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Ankle Pain, ankle ligaments sprain - Everything You Need To Know - Dr. Nabil Ebraheim
 
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Dr. Ebraheim’s educational animated video describes conditions and treatment methods associated with pain of the ankle. High ankle sprain •A high ankle sprain is a sprain of the syndesmotic ligaments that connect the tibia and fibula at the ankle. •Diagnosis of syndesmotic injury is usually done by the use of external rotation stress view examination or CT scan. This patient may require surgery. Anterolateral impingment •Painful limitation of full range of ankle motion due to soft tissue or osseous (bony) pathology. •Soft tissue thickeneing commonly seen in athletes with prior trauama that extends into the ankle jint. •Arthroscopy of the ankle may be helpful . •Tibisl bone spur impinging on the talus can become a source of chronic ankle pain and limitation of ankle motion in athletes. Osseous (bony) spur on the anterior lip of tibia contacting the talus during dorsiflexion. The patient may need debridment of the spur. Ankle sprain •Pain that is anterior and around the fibula can usually be attributed to a ligament sprain. •Sprains result from the stretching and tearing (partial or complete) of small ligaments that can become damaged when the ankle is forced into an unnatural position. •Treatment includes immobilization, ice therapy, physical therapy and rarely surgery. •With ankle sprain, the patient will be able to walk, but it will be painful. With a fracture, the patient will be unable to walk. Pain that is posterior to the fibula can usually be attributed to an injury of the peroneal tendons. Lateral ankle pain •Patients with peroneal tendon problemes usually describe pain in the outer part of the ankle or just behind the lateral malleolus. •Problems mainly occus in the area where the tendons of the two muscles glide within a fibrous tunnel . Peroneal inflammation/ tendonitis •Tendons are subject to excessive repetitive forces causing pain and swelling. •Peroneal tendon subluxation •Usually occurs secondary to an ankle sprain with retinaculum injury. •Occurs with dorsiflexion and usually eversion of the ankle. Posterior anle pain Achilles tendonitis •Irritation and inflammation due to overuse. •Pain, swelling and tears within the tendon. •Achilles tendon can become prone to injury or rupture with age, lack of use or by aggressive exercises. •The Thompson test is performed to determine the presence of an Achilles tendon rupture. A positive result for the thompson’s test is determined by no movement of the ankle while squeezing of the calf muscles. Posterior ankle impingment •Os trigonum or large posterior process of talus (stieda syndrome) •Common among athletes such as ballet dancers. •May be seen in association with flexor hallucis longus tenosynovitis. Tarsal tunnel syndrome •Compression or squeezing on the posterior tibial nerve that produces symptoms of pain and numbness on the medial area of the ankle. •When conservative treatment methods fail, surgical treatment or tarsal tunnel release surgery may be needed. Posterior tibial tendon tears are one of the leading causes of failing arches (flatfoot) in adults. •Too many toes sign •Loss of medial arch height •Pain on the medial ankle with weight bearing Arthritis of the ankle joint •Commonly the result of a prior injury or inflammation to the ankle joint. •Can usually be easily diagnosed with an examination and x-ray. Osteochondral lesion of the talus •Arthroscopic debridment may be necessary. Please go to the following link and support the artist Johnny Widmer in his art contest - Sign to Facebook and click LIKE https://www.facebook.com/marlinmag/photos/a.10153261748858040.1073741838.134227843039/10153261754338040/?type=3&theater Thank you! https://www.facebook.com/JohnnyWidmerArt?fref=ts http://www.johnnywidmer.com/
Views: 641646 nabil ebraheim
Got Ankle Impingement?  Do Talus Bone Mobilization!
 
