated by a fracture. Throughout the course of treatment, minor pain and lameness are of concern.

Physiotherapy for the ankle

Procedures are prescribed a day after the injury. They eliminate uncomfortable and inflammatory symptoms, accelerate recovery.

1. Dry air cryotherapy, transcutaneous electrical nerve stimulation are effective for pain relief.
2. Paraffin relieves inflammation, has a compressive effect on the tendons. It is usually used in combination with other methods and massage.
3. High-density infrared optical beams have a positive effect on the intercellular matrix of connective tissues, enzymatic cell structures, and nerve endings.
4. Diadynamic therapy, UHF relieve puffiness, enhance regenerative processes.
5. Treatment with magnetic fields enhances peripheral blood supply, accelerates the fusion of fibers.
6. Amplipulse therapy activates cellular metabolism, increases the elasticity of ligaments and muscle fibers.
7. Ultrasound improves enzymatic and trophic processes in tissues. In combination with the procedure, pelotherapy (mud therapy) is prescribed, which has a thermal and compressive effect on the ankle.

Therapeutic measures and the number of sessions are assigned at the discretion of the traumatologist after collecting information.

Ankle exercises

In case of a moderate injury at home, it is recommended to develop the joint as early as possible. Lost time will further lead to immobility of the Achilles tendon. With stretching of the 1st degree, it is recommended to start exercising already on the 2nd day. In difficult cases, articular gymnastics is prescribed after the end of conservative therapy.

Even with a splint, you need to move your fingers. Movement will provide microcirculation of the capillary network, which will accelerate the fusion of fibers.

To begin with, they remove the tightening bandage and try to roll a tennis ball with the sole or pick up small objects from the floor with their fingers. More complex practices are carried out according to the doctor's prescription in the clinic.

Physical therapy is indicated to restore ankle mobility. Incorrectly selected practices and violation of the execution technique will aggravate the condition and nullify the effect of treatment. Correctly performed exercises will quickly restore lost functions and strengthen ligaments.

Warm up

Lying on your back, perform several cycles of flexion-extension with your fingers, moving them to the sides. After a short pause, they make circular turns with their feet counterclockwise.

Ball squats

Leaning against the wall and placing the feet further than the knees, a large fitball is pressed against the lower back. Taking the pelvis back, squat to the parallel with the floor, keeping a right angle in the knees. During movement, the ball is rolled along the spine. In reverse order, return to the base position.

Foot flexion

Resistance practice is performed while sitting. The sore leg is placed on the couch, the sole is hooked with an elastic loop, and pulled to the chest with both hands. Sitting in a chair of the Biodex simulator, opposite plantar flexions are performed. Isokinetic training is great for strengthening joints and tendons.

Balance exercises

Classes on a mobile platform develop coordination, strengthen connective tissue fibers. Standing on a healthy half-bent limb and balancing the body, they throw the ball into the wall.

A loop of their elastic band is fixed to the wall 15 cm above the floor. At a distance of 80 cm, they put a healthy foot into the lasso and stand on the roller. Keeping the body static, the injured leg swings in different directions.

Walking with resistance

The exercise stabilizes the feet, develops the calf muscles. Both feet are inserted into the loop, equal in diameter to the volume of the hips, raised to the ankles or lower, and squat a little. With a straight body, they move sideways with side steps, overcoming the resistance of the tape. Perform 20 steps to the left and right in 6 repetitions.

Climbing on one toe

Standing sideways to the loop attached to the wall at a height of 20 cm from the floor, the injured foot is thrust into the lasso at the level of the subtalar joint. A healthy limb is retracted and held in weight. With the working foot, stand on tiptoe, stretching the tape, shifting the foot outward. As the muscles adapt to the load, the distance from the wall is increased.

Moving on a treadmill

After a III degree ankle sprain, I recommend walking on the simulator in the pool. In chest-deep water, body weight and axial load on the spine are significantly reduced, which helps to develop a normal gait and keep the foot in the correct position.

Video

Video - Ankle sprain recovery

jumping

At the end of the rehabilitation course, a test is carried out for a sense of balance and muscle strength. Draw a straight line with chalk. The patient moves on one leg, landing alternately on opposite sides of the axis. The effectiveness of treatment is judged by the range and number of jumps.

Another indicator of ligament stability is long jump. The task is to push off and land on the same foot. Comparison of the strength indicators of both limbs allows you to objectively assess the condition of the injured ankle, make or cancel the decision to increase the intensity of training.

Preventive measures

Ankle injury can be prevented if a number of conditions are met. The risk of sprains in women is much higher than in men, so comfortable shoes with a heel no higher than 5 cm are chosen for everyday life. Those who have a high instep are advised to wear stilettos only on special occasions.

