Training Of The Lower Leg Muscles

Talar Tilt Test

Injuries to the lower leg or immobilisation of the ankle joint often lead to atrophy of the lower leg muscles and reduced power output in ankle plantar flexion with straight knee (m gastrocnemius) and with flexed knee (m soleus, m tibialis posterior, m flexor hallucis longus, m flexor digitorum longus) and in dorsi-flexion (m tibialis anterior and m extensor digitorum). The lower leg muscles are of vital importance for activities like jumping, running on hard surfaces and most ball sports....

Rupture Of The Gastrocnemius Or Soleus Muscles Cont

Fig. 73 This MRI demonstrates an intramuscular haematoma three months after the rupture. The tennis player can still not even jog Fig. 73 This MRI demonstrates an intramuscular haematoma three months after the rupture. The tennis player can still not even jog Fig. 74 The organised haematoma evacuated through a surgical incision with immediate improvement Fig. 74 The organised haematoma evacuated through a surgical incision with immediate improvement TREATMENT This injury most often responds to...

Cartilage Injuries Cont

EXERCISE PRESCRIPTION Rest is only recommended temporarily. Cycling and swimming are good alternatives to keep up general fitness. Rehabilitation back to full sport usually takes a long time, up to 12 months or more. EVALUATION OF TREATMENT OUTCOMES Monitor clinical symptoms and signs. Different functional knee scores for different sports are available to measure when the knee allows the return to full sport. DIFFERENTIAL DIAGNOSES Meniscus injury, loose bodies, medial plica syndrome all...

Chondromalacia Patella Cont

Sinding-Larsen's syndrome, synovitis, PVNS, patel- PROGNOSIS Because many cases never reach an lar tendon disorders, referred pain, secondary absolute diagnosis and correct treatment, chon- symptoms from ankle or back insufficiency, core dromalacia patella ends the career of many young instability and more. athletes. SYMPTOMS There is a gradual or acute dramatic onset of effusion and often severe pain in the knee, without preceding trauma. This condition can affect virtually any joint but is...

Patella Dislocation Cont

EXERCISE PRESCRIPTION Cycling and swimming are good alternatives to keep up general fitness. Valgus stress to the knee should be avoided so breast stroke is not recommended. EVALUATION OF TREATMENT OUTCOMES Monitor clinical symptoms and signs. Different functional knee scores for different sports are available to measure when the knee allows a return to full sport. DIFFERENTIAL DIAGNOSES This is a straightforward diagnosis but associated injuries to the menisci, cartilage or cruciate ligaments...

Osteoarthritis Cont

Progressive disease affecting both the soft tissues and the cartilage of the knee joint. According to the Outerbridge scale, which is arthroscopic, osteoarthritis is graded from I (chondromalacia) to IV (bare bone) and correspondingly in a radiological score (as seen by X-ray) from 0-4. CLINICAL FINDINGS Depends on the severity. There is effusion in around 70 per cent of cases. Deformation of the knee and protruding osteophytes can be found. A systematic and thorough approach in the clinical...

Tarsal Tunnel Syndrome

SYMPTOMS There is aching or sharp pain around the medial part of the foot and ankle joint, often radiating along the medial or the lateral part of the foot, or towards the plantar fascia insertion. AETIOLOGY This syndrome is caused by trapping of the posterior tibia nerve or any of its branches in the tarsal tunnel, most often after scarring from trauma. Other non-traumatic aetiology, such as varicose veins, neuroma or tumours, may also trap the nerve. CLINICAL FINDINGS There is tenderness on...

Hidden Home Exercises

Ankle Exercises After Surgery

Even for the general, sedentary, non-sporty population, exercise is an essential part of well-being. Exercise is also the 'drug' prescribed for a number of major health problems such as high blood pressure, heart insufficiency, diabetes, asthma, obesity, osteoporosis, rheumatoid arthritis and multiple sclerosis. Although for each of these disorders there are exercise alternatives that may be prescribed under the close supervision of a specialist doctor, we should be wary of sending unmotivated...

Patellar Instability Or Maltracking

Septic Bursitis Thigh

Fig. 134 Mal-tracking patellae, as shown by 3D CT scan Fig. 134 Mal-tracking patellae, as shown by 3D CT scan Fig. 135 Patella alta, as shown by 3D CT scan Fig. 137 Genu recurvatum, often seen in players with general joint laxity Fig. 136 Anatomic view of patellar mal-tracking SYMPTOMS The knee feels unstable or weak, or gives way in association with recurrent pain around the anterior part of the knee, with or without preceding trauma. It is particularly common in young female athletes....

Lateral Collateral Ligament Tear

SYMPTOMS The symptoms are immediate haemarthrosis and pain in the lateral part of the knee. This injury is common in contact sports such as football, rugby and other high-intensity sports. LCL ruptures occur during a varus sprain and cause an inability to continue sport. The forces involved are high since the lateral knee structures are stronger than the medial, these injuries are rare. AETIOLOGY The ligament can rupture either partially (Grade I-II) or completely (Grade III-IV). Note This...