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My Site: http://fitnessoriented.com/ Thumbnail Image From © decade3d / Fotolia Have you ever tried to stretch your calves and feel pinching in the front of your ankle joint? This isn't normal, as you should primarily feel a stretch in your calves. A reason why this could be happening is that your Talus bone in your ankle is too far forward. This can happen for a variety of reasons, such as your calves being too tight. Normally when your foot and ankle come closer together, the Talus bone is supposed to glide backwards. However, if this bone is stuck too far forward, you can experience ankle impingement where the Talus bone and Tibia jam into one another. Not only can this cause stiff ankles, but it can also be painful. A simple thing you can do to try to address this problem is to mobilize the Talus on yourself. Simply sit with one leg over the other. Grasp the bottom of your foot with one hand. With your other hand, make a cup shape. Then with that cup shape, go beneath the Malleoli of your ankle. Now, when your foot comes up with your bottom hand, use your cup hand to push backwards on your Talus. Do this a dozen times and try doing it twice a day. Over a period of time, you should notice less foot problems due to ankle impingement occurring. Follow me on Pinterest: www.pinterest.com/fitnessoriented/ Follow me on Twitter https://twitter.com/FitnessOriented Follow me on Google+: plus.google.com/+FitnessOriented Intro Music (provided by NCS a.k.a. NoCopyrightSounds): Title: Aero Chord feat. DDARK – Shootin Stars Creators: Aero Chord & vocals by DDARK Link to Song: https://youtu.be/PTF5xgT-pm8 Follow Aero Chord: https://www.youtube.com/user/TheAeroChord https://twitter.com/TheAeroChord https://soundcloud.com/aerochordmusic http://facebook.com/AeroChord Follow DDark: https://www.facebook.com/ddarkonline http://soundcloud.com/ddark http://twitter.com/ddarkonline http://youtube.com/user/DDARKTV Background & Outro Music (provided by NCS): Title: Free Fall Creator: Audioscribe Link To Song: https://youtu.be/8ciZGNmlWgo Follow Audioscribe: https://soundcloud.com/audioscribe http://www.facebook.com/AudioscribeMusic http://twitter.com/AudioScribed https://www.youtube.com/user/AudioscribeMusic Intro, Background & Outro music all made usable by NCS (NoCopyrightSounds) Link to NCS YouTube Channel: https://www.youtube.com/channel/UC_aEa8K-EOJ3D6gOs7HcyNg NCS SoundCloud http://soundcloud.com/nocopyrightsounds Facebook: http://facebook.com/NoCopyrightSounds Google+ http://google.com/+nocopyrightsounds Instagram: http://instagram.com/nocopyrightsounds
Views: 71274 Fitness Oriented
Musculoskeletal Physical Exam: Ankle
 
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Dr. Mark Stovak demonstrates how to conduct a musculoskeletal physical exam: on the ankle. http://www.viachristi.org/doctor/mark-l-stovak-md
Views: 310167 Ascension Via Christi
Ankle Arthroscopy and Open Repair
 
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Post-collision injury to talar dome cartilage and associated tear of peroneus brevis tendon. Arthroscopic shaving of joint cartilage defects and suture repair to tendon injuries.
Views: 87978 Trial FX
Top 3 Treatments for Posterior Tibial Tendonitis (Exercises Included)
 
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Famous Physical Therapists Bob Schrupp and Brad Heineck demonstrate the top 3 treatments for Posterior Tibial Tendonitis. They have included some effective exercises. Check out the Products Bob and Brad LOVE on their Amazon Channel: https://www.amazon.com/shop/physicaltherapyvideo
Views: 204814 Bob & Brad
452 Gait Analysis and Differential Diagnosis
 
