Achilles Tendon Sprain Case Study

Achilles Tendon Sprain Case StudyName Lani ThompsonAge 26Sex FemaleOccupation MerchandiserHeight 179Weight77.8, BMI victuals MixedFamily She lives with her partner, no kids.Medical History No history of Hypertension, Cardiovascular, Diabetics mellitus, pulmonary or some(prenominal) chronic disease.Footwear A comfortable, properly fitted plunkwear should be go ford. Avoid High heels.Daily activities Usually she goes to Gym thrice in a week, occasionally she goes for swimming.BalanceMuscle performance No muscle wasting. deportCircumferential measurementAlignment There is no difference in alignment while she walks.History Lani Thompson is a hockey and rugby player. About 4 months back, while she was training rugby she had a right ankle joint sprain. The Incident was happening near 7 in the night. Soon after she was shifted to the hospital and consulted with the doctor. On the equivalent day she had downstairsgone several investigations and examinations, including X-Ray and ultra sound. No evidence of any fracture on the x-ray and was diagnosed as an Achilles brawn sprain. Initial 2 weeks she was in a brace, subsequently she started ankle crops. Later she workd with Theraband and had started physi otherwiseapy treatment for 2 weeks, eventually continued her exercises at home.Past Medical History She has never been hospitalized for any chronic diseases. No history of Diabetes mellitus, Hypertension, Heart diseases, Asthma, Hepatitis, Sexually transmitted diseases or Tuberculosis.She regularly takes medications for depression/anxiety and for contraception.Medication Venlafaxine, Quitiepine and a contraceptive pill.Surgical interjection No surgical interference.Gait pattern Altered, limping of right offset. mark of Motion (ROM) Normal on left side, right ankle ROM is approximately altered, No muscle stiffness.Palpation No tenderness or any abnormalities.Anatomy of the Ankle joint The ankle joint mainly consists of two joints, the subtalar and the neat an kle joint. The subtalar joint comprises three drum, the tibia, the fibula and the talus. The mechanism of the ankle joint is very complex. True ankle is responsible for the up and down movements of the foot. The subtalar joint is positioned under the true ankle joint and consists with two bones, the cal hoboeus and the talus. This joint is responsible for the side to side movement of the foot. The joint is c everywhereed with a cartilage know as articular cartilage. The articular joint is lubricated with synovial fluid.Many ligaments connect the ankle bones together, they are anterior fibular ligament, which attaches the fibula to the tibial bone. The gage ligament is known as the lateral collateral ligament, which connects calcaneus bone with the fibula and the tibial bone and the third one is deltoid ligament, it connects calcaneus and the talus bones together to the tibia.Many tendons attach the muscles of the lower limb and the bones of the ankle, they are the Achilles, the fl exor hallicus longus, the flexor digitorium, the peroneal tendons, the posterior tibialis and the anterior tibialis tendons. Among these tendons the Achilles tendon is considered to be the strongest tendons in the human body. It is located at the posterior of the leg and connects the calcaneus bone to the gastrocnemius ,solens and plantarius muscles. The Achilles tendon is somewhat six inches long and can withstand around four time of body mass during walking and almost eight times while running.Achilles Tendonitis It is the inflammation of the calcaneus tendon.Over use of the tendon causes trouble and stiffness, for instance running up hill or climbing up stairs.Achilles Rupture asdf..ExercisesGroup 1 ExerciseEvertion/ Invertion isometric exercises.Evertion This exercise can be performed by placing the wound foot adjacent to a door or the leg of a table and gradually push extremely to the lateral side of the foot.Inversion This exercise can be done by placing the medial aspect of the foot to any rooted(p) objects such as a table leg or a door, then to push gently outward in for two to three seconds.Evertion/Invertion with an exercise bandEvertion The guest has to sit and fix the leg straight, with the help of an elastic band One end of the elastic band is attached to a table leg and other to the foot and then gradually turns the foot outwards.Invertion Rotate the foot inwards by reversing the position of the band .The movement of the foot should be apart from the leg of the table.The node can proceed to the group two exercises, if he tolerates to do group one exercise.Group 2 exercisesGastrocnemius stretch The patient has to wrestle forward and push the wall with his hands. The injured leg should