Physical therapy after rupture of ligaments. Strengthening the ligaments of the knee joints after sprains and ruptures of exercise therapy in case of damage to the cruciate ligament

The date: 01.07.2020

Damage to the knee joint is an injury that often occurs during physical education, sports, and simply with an accidental fall. Knee injuries can have varying degrees of severity and require a mandatory consultation with a doctor, and in some cases serious treatment, including surgery.

Injuries and their main symptoms

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The knee joint (diathrosis) is the largest in the human body. It is located between the femur and tibia. Above the joint is the patella (patella). In the cavity of diarthrosis there are two menisci (cartilaginous formations that act as a shock absorber). Ligaments are located on the sides. The diarthrosis itself is covered with an articular bag.

Types of knee injuries:

sprains and ruptures of ligaments;
bone fractures with the entry of the fracture line into the joint cavity;
dislocation of the joint;
trauma of the cup of the knee joint;
cracks and ruptures of the menisci.

The main symptoms of a knee injury are:

pain;
swelling;
bruise;
discoloration of the skin (pallor, cyanosis);
sensations of numbness, coldness, weakness, paresthesia ("goosebumps").

Tip: if you have these symptoms, you should seek help from a traumatologist as soon as possible.

First aid for knee injury

Treatment of a knee joint injury includes self-administration of first aid, and the second stage is the provision of qualified medical assistance followed by rehabilitation.

There are a number of injuries accompanied by the occurrence of life-threatening conditions and requiring immediate hospitalization:

displacement (dislocation) of the joint;
fragmentation of bones in the area of diarthrosis;
the presence of ongoing bleeding;
pain shock.

In these conditions, you need to call an ambulance.

For mild knee injuries with little pain and no bleeding, a person can provide first aid to themselves.. Main stages:

Ensuring rest. The cessation of physical activity on the injured limb will prevent the displacement of parts of diarthrosis and self-damage by them.
Applying ice. Cold in the area of injury will cause spasm of the blood vessels and reduce the rate of swelling, as well as reduce pain.
Applying a fixing bandage. It can be bandaged, or using a special fixator for the knee joint. The bandage should not be too tight, so as not to cause ischemia in the area of diarthrosis and below.
Appeal to the traumatologist.

Note: This simple set of measures will reduce pain in the knee joint, reduce swelling and shorten the recovery and rehabilitation period.

Conservative treatment at home

Home treatment includes, first of all, the observance of the correct regimen of physical activity on the injured limb and a series of manipulations.

Acute period

In the first few days after the injury, it is necessary to ensure complete rest for the injured knee. It is necessary to exclude or limit any movement in the joint.

When walking, it is advisable to use crutches or a cane, shifting body weight onto them. In the supine position, the knee should be on a soft bedding (pillow) in an elevated position.

It is imperative to conduct self-massage sessions (soft, gentle strokes in different directions) - this will help improve blood circulation.

Applying ice will help reduce swelling. The procedure lasts 10-15 minutes 3 times a day for the first 2 days. To carry out such a compress, it is necessary to wrap the ice in a damp towel.

Important: this procedure is carried out with extreme caution. there is a risk of frostbite. The time limit must be strictly observed.

In the first 48 hours, it is necessary to avoid any activities that can lead to increased edema (bath, hot shower). It is possible to use a fixing bandage lasting no more than 24 hours.

Recovery period

It starts 3-4 days after the injury. Puffiness subsides, soreness decreases. Feeling better. During this period, it is important to begin the gradual introduction of physical activity. At first - slow warm-up exercises with a gradual increase in their amplitude and strength.

If you experience pain in the knee, you should consult with your doctor about the need to choose another set of exercises or postpone the load for 1-2 days.

It is necessary to perform these exercises 2-4 times with each leg.

Note: a long period of immobilization can lead to the onset of atrophic processes in the muscles and joints. Therefore, it is necessary to start physical activity as early as possible.

When a knee joint injury is combined with various inflammatory and degenerative diseases (arthritis, arthrosis), the duration of each period increases.

Medical treatment

Most knee injuries do not require specialized medical treatment. With severe pain syndrome, it is recommended to take non-steroidal anti-inflammatory drugs (Ibuprofen, Acetaminophen, Ketanov, etc.). However, their use on the first day creates a risk of increased bruising.

Symptoms for Anxiety

There are a number of symptoms of anxiety in which it is urgent to consult a doctor again:

the appearance of numbness of the limb;
pallor and cyanosis of the skin in the area of the injured joint;
fever, general weakness, drop in blood pressure;
persistence of pain syndrome for more than 3 days;
pain syndrome that is not relieved by the use of non-steroidal anti-inflammatory drugs.

Important! Any of these symptoms indicates the development of complications of a traumatic lesion and the need for extended treatment measures, sometimes surgical intervention.

Rehabilitation

Rehabilitation after a knee injury is a mandatory stage of treatment. During this period, there is a complete restoration of the function of the damaged limb. The duration of rehabilitation ranges from several weeks to a year, depending on the severity of the injury. Rehabilitation is prescribed after a knee joint injury by a traumatologist or physiotherapist. Most often it includes:

physiotherapy exercises;
massage;
physiotherapy treatment;
water treatments.

Therapeutic exercise for a knee joint injury is a set of exercises specially selected to strengthen muscles and ligaments, as well as to prevent the formation of contractures.

A set of exercises is performed at first under the supervision of a doctor or exercise therapy instructor, in the future it is possible to conduct classes on your own at home.

Physiotherapy of the knee joint after an injury includes mud applications, paraffin treatment, magnetotherapy, electromyostimulation, electrophoresis, phonophoresis, UHF therapy.

A rational approach to physical activity will help to avoid injuries. And proper care of the joints and timely correction of violations will extend their service for many years.

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Therapeutic exercise for ankle sprains

Introduction

Healing Fitness

Conclusion

Bibliography

Appendix

Introduction

The ankle joint is a complex anatomical formation consisting of a bone base and a ligamentous apparatus with vessels, nerves and tendons passing around it. In functional terms, the ankle joint combines the functions of supporting and moving the weight of a person. Therefore, the strength and integrity of its articular cartilage, bone and ligamentous elements and maintaining the correct load are of particular importance for the normal function of the ankle joint.

