Physiotherapy for peroneal paresis aims on the one hand to activate the affected nerve and the corresponding muscles, and on the other hand to treat the compensatory muscle groups. As a result of peroneal paresis, the patient cannot lift his or her foot and therefore has to work through increased knee joint movement. This results in increased muscle traction over the hip, often leading to circumduction, a rotational movement of the hip to bring the leg forward.
This changes the muscle tension in the area of the hip, the knee and especially the lumbar spine. Mobilization of the lower back and the pelvis, preferably in a lateral position, can improve mobility and movement transitions. The hip and knee joint should also be mobilized.
If the joints can only be mobilized with difficulty, the muscles are usually already too tense. This phenomenon can be countered by soft tissue techniques, massage grips, stretching and fascial release. Equally important is a comprehensive stabilization program for the entire trunk to compensate for incorrect posture and incorrect loading as well as possible so that no further pain occurs.
Exercises such as forearm support, lateral support, hand support, quadruped stand and all exercises with Pezzi ball or other equipment are suitable. and mobility training – spine, shoulder, knee, hip. The affected nerve should also be stimulated, for example by tapping or stroking along the outside of the lower leg.
Likewise, the nerve can be stimulated by means of an ice lolly via a cold stimulus. While a stimulus is set by the therapist, the patient should lift his foot in his mind. He can also support the healthy foot by moving it.
In general, mirror therapy is often used in the treatment of neurological clinical pictures, including paralysis due to nerve damage. A mirror is placed in front of the patient so that only his healthy foot is visible. The movement in the healthy leg and the reflection of the healthy leg on the other side can create a link in the brain, which has a positive effect on the affected side.
A further therapy method is electrotherapy. Here, a form of current should be chosen which has an activating effect on the muscle tone. While the current flows, a contraction of the actually flabby muscle is visible.
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