For sports, high-top sneakers with a hard heel and arch support are preferred. At first, it is desirable to support the ankle with an elastic bandage "Pharmix" or an orthosis.

Incorporating exercises into balance training programs and developing the peroneal and calf muscles is beneficial for coordination and stability of the feet. It is important to start and end stretching exercises.

Development and strengthening of the ankle joint after injury: exercises and exercise therapy

The ankle joint is a complex articulation formed by the tibia, fibula, and talus. Its structure is stable and reliable, but often the applied force can exceed the strength of the anatomical structures.

In this case, damage to various structures develops: bones, ligaments, joint capsule. There are fractures, dislocations, sprains and bruises.

Often the ankle is injured when playing sports, as well as at home due to one's own negligence.

The type of damage depends on the degree of impact of the mechanical factor. This also determines the symptoms of pathology, which in each case will have their own characteristics. But even a minor injury can cause significant inconvenience to the patient, because it disrupts walking and support function, without which it is impossible to imagine everyday life.

The exclusive role of the ankle joint in human motor activity dictates the need for effective methods of treating its injuries.

General principles of treatment

In the arsenal of modern traumatology, there is a sufficient number of methods that allow for the correction of structural and functional disorders of the ankle. Their choice is determined by the type and degree of injury, as well as the need to obtain a pronounced and lasting effect in a short period of time. Most often used:

• Medical treatment.
• immobilization.
• Physiotherapy.
• Massage and exercise therapy.
• Operative treatment.

Which of the methods is suitable for a particular person, only the doctor will tell after a comprehensive examination.

General recommendations for ankle injuries should be taken into account. Performing certain first aid measures will speed up further treatment and improve the patient's condition even before contacting a doctor. Immediately following an injury, the following should be done:

• Provide rest to the ankle - fix it with a bandage or an impromptu splint.
• Apply cold.
• Give the leg an elevated position.
• If necessary, take painkillers in tablets.

This will be enough to reduce the symptoms until medical attention is provided. Everyone should know such rules, because no one can exclude damage to the ankle in the future.

Physiotherapy

Physical therapy is of great importance in the treatment of ankle injuries. Its positive effect on the osteoarticular apparatus is undeniable, because only through movements can the normal function of all joint structures be restored.

The basis for the treatment of many injuries is the early activation of motor function. The start time of the exercises is determined by the type of injury received and previous treatments.

If a bruise or sprain has occurred, then gymnastics should be practiced after the elimination of acute phenomena.

In cases of surgical treatment of fractures or immobilization, the development of the ankle joint begins somewhat later. However, at the same time, you need to perform exercises for other joints and muscles, which will indirectly improve blood circulation in the affected area.

At various stages of treatment, special exercise therapy complexes for the ankle are used. Classes are carried out gradually, sudden movements should not be allowed.

Immobilization period

Performing exercise therapy during the period of immobilization for fractures of the ankle joint, normal blood circulation in the affected areas is ensured, muscle tone is maintained, and the function of healthy parts of the limb is preserved. Exercise also helps prevent the development of contractures, osteoporosis, and atrophic changes in soft tissues. During this period, you can perform movements in the prone position:

1. In all unaffected joints: knee and hip joints on both sides, as well as in the ankle of a healthy leg.
2. In the toes of the diseased limb - flexion, extension, breeding.
3. Raise and lower the injured leg.
4. Rotational movements of the limbs in and out.
5. Abduct and adduct a straight limb.
6. Raise the affected limb with outward and inward rotation.
7. Tension of the muscles of the sore leg in isometric mode.

Great importance is given to walking with support on the immobilized limb. This is carried out only after the permission of the attending physician, gradually increasing the duration - from several minutes to an hour a day.

You can not make independent attempts to stand on a sore leg without medical recommendations - this can disrupt the union of the fracture.

Period after immobilization

The exercises that can be performed after removing the plaster bandage are greatly expanded in volume. They are designed to restore the function of the limb, as well as prevent the development of flat feet, when it is necessary to strengthen the muscles of the foot. In addition to those described earlier, in a sitting position, the following exercise therapy exercises are performed:

1. Flexion and extension of the foot.
2. Swinging foot movements to relax muscles.
3. Put your feet on your toes, moving your heels and vice versa.
4. Walking sitting, rolling the foot from heel to toe.
5. Rotational movements of the foot.
6. Putting your foot on a stick, roll it in the center, the outer and outer edge of the foot.
7. Stretch forward with the toe of a straight leg.
8. Leaning on the toe, carry out springy movements with the heel.
9. Grab a small object with your toes and hold for a few seconds.