An ankle sprain or ankle sprain is one of the most serious sprains. Intensive treatment is prescribed, because. in severe cases, its absence can lead to a decrease or even loss of ability to work for life.

Why does sprain occur most often in the ankle joint? There is a reason for this. This joint can turn in almost any direction, which, on the one hand, is very valuable, as it ensures our mobility, but on the other hand, makes it very vulnerable. Since this joint is able to rotate at different angles, it requires many muscles, tendons and ligaments to work.

Clinical and physiological rationale

There are two types of ankle sprains:

The first type is damage to several fibers of the external ligament, while the stability of the joint is preserved.

The second type is a dislocation of the joint, caused by the separation of the anterior and middle groups of fibers of the external ligament from the ankle bone. This species can only be diagnosed based on the materials of a clinical study.

The most common mechanism for ankle sprains is to roll the foot in or out. It happens, more often in winter, on ice, icy steps and sidewalks, on a flat surface while "drunk", etc. It is also possible that such damage occurs when jumping, during sports related to jumping, such as parkour, parachuting, etc.

The lateral ligaments of the ankle are most commonly injured. This occurs with awkward movements, often in women with inept walking in high heels. In this case, when the ligaments of the foot are stretched, the ligament between the talus and fibula, as well as between the calcaneus and fibula, can be damaged.

The very structure of the ankle joint and the peculiarities of human movement in comparison with other mammals predispose to ankle sprain. The ankle is connected to three ligaments: anterior talofibular, posterior talofibular, and fibular-calcaneal. When the ankle is sprained, the anterior talofibular ligament is most often torn first. Only then is damage to the peroneal-calcaneal ligament possible. Thus, if the anterior talofibular ligament is intact, it can be assumed that the peroneocalcaneal ligament is also intact. When spraining the ligaments of the foot with damage to the anterior talofibular ligament, it is necessary to pay attention to the condition of the peroneal-calcaneal ligament. In most cases, isolated damage to the anterior talofibular ligament is noted, and joint damage to the anterior talofibular ligament and lateral peroneal-calcaneal ligament is much less common, while ruptures of the posterior talofibular ligament occur in isolated cases.

There are cases when the ligament comes off completely along with the piece of bone tissue to which it is attached.

A predisposing factor for ankle sprains is sometimes weakness of the peroneal muscles, which may be associated with pathologies of the lower intervertebral disc. A similar pathology leads to damage to the peroneal nerve. The second possible predisposing factor is the peculiarities of the installation of the forefoot, which create a tendency to turn it outward, which is unconsciously compensated by turning inward in the subtalar joint when walking. In some people, a predisposition to ankle sprains is caused by congenital deformity of the subtalar joint, that is, one of the forms of flat feet, which is characterized by the reduced position of the foot. Internal deviation of the foot above 0° causes varus deformity of the foot.

Causes, symptoms and treatment of ligaments

The mechanism of injury is a sharp rotational movement of the lower leg with a fixed foot; tucking the foot to the outside or to the inside; catching the toes of the foot on the ground when running.

The pain is concentrated in the projection of the ankles. Movement in the joint is limited due to pain. Pain in the areas of attachment to the bone of those ligaments that may have been damaged; while the pain increases with the repetition of joint movements similar to those that led to the injury. In the area of damage, there is swelling, bruising in the ankle joint. There is also hemorrhage in the joint cavity.

Before treating an ankle sprain, the severity of the injury must first be determined. For ankle sprains, treatment depends on the severity of the sprain. In case of mild sprains on the ankle and foot, it is enough to apply an elastic bandage, apply ice containers to the injury area, fix the ankle joint in an elevated position, as the condition improves and the pain decreases, the physical activity increases, and its duration also increases. Since the integrity of the musculoskeletal system is compromised due to ankle sprains, treatment should be aimed at restoring mobility, which cannot be achieved without the participation of the patient.

In the case of an ankle sprain, treatment includes: ultrasound, manual therapy and other methods. As soon as the pain subsides, you should start walking with a crutch, partially leaning on the sore leg, gradually transferring an increasing load to the joint, while treating an ankle sprain without increasing mobility is pointless. With sprains of the foot, treatment with alternative methods is also possible: with sprains of the ankle, warming ointments are shown at the stage of development of the joint, but not in the first aid.

For moderate sprains, a fixing device is applied for up to 3 weeks. This allows the person to lean on the fixed injured ankle. For severe sprains, surgery may be necessary. A number of surgeons are of the opinion that the surgical restoration of severely damaged and torn ligaments is superfluous, no different from conservative treatment. Before a person can move normally and engage in work activities, he needs to undergo a course of physiotherapy, physiotherapy exercises, which will help to acquire normal motor activity, strengthen muscles and tendons, and restore balance.

If there are no bone-traumatic changes on the radiograph, then treatment of this kind should be prescribed:

a) creating rest for the limb - to minimize the load on the leg, walk less, sit, putting the leg on the dais;

b) cold locally - use a hypothermic pack or a heating pad with ice (for 20 minutes with breaks for 20 minutes until the ice melts) to reduce swelling;

c) general anesthesia

d) local anesthesia

e) bandaging the joint with an elastic bandage or wearing an orthosis for 4 weeks; with severe pain - the imposition of gypsum for 2 weeks.

Healing Fitness

Therapeutic physical culture (LFK) is a discipline whose task is the use of various types of physical exercises for the treatment of various patients and their rehabilitation after illnesses or injuries. The use of physical exercise for therapeutic purposes should be agreed with the attending physician or exercise therapy specialist. With their help, the nature and intensity of the applied physical exercises are determined. Naturally, the load may decrease or increase depending on changes in the state of health of the practitioner. And, in this case, functional self-control can provide significant assistance.

Features of the method of therapeutic physical culture:

The most characteristic feature of the method of therapeutic physical culture is the use of physical exercises, which involve all the structures of the body in response and selectively affect its various functions.

Improving forms of mass physical culture. To improve health, improve physical performance and prevent diseases by means of physical culture, a system of various forms of mass physical culture and health improvement work has been created. Depending on the tasks to be solved, the conditions of application and the mechanisms of influence on the body, they are divided into two groups: active recreation and physical training.

