* Caution.
1. The methods and data provided in this plan are developed in accordance with the general routine, and the specific implementation needs to be completed under the guidance of a doctor depending on your own conditions and surgical conditions.
2. Pain in functional exercises is unavoidable. If the pain can subside to the original level within half an hour after the exercise is stopped, it will not cause damage to the tissue and should be tolerated.
3, muscle strength exercises should be concentrated until the muscle has a sense of soreness and fatigue, and then proceed to the next group after sufficient rest. The number of exercises, time, load depending on their own situation, and should be practiced at the same time the healthy side. The improvement of muscle strength is a key factor in the middle and late functional recovery, and must be practiced carefully.
4, in addition to the surgical limb brake protection, the rest of the body parts (such as the upper limbs, waist and abdomen, the healthy side of the leg, etc.) should be practiced as much as possible to ensure physical quality, improve the overall level of circulation and metabolism, and promote the recovery of the surgical local.
5, early joint mobility exercises, only 1-2 times a day, and strive to improve the angle can be, avoid repeated multiple exercises. If there is no progress in mobility for a long time (>2 weeks), there is a possibility of joint adhesions, so we should pay great attention to it and insist on completing the exercises, and review them in time when necessary.
6.Ice packs should be given for 15-20 minutes immediately after the mobility exercise. If you usually feel swelling, pain and fever in the joint, you can apply ice again, 2-3 times a day.
7.The side with shadow in the appendix is the affected side.
8.The swelling of the joint will continue throughout the exercise until the joint mobility is normal and the stimulating factors of muscle strength recovery disappear. However, the degree of swelling must be controlled and should not be continuously increased, but the general trend should be gradually decreasing. If the swelling increases, local redness, swelling, heat and pain are obvious, you must stop practicing, increase the number of ice packs, and seek medical attention promptly!
Full text
I. Early – inflammatory response period (0-1 week)
Purpose: to reduce pain and swelling; early muscle strength exercises; early weight-bearing; early mobility exercises to avoid adhesions and muscle atrophy.
In the early stage of functional exercises and the early stage of functional exercises, because the muscle strength level is low and the tissue has a more obvious inflammatory response, so the static force
Exercises are mainly static (i.e., weight-bearing exercises to maintain a certain posture until fatigue). Or when the swelling and pain are not obvious, choose a light load (the amount of load to complete 30 movements that feel fatigue), 10 times / group, 10-15 seconds to maintain / time, 2-4 groups of continuous exercises, 30 seconds rest between groups, until fatigue.
Early on, there should not be too much walking (except for walking without the affected foot on the ground), and walking should not be used as an exercise method. Otherwise, it is very likely to cause swelling, wear out the joint cartilage, and affect functional recovery and tissue healing.
(I) On the day of surgery.
1. After anesthesia subsides, begin to move your toes as much as possible; if pain is not obvious, you can begin 1) quadriceps (anterior thigh muscle group) isometric exercises – that is, thigh muscle tensing and relaxation. Do as many as possible without increasing pain. (Greater than 500 times/day)
2, N rope muscle (posterior thigh muscle group) isometric exercise – the affected leg force down the padded pillow, so that the posterior thigh muscle tense and relaxation (see Appendix 1 – Figure 2). Requirements as above, greater than 500 times/day.
(II) One day to one week after surgery.
1. Movement of toes: forceful, slow, full range of flexion and extension of all toes, 5 minutes/group, 1 group/hour. (Important for promoting circulation, decreasing swelling and preventing deep vein thrombosis)
2.Start straight leg lift exercise: straight leg lift after knee extension to heel 15M from bed, hold until exhaustion. 10 times/group, 2-3 groups/day (see appendix 1-figure 4 for method).
3. Start side leg raise exercise: 30 times/group, 2-4 groups/day with 30 seconds rest between groups. (See Appendix 1-figure 5 and 6 for the method.)
(C) 1 week after surgery: (The time of mobility exercises varies for different surgeries and will be specifically informed by the surgeon after surgery)
1. The surgeon will decide whether to start mobility exercises: active flexion and extension of the ankle joint, i.e. slow, hard, maximum toe tensing and toe hooking. (Within the range of minimal pain. If you are having surgery such as ligament repair, it should be done by a rehabilitation physician, or you should practice on your own with the permission and guidance of your doctor.)
