Treatment protocol: Grade II patellar tendon tendinopathy

This treatment protocol allows the recovery and rehabilitation of the tendon of the muscles involved. Also taking aim at therehabilitation of the athlete for the prevention of clinical recurrence.

PHASE 1:

Objective: To decrease the pain

Promote healing

Educating the athlete

Treatment: (follow the directions listed above) Flexibility slow and progressive, interesting the quadriceps, but not forgetting thelater chains, particularly the hamstrings.

Strengthening muscle range of motion without pain and closedkinetic chain.

Overall strengthening of the lower limb, especially the pelvic girdle.

Initiation of work isometric quadriceps.

PHASE 2:

The athlete, so this stage is when: do not feel pain at rest,diminiuçao significant pain to palpation, without pain in dailyactivities.

Objective: To increase the strength

Increase flexibility

Control inflammation

Treatment: Strengthening isometric

Stretching more aggressive and biarticular

Closed kinetic chain exercises (more intense)

Home working endurance / resistance (swimming, cycling, helical or machine-country skiing.

Proprioception-tablets of unstable equilibrium or trampoline.

PHASE 3:

For this phase, the athlete can not feel pain on a daily basiswithout pain in the race, and strength in the quadriceps of 70/80% of the contralateral side.

Objectives: Resumes sport without pain, as I said before, to educate the athlete for the prevention of not having a relapse.

Maintain strength and flexibility.

Treatment: Exercises for flexibility more aggressive

More intense muscle building, evolving work in isokinetic

Racing program specifies the activity (soccer).

Aerobic and anaerobic work.

MESOTHERAPY SESSION: Chronic tendinopathy Grade IIpatellar TENDON

In this treatment was administered a drug (not chemical), withcompletion to help decrease the inflammation of the patellartendon. After this session, the patient was subjected to further treatment, and transition to the stage: Stage 2.

Anatomy of the Knee

The knee joint is an intermediate of lower limb, and has a major function of human locomotion. It is very important to have a full knowledge of this joint, which requires a combined effort of several disciplines such as anatomy, biomechanics, physiology, surgery and orthopedic surgery in particular.

The knee joint is mobile and stable. As anatomical construction, consists of two functional joints, femoral-tibial articulation (AFT) and the patellofemoral joint (AFP), which allows flexion and extensive, as the rotation when flexed, allowing you to zoom in oraway from the extreme member of its root, namely to regulate the distance that separates the soil body. Essentially, this joint work compressed by the weight it supports.

Moving a little forward, the menisci provide a small increase in stability, since they themselves are unstable. The stability of the knee, depends largely on soft tissue, ligaments, capsule and muscles. This joint is one of the most flexible of the human body.The proper function is closely related to the integrity of the ligament.

In the inner and outer compartments of the menisci are fibrocartilaginous joint. The anterior cruciate ligament (ACL) prevents the excessive slippage of the tibia relative to the femur, the posterior cruciate ligament (PCL) prevents excessive slipping back of the tibia relative to the femur. The patella increases the effect of quadriceps muscle. This muscle and its tendinous expansions contribute greatly to the stabilization and knee function. The earliest clinical indication of a knee injury and atrophy.

From the mechanical point of view, the knee joint to balance two conflicting imperatives:

- Have a great stability in full extension, a position which supports the significant pressure due to body weight and length of the lever arm.

- Allow a high degree of mobility from one degree of flexion, which is necessary in the race for optimal orientation of the foot in relation to the irregularities of the ground.

These contradictions make it possible to solve thanks to ingenious mechanical devices.

The stability of the reduced coupling of the articular surfaces, a necessary condition for good mobility, exposes the joint lesions.

Most post-traumatic osteoarthritis in middle age or older results from minor soft tissue disorders, particularly the menisci.

Partial rupture of the ACL

Anterior cruciate ligament (PARTIAL RUPTURE)

Injury to the anterior cruciate ligament (ACL) remains a major challenge to orthopedic community.

Early diagnosis, evaluation and treatment are constantly discussed in the literature, without agreement between the authors note, especially as it relates to the interpretation and prognosis of these lesions.

The search for explanations for these differences encouraged me to study, and this chapter helped me to a better understanding of ACL injuries, especially injury defined as partial, rarely addressed in the literature, with conflicting results and interpretations.

Obviously, many of ligament injuries in professional athletes, are in fact extremely serious. But as I mentioned in earlier texts, we can not look at each one of them equally, ie a face as more damage and give this recipe for "cake".

In most instances of partial ACL tears, I have observed many experts in health reporting as the only solution and without any hesitation as the only alternative to surgery. (Not all cases should be directed to the "only way")

What I completely disagree, and think it's no harm trying to evolve a little more on sports medicine.