During this period, it is necessary to bandage the ankle with an elastic bandage without getting out of bed, and when doing gymnastics, it is removed.

Classes are carried out carefully so as not to provoke pain. Gymnastics is performed daily 2-3 times.

Recovery period

In order to reliably strengthen the muscles and ligaments of the affected ankle, as well as to fully restore its function, it is required to continue exercise therapy for a month after the injury. During this period, the union of the fracture ends, so you can apply more force to the ankle and increase the duration of gymnastics. The following exercises are recommended, performed with support on the gymnastic wall or the back of the chair:

1. Rolling from toe to heel and back.
2. Transfer body weight from one limb to another.
3. Squat on the entire foot and socks.
4. Walk on toes, heels, outside of the foot, side steps.
5. Lunges forward with the affected limb.
6. Standing on the step of the stairs on your toes, perform springy movements, lowering your heels as much as possible.

All elements of therapeutic exercises for ankle injuries should be performed in strict accordance with medical recommendations - only a specialist will indicate the required range of movements, their frequency and duration.

First, classes are conducted under the supervision of an instructor, and then, having learned, the patient can perform them at home. A properly selected complex of physiotherapy exercises will become the basis of recovery after ankle injuries.

How to forget about pain in the joints?

• Joint pain limits your movement and life...
• You are worried about discomfort, crunching and systematic pain ...
• Perhaps you have tried a bunch of medicines, creams and ointments ...
• But judging by the fact that you are reading these lines, they did not help you much ...

Exercise therapy - Therapeutic gymnastics

Ankle sprain

Foot sprain

The tissues of the legs are regularly subjected to increased stress, as they have to support the weight of the rest of the body. For this reason, one of the most common injuries of the lower extremities in medical practice is an ankle sprain. Treatment in most cases is successful, but the risk of repeated damage to the connective tissues increases in the future.

Ankle and lower leg sprain: causes and symptoms

A sprain is a partial rupture of dense connective tissues in the area of ​​the corresponding joint. As a result, bone joints lose stability, their mobility decreases or, conversely, increases in an uncharacteristic way, which not only interferes with normal walking, but can also lead to pinching of blood vessels, nerve endings and muscles.

At first glance, athletes are at an increased risk of ankle sprains - in the process of regular intense training, the body often acts at the limit of its capabilities. However, medical statistics contain completely different data. Due to a sedentary lifestyle, the ligaments become less strong. Wearing shoes that do not match human physiology, in particular those with high heels, increases the risk of injury. Thus, ankle sprains most often occur in the home or at the workplace. In addition, an individual physiological feature of some people is the lower strength of the connective tissues of the ankles.

Partial ligament rupture can occur as a result of a blow, a fall, or a sharp turn of the foot, for example, if the leg turns up when walking on an uneven surface. In this case, in addition to tissue damage, a dislocation of the joint, and sometimes a fracture of the foot, can occur.

It will not be difficult for a specialist with minimal practical experience to recognize an ankle sprain. Trauma symptoms may include:

• pain on palpation of the damaged area or movement;
• hematoma;
• swelling;
• decreased joint mobility;
• discomfort when walking;
• joint instability.

Re-sprain may not be accompanied by vivid symptoms - in some cases, the patient feels only a slight instability of the joint.

There are three degrees of injury:

• mild or I degree - the ligaments are slightly damaged. Pain occurs only when moving. Edema is hardly noticeable;
• medium or II degree - there is a small tear of the ligaments. The pain is aching or sharp, is felt constantly and increases with movement. Edema, hematoma and local increase in body temperature are observed;
• severe or III degree - the pain is so severe that it can lead to nausea, dizziness, or loss of consciousness. The patient cannot move the injured limb. Edema and hematoma are clearly visible. A severe ankle sprain is often accompanied by a dislocation of the joint.

How to treat an ankle sprain?

Without special knowledge and experience, it is almost impossible to assess the severity of the injury, therefore, at the slightest suspicion of an ankle sprain, you should immediately consult a doctor. Without adequate treatment, pain, bruising, and swelling are likely to gradually subside. However, the joint will remain unstable, causing the patient to experience discomfort when walking. Connective tissues may not heal properly, increasing the risk of repeated and more serious injuries. Finally, delaying treatment increases the length of the recovery period.

Immediately after a fall or impact, the victim should be given first aid:

• remove shoes and clothes from the damaged area, for example, roll up a trouser leg - shortly after the injury, the limb will swell, so it will become more difficult to expose it, which will cause additional suffering to the patient;
• immobilize the injured limb - the foot is bent perpendicular to the lower leg and fixed with a tight bandage;
• reduce inflammation and pain - a cold compress or a bag of dry ice is applied to the sprain site.