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Presented by: Mary Lloyd Ireland Professor Dept. of Orthopaedic Surgery and Sports Medicine University of Kentucky Lexington KY www.marylloydireland.com 0:00 Introducdion 0:24 A good History and Physical is Key 0:39 Foot: Pronated Hand 0:58 Function •Propulsion •Support •Flexibility •Rigidity •Gait mechanics: ankle and foot motions 1:39 Ankle Axis •Thus, with leg fixed and foot free •Dorsiflexion results in outward deviation of the foot •Plantarflexion results in inward deviation 2:30 Ankle Axis: Opposite with foot fixed •With foot fixed, dorsiflexion / Plantarflexion results in rotation of the leg •Dorsiflexion results in internal rotation •Plantarflexion results in external rotation 3:38 Subtalar Joint •Eversion and inversion of the subtalar joint are directly tied to internal and external rotation of the tibia 4:44 Windlass Mechanism •Dorsiflexion of the proximal phalanges pulls the plantar aponeurosis over the metatarsal heads, resulting in depression of the metatarsal head and elevation of the longitudinal arch 5:02 During gait: coupled motion between ankle and subtalar joints •First •Tibial internal rotation •Talar eversion •Foot pronation •Third •Tibial external rotation •Talar inversion •Foot supination 8:08 Leg Movment 8:37 Ankle: Modified Hinge Joint Bony configuration •Mortise •Circular Pretzel Ligamentous stability •ATF and CF laterally •Deltoid superficial and deep medially •Syndesmosis superiorly 9:18 With complete history and physical and appropriate imaging, the diagnosis should be made and be specific.9:34 Lateral Ankle Pain •Sprain ATF and/or CF •Sinus Tarsi Syndrome •Subtalar Joint •Arthrosis Fracture •Cuboid Subluxation •Peroneal Dysfunction 13:14 Summary of Findings From the National Collegiate Athletic Association Injury Surveillance System on Foot and Ankle Injury. 14:12 Basketball Injury Mechanism Video 14:47 EUA Gross instability, right ankle video 16:01 18 YO Female Gymnast •Right ankle injury •Landed awkwardly doing a back tuck •Immediate pain and swelling, right ankle 16:10 Initial X-rays 16:41 Stress tests, L & R ankles 17:12 Dx lateral talus fracture displaced 17:33 Physical Exam of the Foot and Ankle Video 18:32 Lateral Ankle Pain Soft Tissue Soft Tissue Mass •Ganglion Meniscoid of the Ankle •Tomansen, Denmark 1982 Scar + Synovitis Gutter •Ferkel’s Phenomenon, AJSM 1991 Distal Slip Anterior Tibiofibular Ligament •Bassett’s Ligament, JBJS, 1990 19:13 14 YO Female •Soccer athlete •Left ankle •Acute lateral talar dome fracture •Documented by plain films and bone •edema on MRI 19:16 Initial X-Rays 19:46 1 Month after Initial presentation 20:27 Talar Dome Fracture 20:45 Osteochondral Talar Lesions Osteochondritis Dissecans •Men 3 : 1 Women •Medial : Lateral •2 : 1 Etiologies •Trauma •Vascular •Repetitive Loading 21:11 Mechanism of injury of medial border of the dome of the talus. •Berndt, A.L. and Harty, M.: “Transchondral fractures of the talus” – JBJS 41 –A:988, 1959 22:08 Soft Tissue Lesion Location •Ankle •Anterolateral •ATF or CF Sprain •Peroneal Tendinitis •Posteromedial •PT or FHL Tendinitis •Deltoid Sprain 24:32 Physical Exam of the Foot and Ankle Video 25:12 Think About Peroneal Tendon Involvement If: •Recurrent Ankle Complaints •Sprain Not Getting Better •Pain, Swelling Higher in Peroneal Tendon Sheath 25:37 In Acute Ankle Sprain, Assess Peroneal Function 25:58 17 YO WM High school Baseball/Football Player C/O Repeated Inversion Ankle Sprains 26:14 Peroneal Tendon Subluxing Video 27:42 Physical Exam of the Foot and Ankle Video 28:50 19 YO basketball player Os vesalianum bilateral feet. 29:20 Os peroneum 29:33 Medial Ankle Pain Differential Diagnosis •Deltoid Sprain •Medial Malleolus Fracture •Tendinitis •Posterior Tibialis •Flexor Hallucis Longus •Osteochondral •Talus Fracture •Osteochondritis Dissecans 30:25 Posterior Tibial Tendon Dysfunction Stages 31:12 "Too Many Toes" Sign 34:16 18 YO Freshman Div. I basketball athlete •C/O mid-foot pain, L greather than R •Started when she was running, playing in shoes mandated by her school •History of “normal” periods 34:55 Navicular •Initial x-rays 37:06 Posterior Ankle Pain Differential Diagnosis •FHL Tendinitis •Posterior Process Talus Fracture (Shepherds 1982) •Posterior Impingement •Os Trigonum •Achilles Tendon •Overuse •Tear, partial vs. complete 37:48 Bony Impingement of the Ankle Motion & Contact Areas 38:09 Anterior Tibiotalar Impingement Syndrome "Footballers" Ankle 38:32 FHL Tendinitis •“Dancers” Tendinitis 39:19 Witherspoon MOI Video 40:27 Thompson Test Video 41:15 Achilles Tendon Video 43:22 A good History and Physical is Key 44:05 Thank You
Views: 612 UKyOrtho
Posterior Tibial Tendonitis Stretches & Exercises - Ask Doctor Jo
 
