Reader Comments

Joint N-11

by Jerome Princy (2019-12-18)


These could be used in Joint N-11 Review addition to other common core stability exercises (planks, glute bridges etc.). See below for the author's rehab guidelines discussed in this paper. The review provides a systematic detailed guideline for rehabilitation of grade I and II hamstring strain injuries based on current available best evidence. Phase one consists of protection, Ice, NSAIDS and therapeutic exercises. Progression to phase II occurs when: patient can walk a normal stride without pain; perform very low-speed jogging without pain, and perform pain-free isometric contraction against submaximal (50-70%) resistance during prone knee flexion (90°) manual strength test. Phase II consists of utilizing similar guidelines as phase I with emphasis on full range of motion, ice after exercise, discontinuation of NSAIDS and therapeutic exercises with the emphasis on neuromuscular control, agility drills and trunk stabilization. The use of anaerobic training and sports skills are initiated with care to avoid endrange lengthening of the hamstrings and substantial eccentric work. The progression criteria are full strength 5/5 MMT without pain during a 1-repetition maximum effort isometric MMT in prone with the knee flexed at 90 degrees and forward and backward jogging at 50% maximum speed without pain. Inversion ankle sprains are common injuries that tend to heal well on their own, generally resolving with only residual symptoms after one month. Unfortunately these injuries have a nearly 80% recurrence rate. Further, depending on the activity level of the patient, it may be critical to speed this regular recovery interval. According to some reports, these injuries are known to respond well to conservative treatments including manual therapy. Early active ankle mobility exercises are well studied and generally quite successful in the treatment and rehabilitation of inversion ankle sprains. The authors contend that combining manual therapy and active ankle mobility exercises could have additional benefits to those who have encountered an acute ankle sprain. Thus they sought to develop a clinical prediction rule to identify those patients with inversion ankle sprains who might benefit the most from these combined interventions.

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