After that, the victim must be taken to the hospital. When transporting, it is extremely important that the patient, if possible, does not lean on the injured leg. If the pain is very strong, signs of a deterioration in blood circulation are noticeable, in particular, the nails and skin become pale and numb, hospitalization is carried out by an ambulance team.

The treatment of sprains is always preceded by a diagnosis, which includes:

• questioning and examination of the patient;
• radiography - the study allows you to exclude possible damage to the bones;
• MRI - it is usually performed only if additional damage to the tissues of the lower leg or foot is suspected, or in the diagnosis of particularly difficult cases.

Further medical procedures solve the following tasks:

• anesthesia and elimination of the causes of pain;
• removal of blood (with the formation of hemarthrosis or hematoma);
• elimination of edema;
• restoration of normal joint mobility.

In most cases, conservative treatment is performed:

• in the first days after the injury, bed rest is indicated. The injured ankle joint is raised above the level of the heart, which reduces pain, bruising and swelling;
• Every hour, ice is applied to the injured area for 15 minutes. The procedure is repeated during the first day. Ice is placed in a heating pad or wrapped in a thin towel;
• depending on the intensity of pain, anesthetics are prescribed, a course of non-steroidal anti-inflammatory drugs may also be indicated;
• the damaged ligament is pulled together with an elastic bandage, and in case of a more serious injury, a plaster cast is applied;
• prescribe external anti-inflammatory drugs - warming ointments for ankle sprains reduce pain, stimulate blood circulation and reduce swelling.

As a rule, the patient does not need hospitalization if he is diagnosed with an ankle sprain - treatment at home after a preliminary consultation with a doctor shows high efficiency. However, if the connective tissues are ruptured, the patient is placed in a hospital and undergoes surgery.

The main question of interest to patients diagnosed with an ankle sprain is how long does the injury take to heal? The duration of recovery depends on the nature of the damage, individual physiological characteristics, quality and timeliness of treatment. Pain and swelling usually go away in 2-5 days. The main course of treatment for mild to moderate sprains is stopped after about 1-1.5 weeks. In severe cases, the restoration of connective tissues may take a month.

Rehabilitation treatment for ankle sprains

A course of rehabilitation treatment can reduce the negative consequences that sprains are usually associated with. The legs then regain their former mobility, and the risk of re-injury is reduced. Rehabilitation may include:

These procedures allow you to restore blood circulation, mobility and strength of the ligaments, strengthen muscles, and relieve inflammation.

Depending on the nature of the injury, physiotherapy can be carried out in parallel with the main course of treatment. In this case, a course of UHF therapy is most often prescribed.

Restoration of damaged ligaments is facilitated by therapeutic exercises. Exercises and the feasibility of a wellness program are determined by the doctor, otherwise you can negate the results of previous therapy and get additional injuries. With a slight degree of sprain, already for 2-3 days, you can perform light rotations of the foot or flexion-extension of the ankle joint. For more serious injuries, exercise therapy is carried out at the end of the main course of medical procedures. Gymnastics sessions include light warm-up exercises for the lower extremities.

After the end of treatment, the patient should reduce the load on the legs over the next few months, in particular, reduce the intensity or completely eliminate sports training, and women should also not wear high-heeled shoes. Since any damage to the connective tissues reduces the strength of the associated ligaments, the person will need to take extra care in the future to reduce the risk of re-injury.

Two types of ankle sprains: damage to several fibers of the external ligament and avulsion of the anterior and middle groups of fibers of the external ligament from the ankle bone. Tasks of medical physical culture. A set of exercises for the ankle joint.

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Therapeutic exercise for ankle sprains

Healing Fitness

The ankle joint is a complex anatomical formation consisting of a bone base and a ligamentous apparatus with vessels, nerves and tendons passing around it. In functional terms, the ankle joint combines the functions of supporting and moving the weight of a person. Therefore, the strength and integrity of its articular cartilage, bone and ligamentous elements and maintaining the correct load are of particular importance for the normal function of the ankle joint.

An ankle sprain or ankle sprain is one of the most serious sprains. Intensive treatment is prescribed, because. in severe cases, its absence can lead to a decrease or even loss of ability to work for life.

Why does sprain occur most often in the ankle joint? There is a reason for this. This joint can turn in almost any direction, which, on the one hand, is very valuable, as it ensures our mobility, but on the other hand, makes it very vulnerable. Since this joint is able to rotate at different angles, it requires many muscles, tendons and ligaments to work.

There are two types of ankle sprains:

The first type is damage to several fibers of the external ligament, while the stability of the joint is preserved.