be placed just behind the other foot, keeping the foot firmly to the floor for about 30 seconds.Soleus Stretch Place the non injured foot behind the injured foot and bend the other genu joint. The heel should be increase while reach.Weight bearing exercises The client should stand on the floor with the affected leg and bend the other leg, so that the whole body tip should bear on the injured leg for 30 seconds and then lift the heel up and down.Injured leg stand with a clothThe client is asked to stand on a 2inches thick cloth with the injured leg for 30 seconds.The client can proceed to the group three exercises, if he tolerates to do group two exercises.Group 3 exercisesLateral step and bound exercise.This exercise is performed by placing a folded towel on the floor and to stand beside the towel and client steps on the folded towel. Other foot should be placed firmly on the floor. Repeat the same exercise with other leg. As the pain allows, increase the repetitions and speed accordingly.Hop exercise It is performed by placing a folded towel on a floor and the client is asked to stand beside the towel and bound over the folded towel and to rest on the other foot. Then reverse the entire exercise with the other leg.As the pain allows , slowly raise the speed and hops.RehabilitationRange of movementStretching of the calf muscle When the patient will be able to sand comfortably with an injured leg, he is asked to move back the injured foot and move the hip gradually forward, so that the calf muscle is stretched. Hold for 20 seconds and repeat for at least 2 times per day. first rudiment writing The patient has to write alphabets with his greater toe at least 2 times per day.Balance training exercises By holding a fixed object firmly with one hand and stand on a single leg, keeping the other knee folded. Repeat the same with the other foot as well. As the patients balance improves, he is encouraged to repeat the same exercise with eyes shut.GOALSShort destination Phase 1 and 2 meliorate joint range of motion and flexibilityIncrease ankle strengthGain normal gait patternProgressive Proprioception and motor coordinationLong term Phase 3 and 4Improve cardiovascular enduranceReturn to complete sports activityRehabilit ation program involvesStretching of the calf muscle and around the ankle muscleStrengthening exerciseDeep massage techniquesCardiovascular endurance exerciseAgility trainingPhase 1 T o gain range of motionStretching-Calf plantar fascia stretchSit on the floor with leg extended and knees straightLoop a towel around the affected leg and grip the end of towel on each hand.Affected leg should be in straight and institutionalize the towel near the bodyHold the position as same for 30 seconds and relaxRepetition 3 to 5Calf muscle stretchingOpen kinetic chain exerciseToe curlsMarble pickupsFour-plane surgical tubing exercisesSub maximal Isokinetics in short arcStrengthening exercisePlantar flexion exercises with TherabandInversion and eversion exercise isometric exerciseFlexibilityGrade 1 and 2 mobilizationAlphabet ROMproprioceptiveStork standingSingle plane tilt boardBiomechanical ankle platform system in non-partialWeight bearing position.Cardiac endurance exercisekitty therapyStationar y cycling.PHASE 2StretchingAchilles stretches in sitting and standing positionsOpen kinetic chain exercise full arc ISO kinetics scrawny kinetic chain exerciseShuttle squatsHeel raisesToe raisesTubing lunge stepsProprioceptionWobble board workWalking on scratchy surfaceBiomechanical ankle platform system with partialCardiac endurance trainingTreadmill StairmasterPHASE 3Program in this phase should be considered according to theStrength and progression of the client.The program involves dynamic and functional tolerance of the patient.Start up with increase weight bearing force on the ankle jointStretching of Achilles tendon in a supinated positionEccentric heel drop with knee straightEccentric heel drop with knee bentLunges and squatsStep upsSide step ups with weight bearingTo focus on lateral stability up and down sideways movement patronise pedalling exerciseCaricosPlyomettric drillsProprioceptionLadder drill Netball throwing and catching with Standing on the affected leg moving t o catch the ball and return to land on the same leg.Four square hopping drillsAgility trainingShuttle running with changing the directionZigzagging or figure of 8 runsPhase 4 functional replenishment activities such as tip toe walking.Polymeric progressions hopping, bounding, depth jumps and box drillsSport-specific trainingUnstable surface trainingStationary cross country skier interpret normal plantar to dorsiflexion strength ratios and muscle balanceCareful increase in training regimens