Tasks of exercise therapy:

impact on the affected joint and ligamentous apparatus in order to develop their mobility and prevent further dysfunction;

strengthening the muscular system and increasing its efficiency, improving blood circulation in the joints, combating atrophic phenomena in the muscles; ankle injury ankle exercise

counteracting the negative effects of prolonged bed rest (stimulation of the function of blood circulation, respiration, metabolism, etc.)

increase in the general tone of the body;

reduction of pain by adapting the affected joints to a dosed load.

Ankle exercises:

IP - lying on your back or sitting with legs slightly bent at the knee joints. Flexion and extension of the toes (active passive). Flexion and extension of the foot of a healthy leg and the patient alternately and simultaneously. Circular movements in the ankle joints of the healthy leg and the patient alternately and simultaneously Rotate the foot inward and outward. Extension of the foot with an increase in the range of motion with the help of a band with a loop. The pace of exercises is slow, medium or changing (20-30 times).

IP is the same. The toes are placed one on top of the other. Flexion and extension of the foot with resistance exerted by one leg while moving the other. Slow pace (15-20 times).

IP - sitting with legs slightly bent at the knee joints Capturing small objects with toes (balls, pencils, etc.)

IP - sitting: a) feet of both legs on a rocking chair. Active flexion and extension healthy and passive - sick. The pace is slow and medium (60-80 times), b) the foot of the sore leg on the rocking chair. Active flexion and extension of the foot. The pace is slow and medium (60-80 times).

IP - standing, holding on to the rail of the gymnastic wall, or standing with your hands on your belt. Raising on socks and lowering on the whole foot Raising of socks and lowering on the whole foot. The pace is slow (20-30 times).

IP - standing on the 2nd-3rd rail of the gymnastic wall, grip with hands at chest level. Springy movements on the toes, try to lower the heel as low as possible. The pace is average (40-60 times).

Sitting on a chair.

1. Roll your feet from heel to toe and back 6-10 times.

2. Describe circles with feet towards each other and in the opposite direction 6-8 times.

3. The feet are separated and parallel to each other. Reduce with effort and part without tension socks of the legs 6-8 times.

4. Bend your toes and hold in this position for 3-6 seconds, then straighten them 6-10 times.

5. Holding the ball with your feet, bend and unbend your knees 6-8 times.

6. One leg is located on the other. Bend and unbend the leg, the sole slides over the other leg 4-6 times with each leg.

7. Press a stick or a small ball with your foot to the floor. Roll the object on the floor with the arch of the foot for 20-30 seconds with each foot.

8. Grab a small ball or pencil with your toes, release. Repeat with each leg for 20-30 seconds.

In a standing position (holding the back of a chair).

1. Rolling feet from heels to toes and back 6-10 times.

2. Bend the toes, move the weight of the body to the toes 6-10 times.

3. Feet shoulder width apart. Bending the knee joint, transfer the weight of the body from one leg to another without lifting the foot 6-8 times.

4. Step on a stick (ball), roll the object on the floor for 20-30 seconds.

5. Holding on to the back of the chair, bend the legs at the knee joints (without bending the hips) without lifting the foot off the floor.

A few bodyweight exercises:

Stand on the carpet with bare feet and move by bending and unbending your fingers. This exercise is more commonly known as the "caterpillar".

Lie on your back, take the expander, clasp your ankle with it and do the following movements: pull the toe towards you, gently rotate the foot. When discomfort is minimized, you can start walking on the outside and inside of the foot. This exercise works great as a preventive measure as well.

At the final stage of recovery, you can do elastic lifts on the toe, eventually turning into a small jump.

Smooth running for 15-20 minutes is also connected here. Necessarily on a soft surface, for example, a treadmill. I will single out the work on the balancing board as a separate line. First you need to learn how to stand on one leg for 5,10,15 seconds. Then we complicate the exercise by doing semi-squats. Next, we go into the "swallow" and reach the floor, still standing on one leg.

Naturally, it is possible and necessary to apply a load with weights: Rises on a toe with a dumbbell in hand. Obviously, you are holding the dumbbell on the side of the leg that you are lifting. Presses in the leg press machine. Place your feet on the bottom edge of the platform so that your heels hang down and work only by extending the foot.

It is very important in the course of treatment to gradually increase the load on the joint; this will help you not only restore the function of the joint after sprain, but also avoid re-injury. With a mild stretch, you will likely be able to exercise on a stationary bike and swim in the pool, as soon as the swelling begins to subside, the pain decreases. But it's best to check with your doctor before resuming vigorous exercise.

Keep fit. Fitness is a kind of insurance against sprains. Trained muscles respond better to situations that can lead to sprains, such as twisting your leg while walking off the sidewalk. By keeping yourself in shape, you will react faster in such cases and thereby prevent sprains.

Conclusion

As a conclusion, I will give a generalization of everything stated in this paper. Injuries that disrupt the functions of the musculoskeletal system lie in wait for a person all his life at every step.

Ankle injuries are the most common of all limb injuries. The largest percentage of ankle injuries occur from improper landings when jumping off high objects, landing on uneven surfaces, and falls. In these cases, dislocations and fractures are most characteristic. Both injuries and diseases of the soft tissues of this area can be observed - the calf muscles, the Achilles tendon, sprains and inflammation of the ligamentous apparatus.

And in order to avoid injuries in the lower leg, you must follow the recommendations:

Avoid obvious bumps in the road. Running in the dark or on rough roads means asking for trouble. Run during the day and in flat areas where there are no obstacles or they are clearly visible.

Dress appropriately for the occasion. High-top athletic shoes can provide some protection against ankle sprains. For example, hikers walking in difficult terrain may want to wear boots that support this joint. Basketball players can also benefit from high-top sneakers. However, some studies have shown that low sneakers combined with protective or supportive gaiters (the best ones that can be laced up) can reduce the risk of ankle sprains.

With frequent preventive exercises, you can reduce the risk of injury to zero.

