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Resin and Orthotics team up to treat ankle sprain.

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Introduction

All histological and animal studies have demonstrated the value of a measured mechanical stress for a ligament scar quality. However, in practice, resin and orthosis can partner effectively!

Here is the story of a sporty and dynamic patient, who suffered a severe ankle sprain. Brave and eager, he is unable to limit the use of his ankle. He takes off his splint few days after injury, when the pain has decreased. After a bit of therapy, her therapist overworked her program immediately in charge of the proprioception and abandons teetering on a freeman tray. The ankle still swollen and painful. However, without waiting for the approval of his doctor, he resumed running, tennis or football. A five or six weeks of the sprain, a possible control ultrasound shows a broken ligament structure embedded in connective magma without functional interest. Ankle appears quite lax and her therapist a good command hopes to limit recurrences proprioceptive! Two months later, he finished an exhausting tennis match, articulation twists violently again. To cause instability or microlaxit├ę in a few years, it will take over his ankle osteoarthritis!

The resin still has its place in the treatment of severe sprain

Of course, the functional treatment is not therapeutic abandonment but there are cases where human nature brings some risks to the protocols from histopathological research! The field doctor knows that. Sometimes it proposes to begin 6 weeks of joint mobility reduction through strict asset. In practice, when the sprain includes many severity criteria at the end of the GREC, we begin treatment with 10 to 21 days of rigid or flexible resin. Obviously the support and walking are permitted. This type of care helps limit inflammation and excessive traction on the ligaments. This method does not exclude the muscular work and stress on stabilizing reflexes to avoid the loss of strength and coordination. The new joints from trauma mobilized without limitation.

Strict immobilization is associated with rehabilitation and physical maintenance

To comply with these principles, the boot is irremovable. It does not rise above the lower terrain calf and did not cover all of the metatarsals. The sural triceps and side stabilizers can contract. Our sport has easily drainage massages, stimulations excitomotrices well as distal and proximal mobilizations. Proprioceptive work by gradually increasing load begins early without risk. The injured is invited to ride a bike because this activity perfectly tolerates ankle locked at 90 ┬░. This way, it keeps good cardiovascular shape. Isometric contractions or short strokes of the muscles of the leg and foot reduce the risk of adhesion. It can also do weight training of the lower limbs without support (open chain) emphasizing the braking load (eccentric predominance). Thus, our athlete is not embarrassed by its resin and suffer fewer aches for the resumption of the race.

The brace allows the intensification of therapy and tissue mechanization

After 10 to 21 days, the resin removal, we often pleased to see that the ankle is fine; often less swollen, less painful after three weeks of tracking poorly functional treatment! To achieve the relative 6 weeks of immobilization, we prescribe an ankle orthosis Bauerfeind kind AirLoc 20 to 35 days. That allows more actively pursue mechanization. An inflatable brace adjusts to better restraint to the morphology of each and residual wheelbase of the joint. By removing the orthosis during rehabilitation sessions, the therapist works directly ligament scar. The dynamic building starts without difficulty. The proprioceptive orthosis is done with binding exercises and without orthosis for less complex techniques.

The brace helps keep the shape to resume soon

Equipped with his brace, our sports can now use devices requiring flexion / extension ankle. The orthosis is less troublesome when his lower extremities are fine and do not deform the sports shoe. Many simulators exist in all fitness and are frequently found in physiotherapy room. And rower, stepper and ellipteur gradually enroll in the program. The gesture is similar to that little bit of running. Far from irritating the ligament structure, this work contributes effectively to mechanize the scar. At approximately 4 weeks of trauma, our patient trots minutes with his brace on carpet or even ground. Initially, it is more of rehabilitation to the race as a workout. Meanwhile, it can work intensively on other devices

The orthosis promotes a return to the field while flexibility

With braces, the footings are faster and more prolonged. An orthosis comprising an elastic sole seems better tolerated. Gradually, if the ankle has no pain or swelling, the brace is removed for the race on mats or on regular ground. back sessions in the field begin parallel. While sharpening the physical condition of our sport, this step is a real physiotherapy proprioceptive scale. The ligament completes its mechanization and acquires the tissue characteristics essential to its specific mission. The side trips begin on condition of orthosis. The latter is retained to perform new exercises, it is gradually removed when the movements are controlled.

The orthosis is useful to return to sport with less apprehension

Finally, our patient returns to his favorite sport at about 6 weeks of the trauma ... when histological scar ends. If our sport is concerned, wear a brace quality, well tolerated, allows the first drives with more security. In the heat of the moment, she informed teammates and opponents that player returns from injury. The back trust in our sport quickly forgets to put her brace. Because he is fit, he returned to competition in stride: he won the time! Moreover, his ankle is not swollen or lax. It is painless and stable. In severe sprain, the resin cocktail then brace associated with early rehabilitation and physical maintenance is often very effective!

REFERENCES:

Rodineau J., G. Saillant 2003
Ligament recent peripheral lesion
Masson Ed.

Doctor St├ęphane CASCUA. - 10 janvier 2009.

Conflicts of interest: the author or authors have no conflicts of interest concerning the data published in this article.

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