How do you heal tennis elbow fast?

Most people who get tennis elbow don’t play tennis! In fact, less than 5% of all tennis elbow cases occur in people who play the sport. Tennis elbow, also known as lateral epicondylitis, is

a type of tendinitis (swelling of the tendons) that causes pain in your elbow and arm. These tendons are bands of tough tissue that connect the muscles of your lower arm to the bone.

Tennis elbow can happen to anyone who repeatedly uses their elbow, wrist, and hand for their job, sport, or hobby. Physical therapists help people with tennis elbow gently heal the affected areas, build muscle strength, and avoid further injury. And, according to a new study, choosing physical therapy for tennis elbow outperforms steroid injections and is cost-effective.

The main symptom of tennis elbow is pain and tenderness in the bony knob on the outside of your elbow. This knob is where the injured tendons connect to the bone. The pain may also radiate into your upper or lower arm, and you can have tennis elbow in both arms. Although the tendon damage is in your elbow, you’re likely to feel pain when doing things with your hands.

Tennis elbow pain may be most intense when you:

  • Lift something
  • Make a fist or grip an object, such as a tennis racket
  • Open a door or shake hands
  • Raise your hand or straighten your wrist

Despite the name, you can get tennis elbow even if you’ve never been near a tennis court. Any repeated arm movement can inflame your tendons. Tennis elbow is the most common reason for elbow pain. It can pop up in people of any age, but it most hits people between ages 30

and 60. Tennis elbow usually develops over time. Repeated motions, like gripping a tennis racket during a swing, can strain your muscles and leave the work up to your tendons, causing them to become inflamed and ripe for microscopic tears.

For the first 24 to 48 hours after acute onset of your pain, your Tennis Elbow Treatment may include:

  • Resting the arm by avoiding certain activities and modifying the way you do others.
  • Applying ice treatments to the affected area.
  • Using elastic bandages or supports to take the pressure off the painful muscles.

Your physical therapist at Vitruvian Italian Physiotherapy Center will decide if a brace or support to protect your muscles will aid your healing.

After the First 48 Hours, a Tennis Elbow Treatment program specific to your needs to speed your recovery will begin. They may use treatments such as:

  • Manual (hands-on) therapy.
  • Special exercises to relieve pain.
  • Ice or heat treatments, or both.

They also will design an exercise program to help correct muscle weakness that you can continue at home.

At Vitruvian Italian Physiotherapy Center your program will include:

Improving mobility. Your physical therapist may use manual (hands-on) therapy, such as massage or other techniques. This treatment helps to reduce tightness in the soft tissue and joints to enable your joints and muscles to move more freely with less pain.

Improving strength. Lack of muscle strength can lead to tennis elbow. Sometimes the weakness is in the muscles of the wrist and forearm. In many cases, the problem stems from weakness of the supporting postural, or “core,” muscles. In fact, you might find that you need to improve your overall level of fitness to help manage your elbow condition. Your physical therapist will work with you to determine the type and amount of exercise that is right for you.

Physical therapists prescribe several types of exercises during recovery from tennis elbow:

  • In early treatment, when the pain is most intense, your physical therapist may perform gentle passive exercises for you. They will carefully move your wrist and elbow without straining the involved muscles.
  • As your symptoms improve, you can begin to perform active exercises yourself, moving your wrist and elbow without assistance. Your physical therapist will guide you, to ensure your safety.
  • As the muscles become stronger and your symptoms lessen, you may begin using weights or resistance bands to further increase your strength. Your physical therapist will carefully monitor your exercises to help you make progress and avoid reinjury.

Your physical therapist will help you stay active by teaching you how to modify your activities to avoid pain and injury. Sometimes it’s necessary to make changes at work, on the playing field, or at home. Your physical therapist can help you make changes to your work site, your computer setup, kitchen devices, sports equipment, and even your gardening tools to lessen the strain on your hand, wrist, and forearm. They will emphasize the importance of taking stretch breaks, so that your muscles get frequent rest from repeated movements and positions.

For an “acute” case of tennis elbow (one that arose in the past few weeks) it is important to get treatment as early as possible. If left untreated, tennis elbow can become chronic and last for months or even years. This is especially true if treatment focuses only on relieving pain and not on correcting the muscle weakness and bad habits that likely led to the condition.