Bibliography

Bahrakh I.I., Gretz G.N. Organizational, methodological and legal foundations of physical rehabilitation: Textbook. - Smolensk: SGIFK, 2003. - 151 p.

Belaya N.A. Therapeutic exercise and massage: Educational and methodological manual for medical workers. - M.: Soviet sport, 2001. - 272 p.

"Emergency Medical Care", ed. J.E. Tintinalli, Rl. Crouma, E. Ruiz, Translated from English by Dr. med. Sciences V.I. Candrora, MD M.V. Neverova, Dr. med. Sciences A.V. Suchkova, Ph.D. A.V. Nizovy, Yu.L. Amchenkova; ed. MD V.T. Ivashkina, D.M.N. P.G. Bryusov; Moscow "Medicine" 2001

Popov S.N. Physical rehabilitation. - R.-N.-D.: Phoenix, 1999. - 608 p.

Appendix

Frequent rupture mechanism

Exercise Options

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dislocations

A dislocation is a displacement of the ends of the bones that form the joint. Closed dislocations are more common in combination with bone fractures and soft tissue injuries. With dislocations, the joint capsule, ligaments, sometimes surrounding tendons and muscles are torn. The joints are set and a removable plaster splint is applied, dislocations of the fingers are fixed with adhesive tape.

Tasks of exercise therapy and massage

In the I period; prevention of muscle atrophy and preservation of movements in the joints of the immobilized limb; in the II period - activation of metabolism in the damaged section, elimination of atrophy and strengthening of the strength of the muscles that cause movements in the joint (creation of a muscle corset); in the III period - restoration of the function of the apparatus of movement and working capacity.

Features of exercise therapy

LH starts from the first days after the injury for a healthy joint, and for an injured one - after removing the fixed bandage.

Dislocation in the shoulder joint

Assign exercises for a healthy joint: with a gymnastic stick, general developmental exercises in the IP lying, sitting, standing, touching the wall with the shoulder blades. Muscle relaxation exercises are essential. For an injured joint, LH is performed after removing the fixing bandage. After 10-12 days, they include exercises in the water, and after 2-3 weeks - classes on simulators, exercises with objects, with weights and resistance. Pull-ups and push-ups from the floor, swing exercises for a damaged joint are contraindicated. With the usual dislocation of the shoulder, the treatment is surgical. After the operation, immobilization for 7-10 days with a bandage and an LH splint is prescribed from the 2nd-3rd day for healthy joints, walking, training on a treadmill. After removing the bandage, exercise therapy is similar to that used for normal dislocation.

Dislocation of the patella

If the dislocation does not resolve spontaneously, it is reduced and a pressure bandage is applied to the patella and posterior plaster splint in the fully extended position. In the first period, exercises are prescribed after cryomassage in IP sitting and lying down, with a ball, a stick; in the II period - exercises in the water, with dumbbells, etc.; in the III period - classes on simulators with an emphasis on training the quadriceps femoris muscle (they put on a knee pad); the load is increased strictly gradually.

Massage

Massage begins from the first days after the injury. The technique is similar to that used for stretching. In case of dislocation of the patella, the lumbar region is preliminarily massaged, and in case of dislocation of the shoulder joint, the neck and trapezius muscle are preliminarily massaged, and then the healthy limb and muscles above and below the injury site. In the II period, the massage of the injured limb is carried out gently (fixing the patella with a hand when it is dislocated).

Joint bruises

The most commonly injured are the wrist, elbow, knee and ankle joints, which are least protected by soft tissues. Bruises are not accompanied by a violation of the skin, often there is hemarthrosis (bleeding into the joint cavity) or reactive effusion into the joint cavity, arthritis (usually microtraumatic), accompanied by stiffness in the joint, crunching during movement, pain in the muscles and along the peripheral nerves.

Tasks of exercise therapy and massage

Strengthen blood and lymph circulation and metabolism in the area of injury; reduce pain, promote resorption of hematomas, restore the function of the damaged part.

Features of exercise therapy

Exercise therapy is prescribed by the end of the week after the injury. LH is performed lying down and sitting, gradually increasing the amplitude and pace of movements, the number of repetitions. Significant loads are excluded. After 2-3 weeks, training sessions on simulators are added.

Massage

From the first days after the injury, a muscle massage is prescribed above and below the injury site, using mainly kneading techniques, and massage of the reflexogenic zones (lumbar or cervicothoracic). From the 4-5th procedure, they also stroke the site of the bruise. With a decrease in pain and swelling, kneading and vibration techniques are included. The duration of the procedure is from 10 to 20 minutes. Course - 15-20 procedures.

Ligament rupture is not fatal, but a very unpleasant phenomenon that requires a long recovery, patience and increased attention.

It is impossible to insure against damage to the tendons. The real trouble can affect everyone, but athletes, dancers, circus and ballet troupe workers are at particular risk. Due to the constant load on the ligaments, they form microtears, pain symptoms, which are easily treated with anesthetic ointments. However, over time, this leads to a thinning of the bonding material and subsequently increases the risk of a complete rupture.

Injuries often occur with sudden movements. When an unbearable weight is placed on the joint, burdened with the speed of the task.

In some cases, the rupture is even accompanied by the separation of a small part of the bone. In severe situations, a fracture may occur.

According to the severity of damage are divided into three types:

Micro-rupture or slight sprain of the tendons. Everyone has experienced this at least once in their life. However, sometimes this injury goes completely unnoticed, without causing discomfort.
Partial rupture of ligaments. There is a decrease in the functionality of the joint, but performance is maintained. There are pain sensations, the joint reacts to external influences.
Complete rupture of the tendon. It is characterized by deformation in the joint area, the formation of hematomas, bruising, the inability to perform standard actions associated with the joint.

If complete rehabilitation after a rupture of the ligaments of the first degree of severity takes from two days to two weeks, then things are more complicated with the second and third points.

Important! If a torn ligament is suspected, it is necessary to keep the joint in a calm, immobile state until examined by a doctor. In no case should you reduce the dislocation or act on the fracture yourself! More often this leads to a deterioration in the condition and makes further recovery difficult.

Appointment of exercise therapy after rupture of ligaments

After diagnosing a gap specialist, a surgical or conservative method of treatment is prescribed. Regardless of the method chosen, exercise therapy is necessarily prescribed for better tissue healing.