The second type is a dislocation of the joint, caused by the separation of the anterior and middle groups of fibers of the external ligament from the ankle bone. This species can only be diagnosed based on the materials of a clinical study.

The most common mechanism for ankle sprains is to roll the foot in or out. It happens, more often in winter, on ice, icy steps and sidewalks, on a flat surface while “drunk”, etc. It is also possible that such damage occurs when jumping, during sports related to jumping, such as parkour, parachuting, etc.

The lateral ligaments of the ankle are most commonly injured. This occurs with awkward movements, often in women with inept walking in high heels. In this case, when the ligaments of the foot are stretched, the ligament between the talus and fibula, as well as between the calcaneus and fibula, can be damaged.

The very structure of the ankle joint and the peculiarities of human movement in comparison with other mammals predispose to ankle sprain. The ankle is connected to three ligaments: anterior talofibular, posterior talofibular, and fibular-calcaneal. When the ankle is sprained, the anterior talofibular ligament is most often torn first. Only then is damage to the peroneal-calcaneal ligament possible. Thus, if the anterior talofibular ligament is intact, it can be assumed that the peroneocalcaneal ligament is also intact. When spraining the ligaments of the foot with damage to the anterior talofibular ligament, it is necessary to pay attention to the condition of the peroneal-calcaneal ligament. In most cases, isolated damage to the anterior talofibular ligament is noted, and joint damage to the anterior talofibular ligament and lateral peroneal-calcaneal ligament is much less common, while ruptures of the posterior talofibular ligament occur in isolated cases.

There are cases when the ligament comes off completely along with the piece of bone tissue to which it is attached.

A predisposing factor for ankle sprains is sometimes weakness of the peroneal muscles, which may be associated with pathologies of the lower intervertebral disc. A similar pathology leads to damage to the peroneal nerve. The second possible predisposing factor is the peculiarities of the installation of the forefoot, which create a tendency to turn it outward, which is unconsciously compensated by turning inward in the subtalar joint when walking. In some people, a predisposition to ankle sprains is caused by congenital deformity of the subtalar joint, that is, one of the forms of flat feet, which is characterized by the reduced position of the foot. Internal deviation of the foot above 0° causes varus deformity of the foot.

Causes, symptoms and treatment of ligaments

The mechanism of injury is a sharp rotational movement of the lower leg with a fixed foot; tucking the foot to the outside or to the inside; catching the toes of the foot on the ground when running.

The pain is concentrated in the projection of the ankles. Movement in the joint is limited due to pain. Pain in the areas of attachment to the bone of those ligaments that may have been damaged; while the pain increases with the repetition of joint movements similar to those that led to the injury. In the area of ​​damage, there is swelling, bruising in the ankle joint. There is also hemorrhage in the joint cavity.

Before treating an ankle sprain, the severity of the injury must first be determined. For ankle sprains, treatment depends on the severity of the sprain. In case of mild sprains on the ankle and foot, it is enough to apply an elastic bandage, apply ice containers to the injury area, fix the ankle joint in an elevated position, as the condition improves and the pain decreases, the physical activity increases, and its duration also increases. Since the integrity of the musculoskeletal system is compromised due to ankle sprains, treatment should be aimed at restoring mobility, which cannot be achieved without the participation of the patient.

In the case of an ankle sprain, treatment includes: ultrasound, manual therapy and other methods. As soon as the pain subsides, you should start walking with a crutch, partially leaning on the sore leg, gradually transferring an increasing load to the joint, while treating an ankle sprain without increasing mobility is pointless. With sprains of the foot, treatment with alternative methods is also possible: with sprains of the ankle, warming ointments are shown at the stage of development of the joint, but not in the first aid.

For moderate sprains, a fixing device is applied for up to 3 weeks. This allows the person to lean on the fixed injured ankle. For severe sprains, surgery may be necessary. A number of surgeons are of the opinion that the surgical restoration of severely damaged and torn ligaments is superfluous, no different from conservative treatment. Before a person can move normally and engage in work activities, he needs to undergo a course of physiotherapy, physiotherapy exercises, which will help to acquire normal motor activity, strengthen muscles and tendons, and restore balance.

If there are no bone-traumatic changes on the radiograph, then treatment of this kind should be prescribed:

a) creating rest for the limb - to minimize the load on the leg, walk less, sit, putting the leg on the dais;

b) cold locally - use a hypothermic pack or a heating pad with ice (for 20 minutes with breaks for 20 minutes until the ice melts) to reduce swelling;

c) general anesthesia

d) local anesthesia

e) bandaging the joint with an elastic bandage or wearing an orthosis for 4 weeks; with severe pain - the imposition of gypsum for 2 weeks.