Research has shown that physical therapy can help people with tennis elbow improve their pain and function. In a recent study, researchers calculated the economic impact of choosing physical therapy for tennis elbow over steroid injections. They found that doing so saves $10,739, including all the hidden costs of your time, pain, missed life events, and the dollars paid for services.

If your tennis elbow is severe, your physical therapist may recommend that you consult with another health care provider for more testing or additional treatment. In rare cases, a cortisone injection or surgery might be needed. Your physical therapist can help you determine whether you need a referral to another health care provider.

How long it takes to recover from tennis elbow depends on the extent of the damage to your tendon and your treatment.

But don’t rush the healing process. If you start pushing yourself to use your arm too early, you could make the damage worse.

You’re ready to return to your former level of activity when:

  • Gripping objects or bearing weight on your arm or elbow is no longer painful.
  • Your injured elbow feels as strong as your other elbow.
  • Your elbow is no longer swollen.
  • You can flex and move your elbow without any trouble.

To learn more about Tennis Elbow Treatment, please visit our dedicated page here: Tennis Elbow Treatment

What is the fastest way to cure sciatica?

Sciatica, a radiating pain that travels along the path of the sciatic nerve, can be a debilitating condition. The sciatic nerve, the longest nerve in the body, runs from the lower back through the buttocks and down the leg. When the sciatic nerve becomes irritated or compressed, it can cause a shooting, burning, or tingling pain that significantly impacts mobility and quality of life. While a “cure” for sciatica might not exist, there are several effective strategies to achieve fast relief and prevent future flare-ups. Here at Vitruvian Italian Physiotherapy Center, a leading physiotherapy center in Dubai, we understand the urgency of finding relief from sciatica. In this blog post, we’ll explore various approaches to expedite your recovery and empower you to manage sciatica effectively.

Causes and Symptoms

The most common cause of sciatica is a herniated disc in the lower spine. When the soft cushion between the vertebrae bulges or ruptures, it can press on the sciatic nerve, triggering pain. Other potential causes of sciatica include:

  • Spinal stenosis (narrowing of the spinal canal)
  • Piriformis syndrome (muscle tightness in the buttocks compressing the nerve)
  • Degenerative disc disease (wear and tear of the spinal discs)

The hallmark symptom of sciatica is pain that radiates along the path of the sciatic nerve, typically starting in the lower back and traveling down one leg, sometimes reaching the foot. The pain can be sharp, burning, or tingling, and might be accompanied by:

  • Numbness or weakness in the affected leg
  • Difficulty walking or standing for prolonged periods
  • Pain that worsens with certain movements (e.g., sitting, bending forward)

Effective Options at Vitruvian Italian Physiotherapy Center

Following the initial pain management phase, our physiotherapists might recommend various sciatica therapies to promote healing and prevent future flare-ups:

  • Physical Therapy: This forms the cornerstone of sciatica treatment. Our therapists will design a personalized program focused on:
    • Manual therapy techniques: Techniques like massage, joint mobilization, and neural gliding can help reduce inflammation, improve nerve mobility, and alleviate pain.
    • Stretching exercises: Stretching tight muscles in the lower back and legs can improve flexibility and reduce pressure on the sciatic nerve.
    • Strengthening exercises: Strengthening the core and gluteal muscles can improve overall spine stability and support, preventing future nerve compression.
  • Spinal Decompression: This therapy utilizes specialized equipment to gently stretch the spine, creating space between the vertebrae and potentially relieving pressure on the sciatic nerve.
  • Sciatica Pain Relief Massage: Our physiotherapists might incorporate targeted massage techniques to improve circulation, reduce muscle tension, and promote pain relief. However, this is usually not the first line of treatment.

In addition to the therapies provided by our team, there are steps you can take to manage your sciatica and expedite your recovery:

Maintain proper posture: Maintaining good posture while sitting, standing, and lifting objects can significantly reduce stress on your spine and sciatic nerve.

Apply heat or ice: Applying heat or ice packs to the affected area for 15-20 minutes at a time can help manage pain and inflammation.

Maintain a healthy weight: Excess weight puts additional strain on your spine and can aggravate sciatica symptoms.

Stay active: Regular physical activity, even low-impact exercises like walking or swimming, can promote healing and prevent muscle stiffness. However, avoid activities that aggravate your pain.