Physiotherapy exercises are very popular in restoring the functions of damaged ligaments. This type of rehabilitation is considered one of the most effective, along with:

physiotherapy;
massage;
herbal treatment;
spa treatment.

Exercise therapy is prescribed by a specialist and is carried out under the supervision of a doctor.

Important! The gymnastics complex is divided into small blocks with a gradual increase in load. Basically, there are complexes of weekly rehabilitation after ligament rupture. You should not "jump" through the stages on your own, even if the load seems feasible! This often leads to re-injury.

Description of sets of exercises

Exercise therapy is a whole science, divided into small podcasts. That is, a separate recovery complex has been developed for each injury. There are several main locations of gaps and exercises for them:

Rehabilitation after rupture of the clavicle ligaments. If the acromioclavicular joint is damaged, gymnastics is started, on average, in the second week. Exercises should be carried out until a feeling of slight pain discomfort. In the prone position, slowly spread your arms 90 degrees, while standing, make rotational movements with your hands, raise your limbs straight.
Rehabilitation in case of rupture of the cruciate ligament of the knee. At the initial stages of recovery, it is recommended to conduct classes while sitting or lying down so as not to load the diseased joint. It is necessary to bend the injured leg at the knee, strain the thigh muscles, sitting on a hill, depict walking, lightly touching the ground. Increasing the load, you should perform semi-squats, holding on to the handrail, roll the load from heel to toe and vice versa, roll the ball on the ground.
Attention! The injured knee joint should be kept in a slightly flexed position during exercise to avoid excessive impact.
Rehabilitation after rupture of the ligaments of the shoulder joint. Rehabilitation of an injured shoulder is in many ways similar to the rehabilitation of an ACL tear. Exercises should be performed slowly and consistently. Sharp movements are excluded. Standing - rotation with straight arms, circular movements of the shoulders, throwing the ball with the removal of the shoulders, throwing the ball from the chest. Later, when the ligaments get used to the loads, push-ups are added. First from the wall, then full-fledged bench presses.

A possible set of exercises for rupture of the anterior cruciate ligament:

Exercises for torn posterior cruciate ligament:

Exercises in case of problems with the ulnar collateral ligament:

Exercise rules

Incorrect execution of the exercise program leads to a long rehabilitation, distorted fusion, and sometimes to a repeated rupture. To avoid such consequences, it is necessary to obey a small set of rules for performing the load:

The program of exercises for rehabilitation is compiled by the attending physician and must be carried out flawlessly according to the stages. Any independent addition is possible only with the permission of a specialist.
Each exercise is performed until slight pain. There should be no acute discomfort from the action. If the load seems unbearable, you should stop doing the exercise or this lesson as a whole.
To achieve the greatest effect, it is recommended to conduct a simple warm-up workout. In difficult cases, a regular heating pad will help warm up the necessary muscles. This is especially good for rehabilitation with a rupture of the anterior cruciate tendon in the knee.
If possible, deviations from the schedule should be excluded. Therapeutic gymnastics prefers constancy. If it is not possible to visit the exercise therapy room, it is recommended to conduct a lightweight version of the exercise at home. Be sure to notify the doctor about this and get personal recommendations.
Also, be sure to monitor the correct breathing. Cells equipped with sufficient oxygen tend to regenerate as soon as possible. Synchronized breathing increases the endurance of the body, allows you to adequately withstand the lesson from start to finish. During rehabilitation after surgery for torn ligaments of the shoulder joint, breathing exercises are an integral part of the loads. A disturbed breath in this case will lead to unpleasant stabbing sensations.
Despite the individual approach to each individual patient, it is recommended to work in groups. This contributes to raising the general tone, mood and the speedy assimilation of tasks.

Application of massage procedures

Massage is an excellent aid in repairing torn ligaments. It relieves inflammatory edema, promotes the resorption of hematomas, improves blood circulation in the area of injury, accelerates stagnant lymph.

But, depending on the localization of the injury, there are several basic rules for restorative massage:

During rehabilitation after a rupture of the knee ligaments. One of the most difficult is the massage of the knee joint. It requires special concentration, since with prolonged edema in the area of injury, fluid or excess blood accumulates in the joint bag. If you "run" - the consequences can be irreparable. To begin with, the quadriceps femoris muscle, which supports the joint, is affected. Movements are made with fingertips in a circle, then rubbing and bending of the joint is possible without using muscles. The main purpose of this procedure can be considered to tone the tissues, which will contribute to active blood flow and lymph resorption in the area of injury. Massage seems easy and accessible to independent performance, but it is not. For speedy rehabilitation after a rupture of the knee ligaments, it is better to turn to professionals.
When restoring a rupture of the shoulder joint. With a restorative shoulder massage, an additional need is to relieve swelling, as this can lead to fluid accumulation in the joint bag. Start to influence the shoulder joint should be gradual. First you need to stretch the muscles of the neck. It is allowed to knead the injured area for no more than 10 minutes. The movements should be stroking, kneading the front and back at the same time. The procedure is performed with the patient in a sitting position.
During rehabilitation after ankle injuries. Massage during stretching of the Achilles tendon is done by laying the patient on the couch, placing a small pillow under the injured limb. The effect is made by stroking, rubbing on both sides of the ligaments. However, when rehabilitating after a complete rupture, care must be taken with the pressure on the area of the injury so as not to damage it with too much girth. Massage on the ankle is always done from the bottom up for 3-5 minutes. The undoubted advantage of the procedure is the possibility of its independent completion.

All massage movements are performed with smooth, measured movements. For a better effect, warming up, special massage oil is used. Often used baby oil, such as Johnsense baby.

Finally

Ligament rupture is a very unpleasant phenomenon that requires a lot of time for rehabilitation. However, with patience and following all the doctor's instructions, you can get back on your feet in the shortest possible time (literally and figuratively).

The disease is characterized by hereditary predisposition. In the process of embryogenesis, there is a violation of the development of eye structures (Schlemm's canal and scleral veins), which are responsible for the outflow of intraocular fluid. The first signs of pathology appear after 40 years. The intraocular fluid accumulates in the anterior chamber of the eye, causing an increase in pressure.

