Transcripción de audio Generada automáticamente
- 00:02 - 00:03
acute ankle sprain.
- 00:04 - 00:05
This is Alicia 10.
- 00:05 - 00:08
Just March 1st 2020 spg for 25.
- 00:08 - 00:09
Spring of 2020.
- 00:10 - 00:15
Therapeutic exercise According to flail 2014 a sprain is a
- 00:15 - 00:16
stretching or tearing injury.
- 00:17 - 00:19
Tore a ligament In the case of an ankle sprain,
- 00:20 - 00:22
it is the stretching or tearing of the ligaments that
- 00:22 - 00:23
hold the ankle bones together.
- 00:24 - 00:26
Pressure of an incorrect position of the foot brings the
- 00:26 - 00:29
body's weight to bear on the ligament instead of the
- 00:29 - 00:32
foot with its cushioning mechanics, because is stretching or, in
- 00:33 - 00:35
more serious brains, tearing of the ligaments altogether.
- 00:36 - 00:38
An ankle spring can happen when an athlete rules or
- 00:38 - 00:41
twists an ankle from landing a jump or stride and
- 00:41 - 00:44
correctly to collision during play or trauma Higher up the
- 00:44 - 00:48
leg. Ankle sprain is most common ankle injury overall, and
- 00:48 - 00:52
the most common type is due to inversion, which causes
- 00:52 - 00:53
a lateral sprain.
- 00:55 - 01:00
Epidemiology in the overall population rate of acute ankle sprains
- 01:01 - 01:04
19 to 26.6 per 1000 person years.
- 01:05 - 01:07
That's according to Herzog Cur, Marshall and Wilkes from 2019.
- 01:09 - 01:11
This is a significantly large number for such a specific
- 01:12 - 01:15
injury, though it does include ankle sprains that were and
- 01:15 - 01:16
were not treated and emergency departments.
- 01:17 - 01:21
50% of all ankle sprains treated in US emergency departments
- 01:21 - 01:26
were not sport activity related, most common muscular, skeletal, injury
- 01:27 - 01:30
and active population and very high occurrence in the overall
- 01:30 - 01:30
general population.
- 01:31 - 01:33
That's according to grumble at all.
- 01:33 - 01:38
2016 youth and adult active population.
- 01:38 - 01:42
Specifically, sports sports involve running and sharp maneuvering, which plays
- 01:43 - 01:44
a great amount of stress on the lower limbs.
- 01:45 - 01:47
An ankle injury can be one of a few specific
- 01:47 - 01:50
injuries, such as a fracture and ankle bone's contusion, or
- 01:51 - 01:53
a sprain in one or both the ligaments on the
- 01:53 - 01:55
Insider outside of the ankle.
- 01:57 - 02:00
Most common injuries in high school sports are ankle injuries.
- 02:00 - 02:03
That's according to Nelson Collins, Yaar of Fields and Comstock
- 02:03 - 02:07
2007. The ankle is the most common sight of injury
- 02:07 - 02:13
and 24 of 70 sports, accounting for 76.4% of all
- 02:13 - 02:16
injuries. That's according to Clinton, Bethany, Jarvis and Deron Amiss
- 02:17 - 02:22
in 2000 well, ankle sprains represent 15 to 20% of
- 02:22 - 02:23
all sporting injuries.
- 02:24 - 02:28
It's Narva, Annie Thomas and let in 2006 sports that
- 02:28 - 02:31
include sudden stops and changes in direction have higher rates,
- 02:31 - 02:35
along with an increase in incidents in court and outdoor
- 02:36 - 02:38
sports, especially at the field or terrain is uneven.
- 02:39 - 02:42
This means sports such a soccer football across basketball, sprinting,
- 02:43 - 02:47
jumping, cross country and more have higher rates of ankle
- 02:47 - 02:54
sprains. The ankle as a whole working unit, is fairly
- 02:54 - 02:57
complex. It is made up of two leg bones and
- 02:57 - 02:58
several bones of the foot.
- 02:58 - 03:01
These bones are held together by multiple ligaments, which combine
- 03:01 - 03:03
into two primary ligament structures.
- 03:04 - 03:08
Wrinkled sprains involved the true ankle joint, along with sub
- 03:08 - 03:09
Tyler joints and ligaments.
- 03:10 - 03:13
The ligaments are the cow Canio fibula or lateral ligament
- 03:14 - 03:15
on the outside of the foot, and the deltoid, or
- 03:16 - 03:17
medial ligament, on the inside of the foot.