Sciatica doesn’t have to control your life. With a prompt diagnosis, personalized treatment plan, and commitment to self-care strategies, you can achieve significant pain relief and regain control. At Vitruvian Italian Physiotherapy Center in Dubai, we’re dedicated to helping you manage your sciatica effectively. Here’s what sets us apart:

Experienced and Certified Physiotherapists: Our team comprises highly qualified and experienced physiotherapists who stay updated on the latest advancements in sciatica treatment.

Evidence-Based Treatment Approaches: We utilize treatment methods supported by scientific research and proven to be effective in alleviating sciatica pain and promoting long-term recovery.

Personalized Care: We understand that every case of sciatica is unique. We tailor our treatment plans to your specific needs, severity of your condition, and lifestyle factors.

Patient-Centered Approach: We believe in clear communication and collaboration throughout your journey. Our physiotherapists will explain treatment options in detail, answer your questions, and involve you in the decision-making process.

Focus on Long-Term Well-Being: Our goal extends beyond immediate pain relief. We’ll equip you with the knowledge and tools to manage your sciatica effectively and prevent future flare-ups.

To learn more about Sciatica Treatment, please visit our dedicated page here: Sciatica Treatment

Can an ACL heal without surgery?

The anterior cruciate ligament (ACL) is a crucial stabilizer in the knee joint, preventing excessive forward movement of the shinbone relative to the thighbone. A torn ACL, often a result of sports injuries involving sudden pivots or stops, can significantly impact mobility and stability. While surgery is a common treatment option for ACL tears, many people wonder: “Can an ACL heal without surgery?”

The answer depends on the severity of the tear and your individual goals. At Vitruvian Italian Physiotherapy Center, a leading physiotherapy center in Dubai, we understand the challenges associated with ACL injuries.

Understanding ACL Tears: Severity Matters

ACL tears come in varying degrees of severity, ranging from minor microtears to complete ruptures. The extent of the tear significantly influences the potential for non-surgical healing.

Partial Tears: In some cases, the ACL might experience a partial tear. While still causing pain and instability, these tears have a higher chance of healing without surgery, especially with proper rehabilitation.

Complete Tears: A complete ACL tear disrupts the ligament entirely, significantly compromising knee stability. Complete tears usually require surgical intervention for optimal long-term outcomes.

Factors Affecting Non-Surgical Healing

Several factors influence the feasibility of non-surgical healing for an ACL tear:

Age: Younger individuals with a higher healing capacity might be better candidates for conservative treatment compared to older adults.

Activity Level: Individuals with lower activity levels and less demanding physical requirements might manage well with a non-surgical approach, focusing on regaining stability and function for daily activities.

Ligament Quality: The overall health and quality of the ACL tissue before the injury can influence its healing potential.

Extent of Associated Injuries: If the ACL tear is accompanied by damage to other knee structures like meniscus cartilage, surgery might be necessary for comprehensive repair.

Living an Active Life: Considerations for Non-Surgical ACL Treatment

While non-surgical treatment can be successful for some individuals, it’s important to understand the limitations:

Recovery Timeline: Non-surgical healing typically takes longer than surgical repair. Be prepared for a dedicated rehabilitation program that might last several months.

Activity Level: Non-surgical treatment might not be suitable for athletes or individuals with very active lifestyles that demand high levels of knee stability.

Long-Term Complications: There’s a higher risk of long-term knee instability with a non-surgical approach compared to surgery, potentially leading to future joint degeneration.

At Vitruvian Italian Physiotherapy Center, we believe in a collaborative approach to ACL injury management. Following a comprehensive evaluation, our physiotherapists will discuss the pros and cons of both surgical and non-surgical treatment options. We’ll consider your individual circumstances, activity level, and goals to recommend the most suitable approach for your recovery.

To learn more about ACL Injury, please visit our dedicated page here: ACL Injury Treatment

How do you get rid of tennis elbow fast?

Tennis elbow, medically known as lateral epicondylitis, is a common condition causing pain and tenderness on the outer elbow. It’s often associated with repetitive motions that strain the forearm muscles that attach to the elbow bone. While the name suggests a connection to tennis players, anyone involved in activities that require gripping or forceful wrist extension can develop tennis elbow.

The good news? You don’t have to live with the discomfort. Here at Vitruvian Italian Physiotherapy Center, a leading physiotherapy center in Dubai, we understand the frustration tennis elbow can cause.