Healing Fitness

Therapeutic physical culture (LFK) is a discipline whose task is the use of various types of physical exercises for the treatment of various patients and their rehabilitation after illnesses or injuries. The use of physical exercise for therapeutic purposes should be agreed with the attending physician or exercise therapy specialist. With their help, the nature and intensity of the applied physical exercises are determined. Naturally, the load may decrease or increase depending on changes in the state of health of the practitioner. And, in this case, functional self-control can provide significant assistance.

Features of the method of therapeutic physical culture:

The most characteristic feature of the method of therapeutic physical culture is the use of physical exercises, which involve all the structures of the body in response and selectively affect its various functions.

Improving forms of mass physical culture. To improve health, improve physical performance and prevent diseases by means of physical culture, a system of various forms of mass physical culture and health improvement work has been created. Depending on the tasks to be solved, the conditions of application and the mechanisms of influence on the body, they are divided into two groups: active recreation and physical training.

impact on the affected joint and ligamentous apparatus in order to develop their mobility and prevent further dysfunction;

strengthening the muscular system and increasing its performance, improving blood circulation in the joints, combating atrophic phenomena in the muscles; ankle injury ankle exercise

counteracting the negative effects of prolonged bed rest (stimulation of the function of blood circulation, respiration, metabolism, etc.)

increase in the general tone of the body;

reduction of pain by adapting the affected joints to a dosed load.

Ankle exercises:

IP - lying on your back or sitting with legs slightly bent at the knee joints. Flexion and extension of the toes (active passive). Flexion and extension of the foot of the healthy leg and the patient alternately and simultaneously. Circular movements in the ankle joints of the healthy leg and the patient alternately and simultaneously Rotate the foot in and out. Extension of the foot with an increase in the range of motion with the help of a band with a loop. The pace of exercises is slow, medium or changing (20-30 times).

IP is the same. The toes are placed one on top of the other. Flexion and extension of the foot with resistance exerted by one leg while moving the other. Slow pace (15-20 times).

IP - sitting with legs slightly bent at the knee joints Grabbing small objects (balls, pencils, etc.)

IP - sitting: a) feet of both legs on a rocking chair. Active flexion and extension healthy and passive - sick. The pace is slow and medium (times), b) the foot of the sore leg on the rocking chair. Active flexion and extension of the foot. The pace is slow and medium (60-80 times).

IP - standing, holding on to the rail of the gymnastic wall, or standing with your hands on your belt. Raising on socks and lowering on the whole foot Raising of socks and lowering on the whole foot. The pace is slow (20-30 times).

IP - standing on the 2nd-3rd rail of the gymnastic wall, grip with hands at chest level. Springy movements on the toes, try to lower the heel as low as possible. The pace is average (40-60 times).

1. Roll your feet from heel to toe and back 6-10 times.

2. Describe circles with feet towards each other and in the opposite direction 6-8 times.

3. The feet are separated and parallel to each other. Reduce with effort and part without tension socks of the legs 6-8 times.

4. Bend your toes and hold in this position for 3-6 seconds, then straighten them 6-10 times.

5. Holding the ball with your feet, bend and unbend your knees 6-8 times.

6. One leg is located on the other. Bend and unbend the leg, the sole slides over the other leg 4-6 times with each leg.

7. Press a stick or a small ball with your foot to the floor. Roll the object on the floor with the arch of the foot for 10 seconds with each foot.

8. Grab a small ball or pencil with your toes, release. Repeat with each leg for seconds.

In a standing position (holding the back of a chair).

1. Rolling feet from heels to toes and back 6-10 times.

2. Bend the toes, move the weight of the body to the toes 6-10 times.

3. Feet shoulder width apart. Bending the knee joint, transfer the weight of the body from one leg to another without lifting the foot 6-8 times.

4. Step on a stick (ball) with your foot, roll the object on the floor for seconds.

5. Holding on to the back of the chair, bend the legs at the knee joints (without bending the hips) without lifting the foot off the floor.

A few bodyweight exercises:

Stand on the carpet with bare feet and move by bending and unbending your fingers. This exercise is better known as the "caterpillar".

Lie on your back, take the expander, clasp your ankle with it and do the following movements: pull the toe towards you, gently rotate the foot. When discomfort is minimized, you can start walking on the outside and inside of the foot. This exercise works great as a preventive measure as well.

At the final stage of recovery, you can do elastic lifts on the toe, eventually turning into a small jump.

Here, smooth running is also connected. Necessarily on a soft surface, for example, a treadmill. I will single out the work on the balancing board as a separate line. First you need to learn how to stand on one leg for 5,10,15 seconds. Then we complicate the exercise by doing semi-squats. Next, we go into the "swallow" and reaching the floor, still standing on one leg.