- 03:18 - 03:24
According to Anatomy and Physiology 2017 Ankle bone True Ankle
- 03:24 - 03:27
Joint, called the Tell Tallow Cruel Joint is made up
- 03:27 - 03:30
of the tibia and fibula of the leg and the
- 03:30 - 03:31
talis bones of the foot.
- 03:36 - 03:39
Your ankle and associative put in motion work using the
- 03:39 - 03:41
action of the ankle joint and several other bones or
- 03:42 - 03:44
joints, including the calle que gnaeus and navicular bones.
- 03:44 - 03:46
That's according to anatomy and physiology.
- 03:46 - 03:48
2017 ankle ligaments.
- 03:49 - 03:50
There's two primary structures.
- 03:51 - 03:52
Medial or deltoid ligaments.
- 03:52 - 03:56
It's the tib you teller, the tibial Cal can ill
- 03:56 - 03:59
and tib you navicular make up the deltoid, or medial
- 04:00 - 04:01
ligament, the lateral ligaments.
- 04:02 - 04:06
The interior tallow fibula that Falconio fibula in the posterior
- 04:07 - 04:07
tallow fibula.
- 04:08 - 04:13
Her makeup the lateral ligaments throw the ankle joint is
- 04:13 - 04:14
a straightforward hinge.
- 04:14 - 04:17
Joint. The addition of the sub Tyler joints make the
- 04:17 - 04:20
whole ankle system and universal joint so the ankle joint
- 04:20 - 04:21
allows for Dorset election plant reflection.
- 04:22 - 04:25
Adding the sub Tyler joints allows for adding Super Nation
- 04:25 - 04:29
probation, abduction, abduction to the door selection and plant reflection
- 04:30 - 04:35
movement mechanisms of inert injury.
- 04:35 - 04:36
The most common is torching.
- 04:37 - 04:39
That's a twisting, a rolling, less common compression.
- 04:40 - 04:42
Well, these are related to sport movements.
- 04:43 - 04:45
Such a son direction changes deceleration in landing.
- 04:46 - 04:49
They can also be related to sports equipment such as
- 04:49 - 04:52
balls rolling ah, foot along the soccer ball, tripping over
- 04:53 - 05:00
a football cross ball, basketball and field surfaces, types of
- 05:00 - 05:00
ankle sprains.
- 05:01 - 05:03
There's the inversion spring twisting or rolling the foot medial
- 05:04 - 05:06
e or the E version spraying, twisting, rolling the foot
- 05:07 - 05:10
laterally. Inversion sprains account for 80% of ankle sprains.
- 05:11 - 05:13
That's according to Floegel 2014.
- 05:15 - 05:19
Grading is not always easy, and assigning a grade to
- 05:19 - 05:20
a sprain is no different.
- 05:21 - 05:23
However, the severity of the spring condition ray she ate
- 05:23 - 05:28
the rehab rehabilitation response as faras timeline pain, range of
- 05:28 - 05:32
motion so it is necessary to understand the grades of
- 05:32 - 05:32
a sprain.
- 05:33 - 05:36
There are three grades to a sprain and inflatable 2014
- 05:37 - 05:38
Classifieds. The grades as follows.
- 05:39 - 05:40
Great one.
- 05:40 - 05:43
The ligament is stretched with or without slight tearing to
- 05:43 - 05:43
some fibers.
- 05:44 - 05:46
Mild pain on the inside or outside the ankle.
- 05:46 - 05:49
Able to bear weight generally mild pain and movement.
- 05:49 - 05:51
Such flexing or pointing foot.
- 05:53 - 05:55
No grade to slightly more serious that the ligament is
- 05:55 - 05:58
stretched and fibers are partially tor NW.
- 05:58 - 06:00
There's moderate pain inside or outside the foot.
- 06:00 - 06:02
Weight bearing There may not be tolerated.
- 06:03 - 06:05
Moderate pain and movements such as flexing point in the
- 06:05 - 06:08
foot and may feel loose or unstable.
- 06:09 - 06:10
No great.
- 06:10 - 06:13
Three. The ligament is ruptured or torn through severe pain
- 06:13 - 06:14
on inside or outside of the foot.
- 06:15 - 06:18
Non weight bearing due to pain in potentially instability, severe
- 06:19 - 06:20
pain and movements such as flax in your part of
- 06:21 - 06:24
the foot and it could feel loose or unstable.
- 06:27 - 06:29
Timeline. This is a general overview.
- 06:29 - 06:31
It will in Cannes.
- 06:31 - 06:32
Very patient.