The repetitive motions that strain the forearm extensor muscles can lead to tiny tears in the tendons that attach these muscles to the elbow bone. This micro-tearing causes inflammation and pain, the hallmark symptoms of tennis elbow.

Here are some common activities that can trigger tennis elbow:

  • Repetitive gripping motions (e.g., using screwdrivers, painting)
  • Weightlifting (especially exercises that involve wrist extension)
  • Certain racquet sports (tennis, badminton)
  • Typing for extended periods

While there’s no magic bullet for a speedy recovery, several effective tennis elbow treatment options can significantly reduce pain and improve function. At Vitruvian Italian Physiotherapy Center, our experienced team will design a personalized treatment plan based on your specific needs and severity of your condition. Here are some common approaches we incorporate:

  • Rest: Avoiding the activities that aggravate your symptoms is crucial for allowing the inflammation to subside. Our physiotherapists can advise you on activity modification techniques to facilitate healing.
  • Ice Therapy: Applying ice packs to the affected area for 15-20 minutes at a time, several times a day, can help reduce pain and inflammation.
  • Compression: Wearing a compression elbow brace can help support the injured tissues and minimize pain during activity.
  • Pain Medication: Over-the-counter pain relievers like ibuprofen or acetaminophen might be recommended to manage discomfort.

Tennis Elbow Therapies: Advanced Options at Vitruvian Italian Physiotherapy Center

In some cases, depending on the severity of your condition and how long you’ve been experiencing symptoms, our physiotherapists might recommend additional tennis elbow therapies:

  • Ultrasound Therapy: Ultrasound waves can promote healing and reduce inflammation in the affected tissues.
  • Laser Therapy: Low-level laser therapy can stimulate tissue healing and pain relief.

Preventing a Comeback: Tips to Keep Tennis Elbow at Bay

Once you’ve recovered from tennis elbow, it’s important to take steps to prevent it from returning. Here are some tips from our team at Vitruvian Italian Physiotherapy Center:

  • Maintain proper form: Ensure proper technique during activities that involve gripping or forceful wrist extension. A physiotherapist can guide you on proper form and recommend modifications if needed.
  • Warm-up and cool-down: Always warm up your forearms and wrists before engaging in activities that might strain them. Similarly, cool down with gentle stretches after strenuous activities.
  • Strengthen your forearms: Regularly incorporating forearm strengthening exercises into your routine can help prevent future injuries.
  • Listen to your body: Pay attention to any pain you experience during activities. Take breaks and modify your intensity if necessary to avoid aggravating the condition.

Here’s what you can expect during your initial consultation at Vitruvian Italian Physiotherapy Center:

  • Detailed assessment: Our physiotherapist will conduct a thorough evaluation, including a physical examination and discussion of your symptoms, medical history, and activities that might have contributed to your tennis elbow.
  • Diagnosis and treatment plan: Based on the assessment, the physiotherapist will diagnose your tennis elbow and create a personalized treatment plan tailored to your specific needs and severity of your condition.
  • Open communication: We believe in clear communication throughout your treatment journey. Our physiotherapists will explain the treatment plan in detail, answer any questions you might have, and involve you in the decision-making process.
  • Education and self-care: We empower you with knowledge and self-care strategies to manage your condition effectively. You’ll receive guidance on activity modification, proper form during exercises, and techniques to prevent future flare-ups.

Don’t let tennis elbow hold you back from enjoying your activities. Contact Vitruvian Italian Physiotherapy Center in Dubai today to schedule an appointment and take the first step towards a pain-free and active life.

We look forward to helping you overcome tennis elbow and achieve optimal health and well-being.

To learn more about Tennis Elbow Treatment, please visit our dedicated page here: Tennis Elbow Treatment

Relieve, Restore, Renew: Tackling Lower Back Pain in Dubai with Vitruvian Physiotherapy Center

At Vitruvian Physiotherapy Center, we recognize the impact that lower back pain can have on your quality of life. In this blog post, we will delve into the common causes of lower back pain and why Vitruvian Physiotherapy Center is your go-to destination for effective Lower Back Pain treatment in Dubai.

1. Understanding Lower Back Pain:

Lower back pain is a prevalent issue affecting people of all ages, stemming from various factors such as muscle strain, poor posture, injury, or underlying medical conditions. Understanding the root cause of your lower back pain is essential for developing an effective treatment plan.