Naturally, it is possible and necessary to apply a load with weights: Rises on a toe with a dumbbell in hand. Obviously, you are holding the dumbbell on the side of the leg that you are lifting. Presses in the leg press machine. Place your feet on the bottom edge of the platform so that your heels hang down and work only by extending the foot.

It is very important in the course of treatment to gradually increase the load on the joint; this will help you not only restore the function of the joint after sprain, but also avoid re-injury. With a mild stretch, you will likely be able to exercise on a stationary bike and swim in the pool, as soon as the swelling begins to subside, the pain decreases. But it's best to check with your doctor before resuming vigorous exercise.

Keep fit. Fitness is a kind of insurance against sprains. Trained muscles respond better to situations that can lead to sprains, such as twisting your leg while walking off the sidewalk. By keeping yourself in shape, you will react faster in such cases and thereby prevent sprains.

As a conclusion, I will give a generalization of everything stated in this paper. Injuries that disrupt the functions of the musculoskeletal system lie in wait for a person all his life at every step.

Ankle injuries are the most common of all limb injuries. The largest percentage of ankle injuries occur from improper landings when jumping off high objects, landing on uneven surfaces, and falls. In these cases, dislocations and fractures are most characteristic. Both injuries and diseases of the soft tissues of this area can be observed - the calf muscles, the Achilles tendon, sprains and inflammation of the ligamentous apparatus.

And in order to avoid injuries in the lower leg, you must follow the recommendations:

Avoid obvious bumps in the road. Running in the dark or on rough roads means asking for trouble. Run during the day and in flat areas where there are no obstacles or they are clearly visible.

Dress appropriately for the occasion. High-top athletic shoes can provide some protection against ankle sprains. For example, hikers walking in difficult terrain may want to wear boots that support this joint. Basketball players can also benefit from high-top sneakers. However, some studies have shown that low sneakers combined with protective or supportive gaiters (the best ones that can be laced up) can reduce the risk of ankle sprains.

With frequent preventive exercises, you can reduce the risk of injury to zero.

Bahrakh I.I., Gretz G.N. Organizational, methodological and legal foundations of physical rehabilitation: Textbook. - Smolensk: SGIFC, 2003.p.

Belaya N.A. Therapeutic exercise and massage: Educational and methodological manual for medical workers. - M.: Soviet sport, 2001.p.

"Emergency Medical Care", ed. J.E. Tintinalli, Rl. Crouma, E. Ruiz, Translated from English by Dr. med. Sciences V.I. Candrora, MD M.V. Neverova, Dr. med. Sciences A.V. Suchkova, Ph.D. A.V. Nizovy, Yu.L. Amchenkova; ed. MD V.T. Ivashkina, D.M.N. P.G. Bryusov; Moscow "Medicine" 2001

Popov S.N. Physical rehabilitation. - R.-n.-D.: Phoenix, 1999.p.

Exercise therapy for an injury to the meniscus of the knee joint is the most important part necessary to restore the full functioning of the limbs. Knee injuries are especially common in people whose professional activities are associated with high physical exertion: athletes, dancers, porters. And only a well-designed set of exercises can help them quickly return to their studies.

Why exercise therapy is needed

Treatment for injuries of the ligaments of the knee joint can be carried out both surgically and conservatively. A torn meniscus usually requires surgery. Today, this intervention is usually performed by arthroscopy. In case of minor injuries, a fixing bandage is applied to the knee. Immediately after injury, the joint requires complete rest to allow the cartilage to heal.

As a result of injury and immobilization of the joint, functional changes occur in it, leading to disability of the limb. If the meniscus is damaged and the complications that follow (edema, increased interstitial pressure), the nerve endings suffer. As a result, muscle hypertonicity occurs and tendon motility is inhibited.

Therapeutic exercise can eliminate muscle spasm and prevent joint degradation.

Prolonged immobilization of the limb leads to negative consequences and significantly increases the risk of complications. Suffice it to say that in a week of complete inactivity, the muscles lose 20% of their abilities. A month and a half without movement leads to the pathology of the articular bag, which becomes too rigid. It takes twice the effort to move the knee. Eight weeks of immobilization causes a loss of 40% of the elasticity of the articular ligaments.

Therefore, exercise therapy for meniscus injury is prescribed from the first days of rehabilitation. Therapeutic gymnastics in the development of the knee joint performs the following functions:

• removal of pain syndrome;
• normalization of blood circulation;
• restoration of ligament mobility;
• toning the leg muscles.

