P5140109

Sever's Syndrome or Apophysitis of the Calcaneus

Scver's syndrome is an inflammation of the insertion of the Achilles tendon onto the calcaneus. This inscrtion point is a traction epiphysis, it may result in a partia! nvuIsion of the epiphysis or cause degeneration from a decreased circulation.

The Kinesio Taping Method will assist in rcducing edema and pain.

There are two Kinesio taping techniques which may proeide reduced inflammation and pain, the practitioner will need to determine which technique is best for their patient. If one technique does not provide signiflcant results, another technique may.

An option which is not shown is to apply the Achilles' tendon Kinesio Taping Technique.

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For acute treatment, or during periods of in-creased inflammation, the practitioner may choose to apply a lymphatic correction technique over the area of inflammation. For complete review see lymphatic correction technique.

Photo on left: application of lymphatic correction from superior medial aspect of the calcaneal apo-physitis of the inferior la terał aspect.

Photo on right: application of lymphatic correction from superior lateral aspect of the calcaneal apophysitis of to inferior medial aspect.

For acute pain relief a mechanical correction strip may be applied in an attempt to "hołd down" the apophysitis of the calcaneus.

Place the patients knee in extension with arlkle dorsiflexion. Begin by tearing the paper backing of a 4-6 inch long Kinesio I strip in the middle. Holding both ends, apply a mechanical correction, available tension of 50-100%, with downward pressure to the center of the Kinesio strip over the insertion point of the Achilles into the calcaneus.

For complete review see mechanical correction technique.

Have the patient remain in knee extension and ankle dorsiflexion, lay down the ends with no tension.

This technique may be applied first and then a second Kinesio taping technique may be applied over the top. The patient may find the greatest decrease in pain during acute pain phases from a combination of taping techniques. Then as the patients pain is reduced, only one technique may be indicated.

Lateral Ankle Sprain

_Asprain to the lateral ligaments of the ankle (anterior talofibular, calcaneofibular and posterior ^tmlar) is the most common location for a sprained ankle. Lateral ankle sprains are gcnerally consid-toaecount for approximately 90 % of all ankle sprain injurięs. The most commonly injurcd ligamcnt SUnkle is the anterior talofibular.

■‘‘^atment of a lateral ankle sprain consists of edema reduction due to acute injury, maintcnancc of sdeStrength, proprioceptive stimuli, and prophylactic taping to reduce reoccurrence. The treatment of ankle sprain should be thought of as occurring in stages. Acute, 24-72 hours minimize edema. ^^I’'\_cUte, when acute post traumatic symptoms subside, to return patient to pre-injury leve\ of activity. ^efoUowing is "A New Approach to the Management of Ankle Sprains" by Jayson Goo, MA, ATC, _d ^thletic Trainer at the University of Hawaii. If your profession does not allow you to use electrical ^^Uties, eliminate those steps from your treatment protocol.

gl££(Rest, Ice, Compression, and Elevation)

Pro per fitting and instructions.

Stimulation: lst 24 hours: Microcurrent .3 Hz. 10 minutes followed by 1.0 Hz for 10 to 20 min-^ mrrtiYf kinesio Taping: Anterior, posterior, medial and lateral lymphatic drainage strips. If the patient ^^a footwear which may affect the application of the Kinesio strips, modify the lymphatic correction

jppropriately.

instructions: Patient should be sent home with crutches, appropriate compression (elastic kuJdage or compression dressing), and if indicated or allowed pain medication. When at home, the natient should keep the ankle elevated and apply ice 20 minutes once per hour. If is not possible to ice the jnlde, it is recommended that the patient keep the ankle elevated and continual compression. If compres-and/or elevation become painful, have the patient cycle periods of compression and elevation.

Instruct the patient to gently plantar and dorsiflex their ankle in a pain free rangę of motion. If the patient kable to, have them spell the alphabet with their toes. The patient should sleep with a compressive dressing, single thickness from below the knees and extending over the toes (TUBIGRIP or TetraGrip).

Acute 24-72 Hours

flfrtrical Stimulation: 24 hours to post-acute: Interferential or Pre-mod at 80-150 Hz.

LfiWffl Leg Łymphedema massage: 10 min. anteriorly, 5 to 10 posteriorly, 5 to 10 minutes anteriorly

jfrngeof Motion (ROM): active to active resistive as tolerated, 3 x 12 plantar flexion, dorsi flexion, ever-sionif inversion sprain, or inversion if eversion sprain

Whirlpool: Cold Whirlpool while wearing compression, 10 to 20 minutes

Repeat the above treatment protocol several times per day if possible. Continue RICE.