2. Why Choose Vitruvian Physiotherapy Center for Lower Back Pain Treatment in Dubai:

Vitruvian Physiotherapy Center stands as a beacon of relief for those seeking Lower Back Pain treatment in Dubai. Our team of highly skilled physiotherapists is committed to delivering personalized care that targets the source of your pain, promoting long-term recovery and a return to an active, pain-free lifestyle.

3. Comprehensive Assessment for Tailored Treatment:

The journey to relief begins with a comprehensive assessment at Vitruvian Physiotherapy Center. Our experienced physiotherapists conduct a thorough evaluation to identify the specific factors contributing to your lower back pain. This in-depth understanding allows us to design a personalized treatment plan tailored to your unique needs.

4. Targeted Physiotherapy Interventions:

Vitruvian Physiotherapy Center employs evidence-based physiotherapy interventions to address lower back pain effectively. From targeted exercises to manual therapy techniques, our programs are designed to alleviate pain, improve mobility, and enhance the strength and flexibility of the lower back muscles.

5. Patient Education for Long-Term Wellness:

Beyond immediate relief, Vitruvian Physiotherapy Center places a strong emphasis on patient education. Our physiotherapists provide guidance on proper ergonomics, posture correction, and home exercises to empower you with the knowledge and tools needed for long-term lower back wellness.

To learn more about Lower Back Pain, please visit our dedicated page here: Lower Back Pain Treatment

Comprehensive Tennis Elbow Treatment in Dubai at Vitruvian Physiotherapy Center

At Vitruvian Physiotherapy Center, we understand the impact that tennis elbow can have on your daily activities. In this blog post, we will explore effective Tennis Elbow Treatment options available in Dubai, and why Vitruvian Physiotherapy Center stands out as a premier destination for rehabilitation.

1. Understanding Tennis Elbow:

Tennis elbow, or lateral epicondylitis, is a common condition characterized by pain and inflammation on the outer part of the elbow. Contrary to its name, this condition is not exclusive to tennis players and can affect anyone engaging in repetitive arm and wrist movements. Understanding the underlying causes is crucial for an effective treatment approach.

2. Why Choose Vitruvian Physiotherapy Center for Tennis Elbow Treatment in Dubai:

Vitruvian Physiotherapy Center is a leading provider of rehabilitation services, specializing in Tennis Elbow Treatment in Dubai. Our team of experienced physiotherapists is dedicated to delivering personalized care that addresses the root cause of your tennis elbow, promoting a speedy and sustainable recovery.

3. Comprehensive Assessment and Diagnosis:

The first step towards effective Tennis Elbow Treatment at Vitruvian Physiotherapy Center begins with a thorough assessment. Our experienced physiotherapists evaluate the extent of your condition, identifying contributing factors such as muscle imbalances, overuse, or improper technique. This comprehensive approach ensures a tailored treatment plan that addresses your specific needs.

4. Individualized Physiotherapy Programs:

At Vitruvian, we believe in the power of individualized care. Our physiotherapy programs for Tennis Elbow Treatment are designed to target the specific impairments identified during the assessment. From targeted exercises to manual therapy techniques, our programs are crafted to alleviate pain, restore function, and prevent recurrence.

5. Education and Prevention Strategies:

Beyond providing treatment, Vitruvian Physiotherapy Center is committed to empowering our patients with knowledge. Our physiotherapists educate you on proper ergonomics, stretching exercises, and preventive strategies to minimize the risk of tennis elbow recurrence. This proactive approach is key to ensuring long-term joint health.

To learn more about Tennis Elbow Treatment, please visit our dedicated page here:

To learn more about Tennis Elbow Treatment, please visit our dedicated page here: Tennis Elbow Treatment in Dubai

Femoroacetabular Impingement: What the science says

What is Femoroacetabular Impingement? In recent times the hip joint has been recognised as a significant cause of hip and groin pain in the athletic population. It accounts for approximately 12% of soccer related injuries and is the third most common injury in the Australian Football League.

Groin pain is frequently reported in those with hip pathology attending for arthroscopy, evidenced by 92% of patients with labral tears. The most common site of pain referral in people with labral tears has been reported as the central groin region. Hip pain often coexists with other groin-related pathologies, including pubic and adductor symptoms, which can make tears, most likely due to impingement of the labrum between the bony components of the hip.

Which are the causes of Femoroacetabular impingement syndrome?