- 06:33 - 06:35
A patient, but great one is 1 to 4 weeks.
- 06:35 - 06:37
Great two is 4 to 6 weeks, and great three
- 06:37 - 06:39
is 6 to 12 weeks.
- 06:39 - 06:43
Generally, there are other aspects that can delay healing, such
- 06:44 - 06:46
as non weight bearing due to pain up to 2
- 06:46 - 06:47
to 5 days.
- 06:47 - 06:49
Immobilization for grade two.
- 06:50 - 06:53
That's a removable boot where brace upto 1 to 2
- 06:53 - 06:54
weeks and four grade three.
- 06:55 - 06:57
The plaster cast or a non removable brace up to
- 06:57 - 06:58
2 to 3 weeks.
- 07:00 - 07:04
Now surgery is rare and usually only after failing to
- 07:04 - 07:08
respond. A nonsurgical treatment and or their significant joint instability.
- 07:08 - 07:09
Post treatment.
- 07:10 - 07:12
So generally, surgery is not one of the delays, but
- 07:12 - 07:12
it could be.
- 07:16 - 07:18
Rehabilitation goals are simple and straight board.
- 07:19 - 07:20
First of all, no pain or swelling.
- 07:22 - 07:24
And then the primary goals start with regaining range of
- 07:25 - 07:28
motion working towards excellent flexibility, increasing the strength of the
- 07:28 - 07:32
muscles, supporting the ankle joint and finally improving balance which
- 07:32 - 07:35
necessitates appropriate section in neuro muscular training.
- 07:36 - 07:40
Rehabilitation does not generally differentiate between the sexes, nor should
- 07:40 - 07:42
it change significantly due to age.
- 07:43 - 07:44
The changes would be due to expectations.
- 07:46 - 07:49
Final stages of rehabilitation may change due to sports specific
- 07:49 - 07:52
considerations or merely get regaining full function.
- 07:55 - 07:56
Typical rehabilitation.
- 07:57 - 07:58
There's usually three phases.
- 07:59 - 08:02
That's according to the Academy, American Academy of Orthopedic Surgeons
- 08:02 - 08:06
2016 nor Vani Thomas and Lynn.
- 08:06 - 08:10
2006. Rehabilitation begins immediately after injury.
- 08:11 - 08:13
That's according to Edna Varney at all 2006.
- 08:14 - 08:17
I could start with just price or that could start
- 08:17 - 08:19
with range of motion.
- 08:19 - 08:24
Slight range of motion rehabilitation ends at return, a full
- 08:24 - 08:27
function or return to sport, or both due to high
- 08:28 - 08:28
risk of recurrence spring.
- 08:30 - 08:33
According to Delahunt at all 2019 increased attention to ongoing
- 08:34 - 08:37
range of motion, flexibility, strength and balance training is important
- 08:38 - 08:43
for that athlete Now Phase one.
- 08:44 - 08:47
The goal is to decrease pain and inflammation, an increased
- 08:47 - 08:48
range of motion and flexibility.
- 08:49 - 08:51
Timeline. It's generally between zero and two weeks.
- 08:52 - 08:57
Exercises like mentioned pride, the rice rest, ice compression and
- 08:58 - 09:02
elevation, passive range of motion, self manipulation injured, ankle crossed
- 09:03 - 09:06
over ankle Oh, vernie and moving in.
- 09:06 - 09:10
All planes will review more of these exercises in the
- 09:10 - 09:11
exercise sheet.
- 09:12 - 09:15
Active range of motion ankle A B C's just draw.
- 09:15 - 09:17
The ABC is in the air using the ankle joint
- 09:18 - 09:20
to point the foot, the gas truck.
- 09:21 - 09:21
And so Leah's tell stretches.
- 09:22 - 09:25
Put that steptoe around the ball of the foot and
- 09:26 - 09:29
pull back gently and a seated were or a reclined
- 09:30 - 09:33
position progressing to next phase.
- 09:34 - 09:36
Decreased pain and inflammation that's a big one.
- 09:36 - 09:38
And then weight bearing with some minimal pain.
- 09:40 - 09:43
Face to the goals for Phase two are to achieve
- 09:44 - 09:47
full, active and passive range of motion and increased strength
- 09:47 - 09:47
in front flexibility.
- 09:48 - 09:50
Timeline is looking at 123 weeks.
- 09:52 - 09:55
The exercises active range of motion now want to do
- 09:55 - 09:59
some towel scrunches all planes gassed rock soli, a standing
- 10:00 - 10:02
stretches that could be using a step or could be
- 10:02 - 10:06
using a wall flexing the knees and up to 90
- 10:06 - 10:07
degrees to get that stretch along the back.