Reporting this with practical examples. When an athlete come to me, is making medical monitor (RM) and had some despair. For it had been observed by a health professional, who seeing the same tests that I had to watch later, the doctor had told him no doubt he would have to undergo a surgical intervention. (Which implies a long break without doubt to the athlete). When I saw the same tests, I performed some tests, I spoke with the athlete and he proposed a treatment protocol for 8 weeks (with the help of Mesotherapy). The athlete immediately accept the protocol that I proposed, and proceeded to work. At the end of seven weeks, the athlete was advised to conduct a new examination in order to observe the evolutionary process of recovery. The result of the 2nd MRI was the opposite of the 1st, while the first test was declared a ruptured part of the ACL, the second was not mentioned any injury to the ACL, here the merit also goes to the athlete who quite sure about the protocol trace. (The protocol basically consisted in the administration of drugs with the help of mesotherapy, which accelerate the healing process of tissue).

This is simply my story is the fact: we will not subject the body to asurgical intervention for everything and anything. For everythingyou need to grow and evolve, and good professional is one who has full knowledge of its limitations (no one who does not have them!). I say this with some sadness, because I have seen many athletes subject to fewer own diagnosis and treatment for theirdiseases in their own clubs.

The Athlete is an F1

- This is a theme to which I have since I struggle a lot in my life. In any professional field, you can not (or should not), drop to room. I have my own professional routines, like any other mortal. but as I mentioned before in other matters, that "a good professional is one who has the knowledge of their own limitations." So each step / task that my professional knowledge are required, always try their best to reduce my limitations, so with that attitude, consciously or "unconsciously," I do not fall into monotony professional.

As I speak from now on, the reader can only interpret what I refer to the soccer player, what is not true, just use the soccer athlete because it is an example to which I can speak with better knowledge of the facts. For respect and admire all the other sports.
- When I say that to me one athlete has to be considered as an F1, is a reality, because not only perform the examinations pre-season, etc ... Every workout sessions for individual work, play, the athlete must be heard by the accompanying clinical department in order to get the best athlete's own, as put down any symptoms at least good that he can report (as a pilot F1 does with his mechanics and other members of your team).Behind an athlete, this is a human being, not being professional has its physical wear, being professional, wear your turns out to be a large percentage too high, because the physical effort turns out to be every day. Often not controlled.
- Many trainers, training in Portugal to the "highest level", is often complain of physical fatigue of his team. If for example, have a game in the 4th or 5th Tuesday, and are playing the following Sunday, the coaches always comment the same: "the team had no time to recover" (something very heard in our country, which until now is found normal and no one says otherwise). What I criticize in this very lack of professionalism "in this field," it just shows how badly it works. I was able to work in a team of Spanish professional cycling, where "a" cyclist is 220km in one day, accomplish more the next day 180, 190, or 200 km, this sometimes 4 days or more followed. The Secrete, called WORK because at the end of each step cyclists are subject to an outstanding recovery work.
In our football at the highest level, 98% of the teams work as amateurs (with respect to recovery). For example, if the teams play at home at the end of the meeting is held only primary care, we take a shower, and ok, all ready to slip inside the cars and return to their homes because in most cases there is only returning to work in the afternoon the next day (rarely in the morning). It is clear that these procedures the recovery levels of athletes, are mediocre. Now do a good job of recovering athletes takes work, but also gives SUCCESS! How to remember the 190 and 220km of cyclists I spoke, on consecutive days, also remember to see the end of many meetings or substitutions, the soccer player (X) has 8 or 10km around the ninety-odd encounterminutes, and spent 3 or 4 days we have our coaches talking about athletes who have tired, because there was no recovery time. Ironic but true!
It is obvious that there are coaches who should occupy the entire recovery of their athletes, but the whole doctor who is behind the scenes. Because the team is not only coach and players, but your entire staff, technical and clinical. The success appears to work, and periodic maintenance / permanently from their F1. An athlete and physically, with all its contents upon the physical and emotional, is really another athlete.
- In many cases in our clubs, with the lack of monitoring athletes (some of them well known names in our football and Europe), and over time, the complaints of athletes appear with your clinical department. And in many cases, some professionals in the health field is no longer able to solve in a short time. What would be avoided if the monitoring was permanent. Who pays this invoice, is the athlete who faces a prolonged stoppage, damaging her career (in many cases), and through no fault of their own, but other actors involved or not, as you prefer!
In the sports area, the term applies in this area of ​​Physical Therapy Sports Rehabilitation and Physical Therapy not only (has to be for some reason, not by chance).

- In the next post here on the blog, I speak as one can see or control the fitness levels of athletes without great physical suffering. Same as F1 when we see and admire your performance and that every year we surprised everyone.

Possibly, many readers are commenting, this is nothing new. I answer, if it is not, why not apply?