Femoroacetabular impingement syndrome (FAIS) is caused by premature contact of the femur and acetabulum during hip motion. The 3 classifications of FAIS are cam, pincer and Mixed impingement. Aspherical deformation of the femoral head occurs with cam deformity, whereas pincer deformity presents with excessive prominence of the outer rim of the acetabulum Mixed is the combination of the 2 types of deformity.

Repetitive abutment of hip structures may damage the labrum and contribute to the early onset of osteoarthritis.

The Physiotherapist assist patients with FAIS using nonoperative or postoperative exercise strategies. Both approaches demonstrate key exercise pillars: postural control (also known as postural positioning), core stabilization (also known as core strength), hip strength (also known as hip strength and motor control), and mobility (also known as functional range of motion [ROM])

Patients with symptoms that lasted 12 to 24 months or longer had worse surgical outcomes. This suggests that surgical intervention may be needed if symptoms have not resolved with nonoperative treatment within 3 to 6 months

Return to sport

Patients who pursue nonoperative approaches often have the same goals as patients who choose surgery: to return to the preinjury or sport performance level after an intervention.

In 6 weeks, the central goals should be to reduce pain in the affected hip to 0 to 2/10 (on a numeric pain scale), improve the range of motion and gradually reload the joint. In 12 weeks nonoperative Patients should be able to walk on varied terrain; jog for at least 30 minutes; and complete sport-specific tasks that involve cutting, jumping, and pivoting. Patients whom undergo for surgery may expect this goal at 13-16 weeks.

The timeline for return to play depends on the procedure performed and varies from patient to patient
Returning to sport is different from returning to the preinjury level of activity, which increases the difficulty of determining timelines for returning to sport. 

Appropriate rehabilitation exercise progressions specific to the patient’s goals and response to therapeutic interventions are needed.

In conclusion

The evidence supporting the best conservative management for FAI is limited
Given the rapid increase in interest in this condition, knowledge of appropriate rehabilitation programs will most likely grow in the coming years. 
Conservative management of symptomatic FAI focuses on decreasing adverse hip loads through the implementation of hip muscle strength programs and modification of external joint loads. This may result in a lessening of symptoms associated with this condition.

To learn more about Injury Prevention, please visit our dedicated page here: Injury Prevention Program

ACL Rehabilitation: all you need to know

The ACL Rehabilitation Protocol has the aim to reduce swelling and inflammation, regaining Range of Motion (ROM) strength and neuromuscular control and gait training.

The later stage of rehabilitation includes full strength and power restorationsport specific exercises and reconditioning.

The patient must be taught how to manage the pain following each workouts/session.

Ice may be need to be applied if pain, inflammation or swelling appears.

Immediately after surgery, weight bearing status is largely determined by concomitant injuries (e.g. meniscal repair). Isolated ACL reconstructions are typically treated weight bearing as tolerated, using brace and/or crutches until adequate quadriceps muscle strength is restored. We can expect to remove both crutches and move to full weight bearing in the first 2 weeks.

The results of ACL reconstruction are good, but current techniques do pose their own challenges and potential issues. These include decreased hamstrings strength, anterior knee pain and loss of proprioception. There is also significant evidence to suggest that ACL reconstruction does not prevent future osteoarthritis.

Return to run (RTR):

RTR decision-making should be individualized for each patient. No universal timeline to RTR exists.

For many patients, it might be reasonable to expect readiness to RTR around the 8th–16th postoperative weeks, provided there is adequate loading: pain <2 at visual analogue scale (VAS) , 95% knee flexion ROM, full knee extension ROM and no effusion.

The clinician may choose to use a battery of tests for individualized clinical decision-making regarding RTR including; strength tests, qualitative performance-based assessments, with focus on dynamic knee control, and quantitative performance-based assessments such as hop tests.

Post-operative ACL Rehabilitation conclusion:

Multiple types of bracing were evaluated, including knee immobilization, rehabilitation bracing, and functional bracing. Overall, no brace or length of brace wear demonstrated an advantage over another type of brace, another duration of bracing, or no bracing at all. Bracing does not provide any benefit and is not necessary.

Accelerated Rehabilitation has shown no deleterious effects, and it is likely safe for patients to begin immediate postoperative weight-bearing, move the knee from 0 to 90 of flexion, and perform closed-chain strengthening exercises.