- 10:08 - 10:09
The leg calf raises.
- 10:10 - 10:12
Those are gonna be working on strengthening.
- 10:13 - 10:15
That could be with or without weights, along with squats
- 10:15 - 10:15
and lunges.
- 10:16 - 10:20
Come you with or without weights, walking good cardio as
- 10:20 - 10:21
well as working on gate mechanics.
- 10:23 - 10:24
Use him some caution.
- 10:25 - 10:26
It'll be on a treadmill or a track in a
- 10:27 - 10:27
controlled environment.
- 10:28 - 10:29
Progressing the next step.
- 10:30 - 10:31
No oedema, no swelling.
- 10:32 - 10:36
Normal gate pattern raise three.
- 10:36 - 10:38
The gold are returned to full function.
- 10:38 - 10:42
Improve neuro muscular control, body mechanics and movement patterns and
- 10:42 - 10:44
increased balance, strength and flexibility.
- 10:45 - 10:46
So the timeline is going to be 2 to 6
- 10:47 - 10:51
weeks. Exercises active range of motion, continuing those you can
- 10:51 - 10:52
use resistance.
- 10:53 - 10:56
Pandora's deflection plant reflection Everton inversion that just put some
- 10:57 - 10:59
pressure on the range of motion exercises.
- 11:00 - 11:01
Resistance band sidesteps.
- 11:03 - 11:04
That's a good lower limb.
- 11:04 - 11:08
Strengthen her, BOS Do Squats and Bos do lunges That's
- 11:08 - 11:12
adding an element of instability to the great work outs
- 11:12 - 11:16
of a squat and at lunch, single leg calf raises.
- 11:17 - 11:18
Now these can work on strength.
- 11:19 - 11:22
They could be unilateral or bilateral, and we can add
- 11:22 - 11:26
in appropriate section training with eyes open eyes close with
- 11:27 - 11:31
a bow, sue or other instability device Progressing to sports
- 11:32 - 11:35
specific training needs to be pain free, light running and
- 11:35 - 11:37
potentially jumping with normal gate patterns.
- 11:38 - 11:43
Maintaining balance in single leg stance for 32 seconds, 60
- 11:43 - 11:47
seconds Bilaterally, there's the home exercise.
- 11:48 - 11:51
She be able to look at it more fully in
- 11:51 - 11:51
the assignment.
- 11:52 - 11:56
That drink and an example of the exercise we dress
- 11:56 - 12:00
for you recurrent you play.
- 12:03 - 12:05
The most important is to have full range of motion
- 12:06 - 12:11
propagate mechanics, neuromuscular coordination, adequate lower legs, drink to support
- 12:12 - 12:12
sport movements.
- 12:12 - 12:18
Those sudden movements stops direction, changes, sports, specific strength and
- 12:18 - 12:18
balance training.
- 12:21 - 12:24
Return to play functional pests grow test, range of motion
- 12:25 - 12:27
balance, appropriate section, agility and strength.
- 12:28 - 12:31
You can find those tests in Clinton, Bethany, Jarvis and
- 12:31 - 12:33
Geronimo's 2012 study.
- 12:34 - 12:37
Each of these tests are standardized and half score ranges,
- 12:38 - 12:41
which set parameters for reliable return to play determination.
- 12:44 - 12:49
There are some precautions Athlete should brace, use bracing or
- 12:49 - 12:53
taping when engaging in athletic endeavors.
- 12:53 - 12:56
That's according to flail 2014 Schyman, Christie Ford and Bury
- 12:57 - 13:03
2017 Balance Training Schyman at all 2017 Now balance training,
- 13:04 - 13:06
as well as bracing or taping, have been shown to
- 13:07 - 13:08
reduce the risk of ankle injury.
- 13:08 - 13:11
Both of those are equally as effective in reducing the
- 13:11 - 13:12
risk of an injury.
- 13:12 - 13:17
According to Shine in O, there is an increased risk
- 13:18 - 13:22
of ran drik injury when exercising when tired or without
- 13:23 - 13:26
an adequate warm up period, so adequate warm up and
- 13:26 - 13:28
seizing activity if it teach both those?
- 13:28 - 13:37
According to the American Academy of Orthopedic Surgeons 2016 here
- 13:37 - 13:37
are the references.
- 13:45 - 13:46
Thank you for watching my presentation.
- 13:46 - 13:47
I hope you enjoyed it.