The correct treatment with the immediate measures of the torn ligament using a simple scheme (PECH scheme (Prof. Böhmer)) help to favorably influence the healing process and prevent further damage.
P Pause
E Eis
C Ccompression
H Hoch storage
P = pause
The following applies to every injury in every sport:
Stop exercising immediately. The affected Ankle joint should be immobilized immediately. A direct examination is usually difficult because the joint is very sensitive due to swelling and pain. The extent of the injury usually only becomes apparent in the first few days after the injury.
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E = ice
Direct application of ice can have a positive effect on the healing process of the torn ligament. The application of cold causes the blood vessels to narrow, which reduces the amount of bleeding and swelling. Furthermore, the metabolism is slowed down by cooling, which leads to a reduction in tissue damage. Finally, cold has a pain-relieving effect. However, it should be noted that the ice never directly on the skin as it can cause cold damage. Always cover the area first with a cloth or wrap a few layers of a compression bandage. Then put on the cold pack and secure it with a compression bandage or an elastic bandage.
The duration of the cooling depends on the extent of the damage and the subjective well-being. If the ice is well tolerated, it can also be cooled for hours. However, the cold effect only extends a few centimeters deep, so this no "Depth effect" can be achieved. If too long and persistent cooling is used, this can negatively affect the healing process. If there is no ice available, cold compresses can be used without any problems. So-called ice packs are also suitable for treating torn ligaments. These are plastic bags that are filled with a thick gel and can be easily deposited in the freezer "in case of an emergency". If there are open wounds, direct and indirect muscle use is prohibited.
C = compression
In order to prevent excessive swelling of the ankle, a compression bandage should be applied for treatment after or after the ice. However, only moderate pressure should be applied to ensure good blood flow. As the swelling increases in the first few hours, the tension of the compression bandage should be checked regularly. If the foot has a bluish discoloration, the bandage must be removed immediately.
H = elevated position
By elevating the injured ankle, the backflow of blood and swelling fluid is physically facilitated. The foot should be completely elevated within the first 48 hours. Regular elevation should be carried out until the foot has completely subsided. A sports medical examination is necessary. In the event of a torn ankle ligament, the emergency room, orthopedist or sports doctor should be your first point of contact.
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Athletes (joggers, soccer players, etc.) are particularly often affected by diseases of the foot. In some cases, the cause of the foot discomfort cannot be identified at first.
Therefore, the treatment of the foot (e.g. Achilles tendonitis, heel spurs, etc.) requires a lot of experience.
I focus on a wide variety of foot diseases.
The aim of every treatment is treatment without surgery with a complete recovery of performance.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.
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Goal of every treatment is the healing of the Torn ligament while maintaining the stability and resilience of the ankle.
Therefore, the optimal therapy is of great importance in order to regain the condition before the injury.
If left untreated, the joint may become unstable with premature joint wear (arthrosis) come.
There are two important ligament structures on the knee. These are the medial and lateral collateral ligament. You will be particularly quick at Rotation- and Flexion movements such as when skiing, for example, and can therefore tear quickly.
Furthermore, these are also anterior and posterior cruciate ligament as well as the Menisci at risk of being damaged in the event of knee injuries. Was such a ligament tear detected by means of appropriate diagnostics such as a clinical examination and possibly with a Computed Tomography determined, the appropriate therapy is initiated depending on the severity.
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Strains and ruptures of the collateral ligaments are generally treated conservatively. The Medial collateral ligament strain is therefore symptomatic. The patient receives Pain medication and depending on the pain it can put strain on the affected leg. He receives support if necessary Forearm crutchesthat relieve the knee and enable pain-free walking.
In order to avoid inflammation on the affected ligament, local Anti-inflammatory drugs (Anti-inflammatory drugs) can be administered. Regular is beneficial Cooling the injury and elevating the leg.
At a Torn ligament on the other hand, the affected leg should initially be relieved with the help of crutches for about 6 weeks. There is also one here Treatment with cold and anti-inflammatory drugs.
Often the rupture heals completely within 6 weeks of immobilization and the knee is able to bear weight again. Ruptures of the anterior cruciate ligament, on the other hand, are usually surgical and then with a Cruciate ligament splint provided.
A reconstruction of the cruciate ligament is carried out especially in physically active people. In the meantime, the pure seam of the torn tape has become obsolete, as it subsequently led to instabilities in the tape. A more stable process is that arthroscopic reconstruction of the ligament with an endogenous transplant.