Eccentric quadriceps muscle strengthening and isokinetic hamstring muscle strengthening were safely incorporated three weeks after surgery; they may be safe sooner, but further research is needed.

Home-based rehabilitation can be effective. Neuromuscular exercises are not likely to be harmful to patients; however, their impact was small, making them unlikely to yield large improvements in outcomes or help patients return to sports faster. Neuromuscular exercises should not be performed to the exclusion of strengthening and range-of motion exercises.

Neither supplemental vitamin C nor vitamin E appears to be beneficial. Postoperative hyaluronic acid injections may improve some measurable parameters, but their cost must be kept in mind.

Single-leg cycling to maintain cardiac fitness may be beneficial. Continuous passive motion (CPM) is still not recommended. The studies presented in this paper focused on improving rehabilitation following ACL reconstruction, with a goal of safely allowing expeditious return of mobility, strength, and ultimately sport participation.

However, few studies actually measured the ability to return to sports and its timing following the interventions. The availability of such data could strengthen the conclusions of studies and should be considered in future research. Despite the large number of randomized trials, further investigations of the timing of rehabilitation and supplemental rehabilitation exercises are needed to continue to improve the care and function of patients following ACL reconstruction

To learn more about ACL Injury, please visit our dedicated page here: ACL Injury Treatment

Ankle sprain: Everything you need to know

The clinical manifestations of Ankle Sprain include the inability to walk or even move the joint, a searing or tearing sensation, pain that increases with mobility, color change and rapid bruising. The intensity of these manifestations depends on the severity of the sprain. Ankle sprain is classified based on clinical signs and functional loss, as follows: grade 1 (mild stretching of a ligament), grade 2 (more severe injury involving incomplete tear of a ligament), and grade 3 (complete tear of a ligament).

An Ankle can sprain in different directions and this will affect different ligaments.

Inversion sprain will affect the ligaments on lateral side of ankle. Eversion will impact those in the internal side and twisting movements can impacts those ligaments that are keeping together tibia and fibula bones

Acute ankle sprain management

It is well-known that all Grade I and Grade II ligament injuries are safely treated non-sugically. The recommended treatment is functional with a short period of restcooling (ice), compression and elevation to reduce the edema (PRICE), during the first 1 to 3 days, depending upon the amount of swelling, bruising and pain.

The ruptured ligaments should be protected from distraction and new injuries during healing, using external support i.e. ankle tape or brace to control the range of motion and to reduce the instability. The results after functional treatment of Grade I and Grade II ligament injuries are almost always satisfactory, and most athletes are able to return to sporting, providing they protect their ankle from further injury using external support.

There is still some controversy in terms of the optimal treatment of Grade III ligament ruptures as to whether these injuries should be treated non-surgically, by physiotherapy and early mobilization, or by primary surgical repair followed by immobilization using a plaster cast (either full or hinged).

All these studies have showed that the long-term results are satisfactory in most patients, regardless of the primary choice of treatment i.e. surgical repair, cast immobilization alone for 3 to 6 weeks or physiotherapy. Taken together, approximately 80 to 90% of patients with Grade III injuries will regain satisfactory functional stability after nonsurgical treatment.

Physiotherapy includes short period of immobilization, using ankle tape or elastic bandages. Training of range of motion, peroneal muscles and coordination training is started as soon as pain and swelling have subsided. Weight-bearing is encouraged from the beginning.

It can thus be concluded that physiotherapy is the treatment of choice when dealing with acute ligament injuries of the ankle joint, irrespective of the grade of injury. The remaining problem is how to identify those approximately 10% of patients who will develop chronic functional instability in spite of adequate primary treatment and may need surgical reconstruction at a later stage.

Chronic ankle sprain management

Chronic lateral ankle joint instability will develop in approximately 10% of patients after acute ligament rupture. This ligament instability, irrespective of its aetiology does not always require surgical reconstruction.

The indication for surgical treatment is recurrent ‘giving way’ in spite of proprioceptive training. Non-surgical treatment is therefore always recommended before surgical treatment. Surgical reconstruction is more often needed in athletes with high demands of ankle stability.

Of all individuals who have sustained acute ligament injuries, it is probable that less than 10% will need stabilizing surgery at a later stage. Before deciding on surgical treatment in a patient with chronic ligament insufficiency, a supervised rehabilitation program based on peroneal muscle strengthening and co-ordination training should be carried through.