Predisposing factors may be:

atherosclerosis;
hypertonic disease;
diabetes;
other pathologies of the eyeball;
osteochondrosis of the cervical spine.

A little about glaucoma and its causes

In the anterior chamber of the eye there is a special sac, which contains intraocular fluid that circulates through the eye and bathes its structures. If for some reason the fluid is retained there in large quantities, the pressure inside the eye increases, and glaucoma develops. The disease is most often diagnosed in the elderly and senile age, but such a pathology also occurs in young children, adolescents, and youth.

The main causes that provoke the appearance of glaucoma are age over 40 years, myopia, thin cornea, previous eye injuries or surgery on the organs of vision, overweight, hypertension, diabetes mellitus, long-term use of steroid drugs.

Glaucoma is open-angle and closed-angle. The first is diagnosed most often. It is she who becomes the cause of premature blindness, since for a long time it does not manifest itself with any symptoms.

Close-angle (narrow-angle) glaucoma, on the contrary, manifests itself with loud symptoms, so people often go to the doctor with this type of disease. Glaucoma is congenital, when a child is born with impaired intraocular pressure and normotensive, in which the pressure inside the eye does not increase, but damage to the optic nerve occurs.

The postoperative, aimed at recovery, period will be successful if you remember the following important contraindications:

within 7 days after the operation, do not allow liquid to enter the eyes;
do not strain your eyes (do not read, do not watch TV, etc.);
do not expose the organs of vision to bright light;
beware of colds, etc.

the spread of the infection;
development of the inflammatory process;
decrease in visual acuity;
increased sensitivity to light, etc.

You can maintain a normal state of health if you regularly see an ophthalmologist and fulfill all his appointments. In no case should you independently, without the permission of the doctor, change the dosage of medicines, arbitrarily cancel or prescribe medications. With glaucoma, a calm rhythm of life is needed, which does not allow unrest and nervous overload, a thoughtful daily routine, moderate physical activity, and rational nutrition.

Life after surgery

Quite often, eye damage occurs simultaneously with glaucoma and cataracts. It is possible to operate on a complex pathology, but there are a number of contraindications when it is forbidden to prescribe everything necessary for the operation:

lack of light sensation;
infectious lesions of the eye;
recent heart attack or stroke;
diabetes;
diseases of the central nervous system;
pregnancy and breastfeeding period.

A pregnant woman with glaucoma and cataracts can postpone surgery until the end of childbirth, and in the case of breastfeeding, until the end of breastfeeding.

Read on the topic: Is it possible or not to give birth with glaucoma?

Medications for glaucoma: what can and what can not?

With this disease, the prohibition to lie down on such medicines:

antihypertensive drugs;
Atropine;
drugs for vasodilatation;
nitrates;
analgesics;
antihistamines;
oral contraceptives;
Aspirin;
sleeping pills based on doxylamine - Donormil and Eunice.

For colds, patients with glaucoma, nasal drops should also not be used if they consist of phenylephrine, oxymetazoline, naphazoline or xylometazoline. It is recommended to replace such medicines with a solution of water with sea salt.

With glaucoma, such antihistamine sprays and drops as Aldecin, Allergodil and Nasonex, as well as sleeping pills - Sanval, Ivadal, are not contraindicated.

You may be interested in: At what myopia give disability?

In what case is it necessary to take pills for glaucoma?

If you are being treated or registered for glaucoma while being treated by another specialist, it is critical that you tell them you have an eye disease. The fact is that certain groups of medicines for glaucoma are contraindicated. These drugs include:

antidepressants;
antiparkinsonian drugs;
vasoconstrictor eye drops;
antiparoxysmal (anticonvulsant) drugs;
some analgesics;
oral contraceptives.

Tableted drugs for glaucoma are of auxiliary importance. Some of them, such as Diakarb and Furosemide, are used during an acute attack, they can quickly reduce intraocular pressure.

Drops form the basis of glaucoma treatment. Tablets are prescribed as pathogenetic therapy. They improve the outflow of intraocular fluid or reduce its formation indirectly. In addition, tablets can reduce the severity of factors predisposing to the development of glaucoma.

Consider the main tablet drugs for glaucoma

What lighting is contraindicated?

Lifestyle in glaucoma should be adjusted in such a way as to alleviate the course of the disease. First of all, significant temperature jumps should be avoided.

Do not stay outside for a long time in severe frosts, the same rule applies to summer heat. It is also not recommended to visit baths and saunas, which are characterized by high temperatures and can be harmful with increased intraocular pressure.

1 important rule is eye protection from the negative effects of ultraviolet radiation. Of course, it will not be possible to avoid sunny weather, so you can protect yourself with the help of special glasses with built-in filters.

At the same time, ordinary sunglasses will not give the desired result, but will only aggravate the situation by straining your eyes. You need to buy special products.

Another important rule is to reduce the amount of stress and try to avoid strong excitement. During significant mental stress, blood pressure rises, and with it the eye pressure. The same goes for irregular working hours, which can lead to overwork.

What not to do is to lift weights. A disease of the 1st degree completely limits any strength training. Of course, it is impossible to completely refuse physical activity and it is even useful to do light exercises, but heavy weight should be completely eliminated.

Glaucoma and a computer are poorly combined concepts, so you need to limit your time in front of the monitor. If there is no other way out, then all security measures should be taken in this case, namely:

A person who constantly works at the monitor should wear special glasses that reduce the negative impact on the eyes.
Work on the computer without fail only in bright light. In no case should the eyes strain.
You can not be in front of the monitor for several hours in a row without a break.

If glaucoma is diagnosed, then alcohol and smoking are automatically blacklisted. Of course, it is difficult to completely give up alcoholic beverages, and one glass of dry red wine will not hurt, but it is very important not to exceed the dose. As for smoking, this is a completely prohibited item.

In addition, you need to exclude all tonic drinks: strong black tea, coffee. Instead, you can drink chicory and green tea. Whatever stage of the disease is present, animal fats, easily digestible carbohydrates should be excluded from the diet and fluid intake should be controlled.

