Therapeutic procedure after ligament stretching
As with many physiotherapeutic treatment approaches, the first thing to consider is the stage of the injury. In the following, the treatment after a buckling injury with damage to the capsule-ligament apparatus (supination trauma) of the ligament stretching is presented as an example. – Acute phase / Initial treatment
- Early functional treatment phase
- Coordination and proprioception training
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Acute phase / Initial care
Immediately after bending / ligament stretching, pressure treatment (compression) of the foot should be applied to prevent excessive swelling. The same applies to a torn ligament. This should be done in the first few seconds, preferably by applying pressure with both hands on the foot or the affected ankle joint.
This pressure should be held for 2-5 minutes. This is followed by the further steps of initial treatment. A still widespread method of first aid after ligament stretching is described by the so-called “PECH rule“.
The correct immediate measures using a simple scheme (PECH scheme) help to influence the healing process favourably and prevent further damage. The first letters of the word PECH describe the central contents of this initial treatment (acute therapy): P Break E Ice C Compression H High PositionIn modern sports physiotherapy, this PECH rule is no longer considered to be fully valid. According to new findings in sports physiology, treatment with ice, whether with a cold pack or ice spray, should be avoided in initial treatment if possible.
The minus temperatures that occur during ice application can have negative effects on the lymphatic vessel system, which is responsible, among other things, for reducing swelling after injuries. It is therefore recommended to choose a milder form of cooling in the initial treatment, which does not impair the function of the lymphatic system. To relieve the pain that occurs, it is quite sufficient to run cold tap water over the injured area.
If the swelling persists for a longer period of time, manual lymphatic drainage can be used. This special form of massage stimulates the lymph vessel system and accelerates the reduction of fluid in the affected area. Manual lymph drainage can be prescribed by a doctor and is carried out by specially trained physiotherapists and masseurs.
Good results in terms of reducing a swollen ankle joint can be achieved with curd cheese packs, possibly in combination with the external(!) application of an ASPIRIN® tablet. This involves crushing an ASPIRIN® tablet, placing it on the injured ankle joint and spreading curd cheese about the thickness of a finger.
The whole thing is then wrapped in cling film and left on the foot overnight if possible. The curd can be washed off again the next morning.