The relatively long and therefore well-suited tendon of the Semintendinosus muscle used. The success of such a transplant is very good. After the healing phase, the patient can often resume his sporting activities.
A torn ligament of the posterior cruciate ligament is initially treated conservatively, as the Quadriceps muscles the instability can be compensated by the crack. If the conservative therapy is unsuccessful, surgical intervention can also be used here. Similar to the reconstruction of the anterior cruciate ligament For posterior cruciate ligament surgery, grafts are also fixed using drilled bone channels. Sufficient knee stability can thereby be achieved.
Traumatic injuries to the ankle ligaments are the most common sports injuries. The ligaments can only be strained (Distortion) or completely ruptured.
If the ligaments are pulled by a sudden overstretch, they are treated conservatively.
The patient should put weight on the affected foot depending on the pain. Regular cooling and elevation promotes swelling. A compression bandage can be applied to support walking, which provides additional stability.
Conservative therapy is also provided in the event of a rupture of one or more ligaments. The patient should take good care of the foot for 6 weeks by bending and stretching the affected foot by a maximum of 20 degrees. On an inward turn (inversion) should be completely dispensed with for the time being.
A splint can significantly reduce the immobilization and the risk of further injury. This is followed by a physiotherapy exercise treatment that promotes stable flexion in the ankle.
Further measures include strengthening the peroneal muscles, elastic bandages and raising the outer edge of the shoe. If conservative therapy is unsuccessful and the instability of the ankle ligaments threatens to become chronic, a reconstruction can also be carried out here. Often parts of the nearby peroneal tendon are used.
The Achilles tendon is the strongest tendon in the human body, but it can also tear. The injuries are often caused by sudden pushing off, in squash players or tennis players, since particularly rapid, abrupt movements place enormous stress on the Achilles tendon. Often there is also a pre-damaged tendon. In this case, the standard treatment of the Achilles tendon rupture includes the tendon suture, which can be additionally reinforced. This reinforcement takes place in the area of the crack through various plastics. If ultrasound has shown that the ends of the tendons can still be brought together, conservative therapy may also be sufficient.
To do this, the foot is plastered in equinus position so that the tendon ends can adapt and grow together. The patient then wears a shoe orthosis according to the treatment plan.
Read more about the topics: Torn ligament on the foot, torn ligament on the ankle and torn ligament on the ankle
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A torn ligament can also be treated conservatively in many cases, for example if only one Overextension or one small rupture is present that can be expected to grow together by itself without further complications. In this case the patient receives a special walking railthat too Orthosis is called. It is available in matching sizes and is selected to have a snug fit around the upper ankle of the foot. It offers optimal support for the injured ligament structures and enables early mobilization. The patient can roll and unroll the foot normally This prevents muscle loss. The splint is usually several weeks daily, sometimes worn at night. It can also provide the necessary stability in the initial phase of resuming sporting activities in order to avoid a new twist. The splint is not only used for conservative treatment of a ligament tear, it comes often even after surgery for use. In this way, the healing of the operating area can be optimally promoted and the foot has the necessary stability to continuously increase the load after the operation.
Relief and protection are the basis of treatment. All measures aim to reduce pain and counteract swelling. Support bandages, bandages or plastic splints are used to stabilize the joint and reduce swelling. In the case of pronounced swelling or severe pain, a plaster cast can be applied in exceptional cases. Painkillers provide relief.
When the swelling and pain have subsided, you can begin by gently putting weight on the leg. The load should be through a physiotherapy treatment are supported with the aim of strengthening the muscles as well as the coordination to improve movement and reflexes. This is also important to prevent another twisting. In most cases the ligaments heal and the joint becomes sufficiently stable again. If the treatment is unsuccessful, a operative tape suture can also be carried out after a few months.
Treating a ruptured ligament of the knee, ankle and foot can take different lengths of time. The choice of therapeutic measures depend on the severity of the injury and the age of the patient and possibly after Job or leisure activitiesso that the treatment can also be tailored to it. With conservative approaches, the affected joint is usually spared. Under certain circumstances this can also contain a plaster of paris. Of the plaster remains on the foot about 6 weeks. Afterwards, the load and mobility must be supported by exercise with physiotherapy so that the Healing process takes about 2 to 3 months persists. A similar long-term treatment can be expected with surgical interventions. In addition, there is the planning of the operation, an inpatient stay, the increased risk of complications. After an operation, the patient receives precise instructions on how to put weight on the affected leg. Here, too, another several weeks of physiotherapy to be required.