Some remarks also apply to medications. Drugs that are contraindicated in glaucoma should be excluded or dose reconsidered. These include:

Hypertensive drugs. It is not recommended to take medications that increase blood pressure. These include drugs that contain caffeine.
Vasoconstrictors. These include drugs that affect the blood vessels. They are often used for significant swelling of the mucous membranes.
Oral contraceptives. Hormonal drugs contribute to fluctuations in intraocular pressure.

Unfortunately, glaucoma is a very insidious disease and can lead to complete loss of vision. Many are wondering what to do to avoid such terrible consequences. Of course, it is to follow all the necessary rules, namely:

Do not disturb sleep patterns.
Rest during the day, especially with constant work at the computer.
The first hour after waking up, try to be in an upright position.
1 time in 2 months to undergo an ophthalmological examination.
Enrich your diet with fresh fruits and vegetables.
Do light exercise.
Use eye drops 1-2 times daily.
Always wear glasses.
Do not read at dusk and always have a bright light source.
To refuse from bad habits.
Be outdoors daily.
Avoid constant bending. This is especially true for gardeners.
Do not lift anything that weighs more than 5 kg.
Do not take any medications without first consulting an ophthalmologist.
Control weight.

Life with glaucoma will be much easier if you take the above warnings seriously. If you ignore the rules, you can completely lose your sight, which no operation can restore.

Patients with glaucoma should not be exposed to direct sunlight for too long. Before going outside, you need to wear special glasses with green lenses to protect against ultraviolet radiation.

As for poor lighting in the room, here the contraindications include:

pitch darkness during sleep;
turned off or weak light while watching TV;
a long period when the eyes are in the dark.

With this ailment, the golden mean in lighting is important - not too bright light, but not complete darkness.

Glaucoma is a fairly common eye disease. If it is not treated, then a person with such a diagnosis may partially or completely lose his sight and remain blind.

The difficulty of treating this problem is that it is diagnosed at the later stages of development, since it is almost asymptomatic. Contraindications for glaucoma also complicate life, but do not cause discomfort. Before you understand how life will change with glaucoma, what is possible and what is not, you need to understand what it is.

The cause of this disease is increased internal pressure of the eye, but there are types of glaucoma with normal pressure. The front of the eyeball contains a sac of fluid that circulates and bathes nearby tissues. There is a pouch between the lens and the cornea. When a failure occurs and the outflow of fluid slows down, it begins to accumulate. As a result, the pressure builds up and affects the nerve endings responsible for vision.

Pathology can be detected from birth or in childhood, but most often occurs in the elderly.

Glaucoma has several varieties.

Here are some of them:

Open-angle view. The most common type of disease. The second name is a quiet thief of vision, since it is completely asymptomatic. The pressure grows, but the cornea adjusts to it, without giving out such a “neighborhood” in any way;
Closed-angle view or narrow-angle. In this case, the normal circulation of washer fluid is possible only at a front chamber angle of 30 degrees. The front corner of the chamber is the place through which the liquid flows out;
Congenital type or infantile. The child is born already with an eye defect;
childish look. The disease develops in childhood;
Normotensive look. In this case, nerve damage occurs without increased intraocular pressure. The reason for this has not been identified.

Common causes of the development of the disease:

Racial affiliation. Most often, the open-angle form suffers from black people. They have an 8 times higher risk of getting the disease than white people;
Age. As mentioned above, glaucoma affects older people, although there are cases of a “younger” diagnosis. For every 10,000 children, only one child is ill;
Thin cornea. An interesting fact: the Negroid race has a thinner cornea than Asians;
Myopia. People with nearsightedness are more likely to get glaucoma as well;
Trauma, eye surgery.

Of course, these are not all reasons. Doctors also call obesity, malnutrition, steroid use, high blood pressure, diabetes, and others.

Unfortunately, patients seek help when the disease is in its "full flowering".

In this case, patients report the following symptoms:

loss of peripheral vision;
the appearance of multi-colored circles before the eyes;
the appearance of a blurry or foggy spot;
long-term adaptation when changing lighting;
slow loss of vision.

If you find any symptom in yourself, immediately seek help from an ophthalmologist.

People who have been diagnosed with such an unpleasant disease will have to live by certain rules. Leading a new way of life is not so difficult, sooner or later it will become a habit, but first you need to be careful.

Here are a few rules that are required to maintain good vision.

Dream. In a dream, a person spends a third of his life, so it is important to take care of the correct position of the head. You need to sleep on a pillow so that the pressure in the eye does not increase. It is also recommended to purchase a sofa or bed with a raised headboard.
Alcohol consumption. Strong alcoholic drinks are contraindicated, but this does not mean that during the feast you will have to do without alcoholic drinks. A glass of wine won't hurt.
Smoking. But doctors have a different attitude to tobacco. The patient will have to give up the bad habit, as it negatively affects the eyes and not only.
Nutrition. The menu, if possible, should be dietary. What does this mean? Doctors do not advise eating smoked dishes, fatty, pickled foods with a lot of spices. Meat is allowed to be eaten boiled or baked. The same goes for vegetables.
Weight tracking. It was previously mentioned that excess weight is one of the causes of glaucoma. Therefore, you will have to lose weight. Fat people should exclude flour products and sweets from the menu, replacing them with fresh fruits and vegetables. If the patient does not have extra pounds, then he needs to continue to follow the figure.
Water balance. According to all the rules of a healthy diet, a person should drink at least 1.5 liters of clean water per day. But with glaucoma, this cannot be done! In this case, the total volume of water should not exceed 1 liter. And this is taking into account coffee, tea, drinks, broths! Be careful.
Reading, embroidery and other small work. In principle, there are no contraindications, the only thing worth watching is the lighting. It should be bright enough, but not blinding. Also take breaks.
Lighting. Actually about the world. Do not hang dark curtains in the apartment that prevent the penetration of daylight. Do not watch TV with the lights off at night. In a word, do not save on electricity.
Computer work. If you sit in front of a monitor a lot, be sure to take breaks of fifteen minutes every hour. By the way, such a regime is prescribed by the Labor Code even for healthy people.
Profession. The less stress, the better! If the work does not bring pleasure, but only spoils the nerves, it is better to change it.
Playing musical instruments. Glaucoma will make a big difference for those people who play wind instruments. They will have to transfer to the guitar or piano.
Visits to the sauna or bath. Not recommended, but not prohibited. The main thing is not to do it too often and ration the time spent in the steam room.
As for physical activity, gymnastics, sports, such activities, on the contrary, improve the general condition of the body. Hence the eye. The main thing is a sense of proportion.
Outdoor walks are also needed. You can't stay indoors all the time.