2.Ice for about 20 minutes immediately after the mobility exercise. If there is usually a clear feeling of heat and swelling in the joint, ice can be applied again 2-3 times / day.
3.Start the standing “leg hook” exercise. (See Appendix 1 – Figure 17, 18, 19). 30 times/group, 4 groups/day.
II. Initial period: (2-4 weeks)
Purpose: To reduce pain; to strengthen mobility and muscle strength; to improve joint control and stability; to gradually improve gait.
(i) 2 weeks after surgery.
1. After review by the doctor, it is considered to be fully weight-bearing, then you can start the anterior-posterior and lateral striding exercises. (See Appendix 1-figures 21 and 23.
And after several weeks of practice gradually transition to Appendix 1 – Figure 24, 25, and gradually increase the load to Appendix 2 – Figure 6, 7, 8, 9) 30
4 sets/day.
2, strengthen muscle strength, start heel exercises: that is, standing on the tips of the feet, including the feet stand apart and shoulder width, the tips of the feet are forward; “external eight” standing; “internal eight” standing three positions. 2 minutes / time, rest 5 seconds, 10 times / group, 2-3 groups / day.
3.If there is no obvious swelling and pain in the joint, you can walk for a short distance off the crutch.
4.Static squatting or sliding exercises against the wall 2min/time, rest 5 seconds, 10 times/group, 2-3 groups/day.
(II) 3 weeks after surgery.
1.Start affected side single leg 0-45° position, squatting flexion and extension knee exercises. 5 min/time, 4-6 times/day.
2.Fixed bicycle exercises, no load to light load. 30 min/time, 2 times/day.
3.Strengthen the mobility exercises, move the ankle joint in all directions with your hands until you start to feel pain, hold for 10 seconds, relax slightly and rest for 5 seconds.
Rest for 5 seconds, then push again, do not repeat the activity, practice for 10 minutes, once a day.
(C) 4 weeks after surgery.
1.Strive to achieve normal gait walking.
2.Strengthen the leg strength, see Appendix 1-Figure 18, 19; Appendix 2-Figure 4, 5, 10, 11.
III. Mid-term: (5 weeks – 3 months)
Purpose: Strengthen joint mobility to the same level as the healthy side. Strengthen the muscle strength and improve the stability of the joint. Restore the ability to perform all activities of daily life.
With the improvement of muscle strength level, absolute strength exercises are the main focus in the middle period. Choose a medium load (complete 20 movements that is the amount of fatigue), 20 times / group, 2-4 sets of continuous exercises, rest 60 seconds between groups, until fatigue.
1.Ankle dorsiflexion: face the step, stand on the edge of the step with only the toe part of the feet, hold the hand to keep the balance, use the body weight to make the heel touch the ground as much as possible, hold at the slight pain for 10-15 seconds, 10 times / group, 2-3 groups / day.
2. Ankle Tsukimbo: Sit on the bed, empty the bed outside below the ankle joint, take a heavy object such as a sandbag and hang it at the toe, 15-20 minutes/time, 1-2 times/day. 3. gradually try to protect under full squat.
Fourth, the late stage: (recovery movement period 4-6 months)
Purpose: full recovery of all activities of daily life. Strengthen muscle strength, and the stability of the joints in running and jumping. Gradually to the surface to resume sports or strenuous activities or special training.
This period to improve the maximum strength, choose a large load (to complete 12 times the action that fatigue load), 8-12 times / group, 2-4 groups of continuous practice, rest 90 seconds between groups, until fatigue.
1, start jumping up and down exercises (see Appendix 2 – Figure 16).
2.Start lateral straddle exercise (see appendix 2-figure 13).
3. 3 months after surgery, the athlete can start the basic movement practice of special sports.
In case of ligament repair surgery, the reconstructed ligaments are not strong enough during this period, so the exercises should be performed gradually, not reluctantly or blindly. If necessary, ankle brace can be worn for protection, but it is only recommended to be used during strenuous sports.