Passive stage of rehabilitation

During the period of immobilization of the knee joint, gymnastics should be aimed at improving peripheral circulation in the limbs and maintaining muscle tone. Movements are made with a healthy leg and exercises of a general developmental nature are performed. The injured limb should be held first in an elevated and then in a lowered position. Consistent tension and relaxation of the muscles of the affected leg is performed.

The main task of this stage is to prepare the ligaments of the knee and muscles for further development in the gym. During this period, you need to lay the foundation for the restoration of the muscles of the thigh, to achieve a confident gait. In addition, physiotherapy exercises help relieve pain, relieve swelling from the injured limb.

Exercise therapy for damage to the meniscus of the knee joint should be prescribed only by a doctor. He determines the complex of necessary exercises, their duration and doses the load. Self-activity in this matter is unacceptable, as it can lead to serious complications.

Gymnastics for the beginning of rehabilitation is usually carried out in a supine position, in an easy mode. Further, the load must be gradually increased, and the range of motion must be expanded.

Exercise examples:

1. Injured and healthy limbs alternately rise up and down. Movements should be smooth, measured. The exercise is repeated 10-15 times.
2. The ankle joint alternately bends in one direction or the other. Circular movements are made with the feet. The number of repetitions is 10–15.
3. A stuffed ball is tossed and caught. We repeat 15-20 times.
4. The patient lies on his back. The legs are bent at the knees, and the feet are pressed against the support for 5-7 seconds. If pain occurs, the exercise should be stopped.
5. The patient lies on his stomach. A roller is fixed under the feet. The sore leg straightens for 5-7 seconds, then relaxes. If pain occurs, the exercise is stopped.

Active rehabilitation period

At this stage, it is required to regain full control over the muscles of the injured leg. Flexibility exercises should help restore joint mobility. It is necessary to achieve an angle of extension of the knee ligaments of at least 90º. To restore the previous muscle tone, strength gymnastics and coordination exercises are performed.

Proper distribution of the load on the meniscus during exercise will help the patient fully regain a firm gait.

At the first stage of active rehabilitation, a set of gymnastic exercises is performed in a gentle mode with careful dosing of the load. Most of the exercises are done in a lying or sitting position. In the future, the load progressively increases. There is more exercise in a standing position. Walking, dynamic activities are added. It is advisable to start walking with crutches: it is easier to control the correct gait.

Exercise therapy for restoring a damaged limb will be much more effective if it is complemented by various types of massage.

Here are examples of exercises that will help restore the knee in the shortest possible time:

1. The patient lies, leaning on the elbows, the back of the head and a bent healthy leg. It is necessary to gradually lower and raise the pelvis without lifting the injured limb from the floor.
2. The emphasis is on 3 points: elbows and a healthy knee. The sore leg slowly rises back, then returns to a bent position.
3. While sitting, the patient grabs various objects with his feet and shifts them. You can grab a medicine ball by gently raising and lowering it.
4. The patient sits on a couch with legs dangling, and the patient is in front of the healthy one. Limbs slowly rise and fall so that a healthy leg insures an injured one.
5. The exercise is performed lying down. The healthy limb is parallel to the floor, and the patient bends at the knee and rises up at a right angle.
6. The exercise is performed on the simulator. Raising the legs is done with support on the bed, when they are lowered, the emphasis is placed exclusively on the diseased limb.
7. At the gymnastic wall, the patient takes the bar at chest level with his hands and performs smooth rolls from toe to heel and back.

Gradually, the loads increase and more strength exercises are introduced:

1. Squats. When performing them, it is better to hold on to the back of the chair. The depth of the squats should be as deep as possible, but sharp pain should not be allowed.
2. The exercise is performed on a treadmill. At a slow pace, relying on the railing, walking backwards is carried out. With each step, the foot should roll from toe to heel.
3. Bicycle training. Here it is necessary to choose the correct landing height on the exercise bike so that in the lower position the leg is fully extended. Pedals should be short.
4. You will need an elastic band with a length of at least 1.5 m. It is tied to the Swedish wall at a height of 15–25 cm from the floor. The patient stands at a distance of 1 m from the wall and fixes the loop on the ankle of a healthy leg. With the same limb, he performs swings to the side with a wide amplitude.
5. Bending one leg, the patient jumps to the other. Jumps are performed through a line drawn on the floor.
6. Run in place. The elastic band is fixed on the Swedish wall and fixed at chest level. In this position, the patient runs, alternately putting one foot to the other.
7. The exercise is done while standing. The injured limb rises at a right angle. Thus, it is necessary to stand for at least 5 seconds.

Exercise therapy for a knee meniscus injury ends with breathing exercises and relaxation. It is desirable to supplement the complex with massage and swimming in the pool.