Complications of glaucoma

Chronically elevated intraocular pressure, especially in the absence of adequate treatment and preventive measures, is fraught with dangerous complications. The main of them are violations of trophism (nutrition) of the tissues and structures of the fundus, as a result of which dystrophic and atrophic changes develop, which can lead to loss of vision as such. The relatively slow and, in some cases, almost asymptomatic progression of glaucoma is one of its most insidious features: the patient seeks ophthalmic care already with severe visual field disorders, advanced pathology of the retina and/or optic nerve head.

Terminal pain (sometimes called “painful”) glaucoma develops in the later stages of the process and is accompanied, as the name implies, by a pronounced pain syndrome, as well as photophobia, blepharospasm, and intense lacrimation. Painful sensations are painful and persistent; The outcome of terminal glaucoma is blindness.

It is needless to emphasize that the therapy of glaucoma (as well as any other disease) is much more effective and promising in the early stages than in a state of neglect for many years and in the presence of gross organic changes in the tissues. Thus, loss of vision due to atrophy of the optic nerve is irreversible, and even surgery in such cases acts only as a palliative, purely symptomatic treatment: the goal is to eliminate the pain syndrome, which is no longer stopped by other means. At the same time, not in every situation it is possible to save the eyeball - enucleation is often performed.

Specialists of the ophthalmological center "MGK-Diagnostic" have extensive clinical experience and have the most modern equipment necessary for the diagnosis and treatment of glaucoma at its various stages. Highly qualified care is provided to patients with any forms and complications of this severe ophthalmic disease.

A prolonged increase in intraocular pressure leads to disruption of the normal nutrition of eye tissues. This leads to complications:

deterioration of central and peripheral vision,
blindness.

Terminal painful glaucoma is a serious complication that is an unfavorable outcome of the disease. It is characterized by blindness of the affected eye. At the same time, a corneal syndrome develops with photophobia, painful spasm of the eyelids, and lacrimation. Pain in terminal glaucoma can be so intense that it deprives the patient of rest and sleep.

Treating complications of glaucoma is much more difficult than the initial stages of the disease. If blindness associated with optic nerve atrophy develops as a result, it is impossible to restore vision. The task of the doctor in this case is to help in the relief of pain with the help of surgery. Organ-preserving surgery is not always possible. If such an operation is contraindicated, in some cases it is necessary to enucleate the eye, i.e., remove it.

It was previously stated that high blood pressure, if treatment is not followed or not, leads to serious complications. Predominantly, malnutrition of tissues and structures develops, this leads to dystrophy, and then to atrophy of the eye, the result of which is loss of vision. There is excruciating pain in the eye area, in this case, the therapy against the pain syndrome will be the removal of the eye with the injured nerve.

Loss of an eye and blindness are the worst complications of glaucoma. To exclude such complications, it is enough to adhere to the appointments and instructions of the attending ophthalmologist, take into account all possible contraindications and not self-medicate.

In conclusion, we note that glaucoma is a disease that makes life difficult. With this unpleasant disease, patients have to constantly control themselves and their actions, taking into account a large number of contraindications, but such work on themselves and their surroundings gives a chance to maintain vision for a long time, as well as the ability to stop the development of the disease and prevent yourself from going blind.

Bad habits for glaucoma: alcohol and cigarettes

Alcohol constricts blood vessels and increases both blood pressure and intraocular pressure. As a result, the outflow of fluid is disturbed and the optic nerve is pinched. So alcohol increases the risk of development and progression of this disease.

Smoking affects no less negatively, affecting the optic nerve with toxic substances and causing its atrophy. Tobacco products and glaucoma are incompatible. The same applies to electronic cigarettes and hookahs, both with a weak dosage and a strong one.

Nutrition for glaucoma

The diet for this eye disease is somewhat reminiscent of nutrition for hypertension. Should:

avoid excess food intake;
limit the amount of water and other liquids you drink per day;
exclude dishes with a high content of fat from the diet (including such dairy products as cream, sour cream, butter, etc.), strong meat broths;

it is not recommended to use smoked dishes, foods with a high content of salt, spices;
do not include carbohydrate-rich foods (sweet and starchy foods) in the diet;
give up tea and coffee;
Alcoholic beverages that cause constriction of blood vessels and intoxication of body tissues are strictly prohibited.

With glaucoma, one should not drink more than 200 ml of liquid at a time, and the total amount of water per day should be equal to 1.5 liters, and evenly distributed throughout the day. Fluid should enter the body slowly. Its increase in the daily diet leads to excessive formation of moisture inside the eye and an increase in intraocular pressure.

It is important to plan your diet in such a way that the intestines function normally and constipation does not occur, which is dangerous for glaucoma diseases.

With glaucoma of any form, you should avoid or at least limit the use of salty, pickled, fatty foods, as well as sweets. The systematic use of alcoholic beverages is a direct danger and is categorically contraindicated.

Nutrition does not change much with glaucoma. All that is needed is to follow a few simple rules: frequent consumption of spicy, salty, fatty and fried foods is not recommended.

Processed cheeses, canned food and sausage are contraindicated for consumption, they contain a large amount of salt, which retains water in the body. Drinking coffee and strong tea no more than 1-2 cups per day. Instead of these drinks, preference is given to fruit vitamin tea and fruit drinks. Foods rich in vitamins A, B, C, E are also beneficial - lean meat, white fish, beans, cottage cheese, hard cheeses, cereals, vegetables and fruits.

Nutrition affects human health, especially a sick person. High salt content in meals, the predominance of spicy, fatty and fried foods that cause an increase in IOP - these foods are a contraindication in the diet for people suffering from glaucoma.