Approximately 50% of patients with chronic functional instability of the ankle will regain satisfactory functional stability after 12 weeks on such a program.

Patients with high-grade mechanical instability have less chance of regaining satisfactory function by physiotherapy. These patients should undergo surgical treatment.

Return to sport after an ankle sprain

Decision-making regarding return to the sport in athletes may be challenging and a sports physician should determine this based on the self-reported variablesmanual tests for stability, and functional performance testing.

Grade I ankle sprain normally takes around 2-3 weeks for the return to play, Grade II can take up 4-6 weeks and for a grade III it can take 3 months or more. There are some common myths and mistakes in the management of ankle sprains, which all clinicians should be aware of and avoid. These include excessive imaging, unwarranted non-weight bearing, unjustified immobilization, delay in functional movements, and inadequate rehabilitation.

To learn more about Injury Prevention, please visit our dedicated page here: Injury Prevention Program

Can you heavy weightlifting during pregnancy?

Can you heavy weightlifting during pregnancy?? Apparently yes but let me explain!A lot of guidelines are suggesting women to be active during their pregnancy, but the intensity is rarely mentioned. Almost all are suggesting aerobic activities like walking, pilates, yoga but what is somebody wants to do some more?Recently this article came out stating that women who lifted heavy during pregnancy showed lower rates of complications like gestational diabetes, gestational hypertenion, perinatal mood disorders. Without any increased risk of pelvic floor disorders postpartum like incontinence.Now that’s a statement…can we send any women to deadlift heavy than?Let’s dig a bit into this; Let’s define weightlifting.

What is Weightlifting?

Weightlifting is something we do regularly in our life. Lifting grocery bags, car seats or babies is part of normal activities of daily living. Therefore also lifting weights in the gym is not that different as long as the weight is moderate. In this article women continued their moderate weightlifting within their first 6 weeks after knowing about their pregnancy.

But in this article was specified HEAVY weightlifting. So we have to do some more considerations
As we increase the weight our body needs to implement some strategies to help us with the lift, one of these is the Valsalva maneuver.
The Valsalva maneuver is performed by a forceful attempt of exhalation against a closed airway, which is normally what happens in weightlifting.
Because it increases the abdominal pressure Doctors normally recommend not to do weitghlifting that requires the valsalva maneuver.
Also another discouraged type of lifting is the one laying on the back (i.e. bench press or some types of leg press) because it increases the blood pressure and might lead to faint.
This article investigate exactly this type of lifting, and it came out that women went back to weightlifting using the Valsavla maneuver between 4.5 and 5.5 months. All of this not only was done with no side effects, but with a lot of benefits too!

So it’s true! All women should do heavy weightlifting. Period. Thanks. Well, no. Unfortunately one study is not enough to safely say this.
First of all, this study have investigated women which were familiar with these exercises and well trained. So these conclusions are not applicable to the whole population.
If we look at further evidence we find out that current guidelines across the globe have, infact, a much milder approach.
Most of them agree that exercises should be a lowered in intensity during the first trimester.

Also the intensity shouldn’t cross 6-7/10 at the perceived exertion scale and is mainly aerobic exercises and not weightlifting.
So what do we do??

2 categories of Pregnant Women

We will have to divide pregnant women in 2 categories;

 Normally active: pregnant women who habitually engage in vigorous-intensity activity or are highly active can continue physical activity during pregnancy and the postpartum period, provided that they keep in mind the reason to stop exercises such as:

• Excessive shortness of breath

• Chest pain

• Painful uterine contractions (more than 6-8 per hour)

• Vaginal bleeding

• Any “gush” of fluid from vagina (suggesting premature rupture of the membranes)

• Dizziness or faintness

 Normally not active: Healthy women who are not already highly active or doing vigorous-intensity activity should get at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity per week during pregnancy and the postpartum period. Preferably this activity should be spread throughout the week.

Conclusions about weightlifting during pregnancy

Apparently weightlifting is not harmful. Women that are used to it are safe to do it starting from 6th week of pregnancy and heavier from at least 4.5 months. However, it is safe to lower the intensity and avoid extreme exertion.

This is valid ONLY for women with a normal gestation and no risk factors. Maintain adequate nutrition and hydration – drink liquids before and after exercise. Know the reasons to stop exercise and consult a qualified health care provider immediately if they occurs.

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