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Posterior tibial tendonitis can be very painful and make the foot unstable. These stretches and exercises should be able to help if your posterior tibial tendon becomes inflamed or torn. See Doctor Jo’s blog post about this at: http://www.askdoctorjo.com/posterior-tibial-tendonitis The posterior tibial tendon can cause a lot of problems in the foot and ankle. It provides support and stability to the foot. It runs on the inside of the leg and foot, and it is the main muscle for inversion, or pulling your foot inwards. Start off with propping your ankle up on a roll or hang your foot off the bed or table so your heel doesn't touch the floor. Put the band around the ball of your foot for good resistance. First, push your foot down and up. This is called ankle plantarflexion. Now you want to wrap the band around your other foot. This time you will have resistance pulling out. This is ankle eversion. Next you are going to cross your foot over the foot with the band as seen in the video, and pull your foot inward. This is ankle inversion. Try not to move the whole leg with these exercises. Just move at the ankle. Now you are going to do some simple toe walking. Lift your heels off the ground and walk on your toes. Try to do this for 30 seconds, and work your way up to a minute. If you need to take a break in between, you can. The next exercise will be a balance series. Stand on one foot, but hold onto something sturdy. Try to balance for 30 seconds to a minute. When that becomes easy, just use one finger one each side. Then just one finger for balance, and finally try balancing without holding on at all. Finally, you will do a stretch. The stretch is similar to a soleus stretch. So you will start off leaning against something sturdy. Put the leg you want to stretch back into a lunge position. Keeping both feet facing forward, bend your front knee, and then keeping your back heel down bend your back knee. The final step to this stretch is to bend the knee inward toward your other knee to get the posterior tibialis stretch. Hold this stretch for 30 seconds, and repeat 3 times. Related Videos: Ankle Strengthening Exercises & Stretches: https://youtu.be/g-iXYapbuqk?list=PLPS8D21t0eO9JGYS958XUh2mkV8Sa2sAq Lateral Sprained Ankle Stretches & Exercises: https://youtu.be/3JJayVC0-20?list=PLPS8D21t0eO9JGYS958XUh2mkV8Sa2sAq =========================================== SUBSCRIBE for More Videos: http://www.youtube.com/subscription_center?add_user=askdoctorjo ======================================= Doctor Jo is a Doctor of Physical Therapy. http://www.AskDoctorJo.com http://www.facebook.com/AskDoctorJo http://www.pinterest.com/AskDoctorJo https://www.instagram.com/AskDoctorJo http://www.twitter.com/AskDoctorJo http://plus.google.com/+AskDoctorJo ======================================= Posterior Tibial Tendonitis Stretches & Exercises: https://www.youtube.com/watch?v=9H1Mf9eRH8k DISCLAIMER: This content (the video, description, links, and comments) is not medical advice or a treatment plan and is intended for general education and demonstration purposes only. This content should not be used to self-diagnose or self-treat any health, medical, or physical condition. Don’t use this content to avoid going to your own healthcare professional or to replace the advice they give you. Consult with your healthcare professional before doing anything contained in this content. You agree to indemnify and hold harmless Ask Doctor Jo, LLC and its officers for any and all losses, injuries, or damages resulting from any and all claims that arise from your use or misuse of this content. Ask Doctor Jo, LLC makes no representations about the accuracy or suitability of this content. Use of this content is at your sole risk.
Views: 86601 AskDoctorJo
Ankle impingement | Feat. Kelly Starrett | MobilityWOD
 
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Ankle impingement case study. SUBSCRIBE: http://bit.ly/1bRdYec About MobilityWOD: MobilityWOD is the ultimate guide to resolving pain, preventing injury, and optimizing athletic performance. Humans have been evolving for 2.5 million years and the human body is extraordinarily engineered. While people are born with this incredible machine, they aren't born with the right software to run that machine. The MobilityWOD is designed to help you hack your body's mechanics and provide the tools to perform basic maintenance on yourself. Connect with MobilityWOD: Visit the MobilityWOD WEBSITE: http://bit.ly/1gA0C9I Like MobilityWOD on FACEBOOK: http://on.fb.me/19Lz3Td Follow MobilityWOD on TWITTER: http://bit.ly/18tCPpf Ankle impingement | Feat. Kelly Starrett | MobilityWOD http://www.youtube.com/user/sanfranciscocrossfit
Views: 173048 Kelly Starrett
452 Foot Ankle Pathology Diagnosis Treatment
 
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Presented by: Mary Lloyd Ireland Professor Dept. of Orthopaedic Surgery and Sports Medicine University of Kentucky Lexington KY www.marylloydireland.com 0:00 Introducdion 0:24 A good History and Physical is Key 0:39 Foot: Pronated Hand 0:58 Function •Propulsion •Support •Flexibility •Rigidity •Gait mechanics: ankle and foot motions 1:39 Ankle Axis 2:30 Ankle Axis: Opposite with foot fixed 3:38 Subtalar Joint 4:44 Windlass Mechanism 5:02 During gait: coupled motion between ankle and subtalar joints 8:08 Leg Movment 8:37 Ankle: Modified Hinge Joint 9:18 With complete history and physical and appropriate imaging, the diagnosis should be made and be specific 13:14 Summary of Findings From the National Collegiate Athletic Association 14:12 Basketball Injury Mechanism Video 14:47 EUA Gross instability, right ankle video 16:01 18 YO Female Gymnast •Right ankle injury •Landed awkwardly doing a back tuck •Immediate pain and swelling, right ankle 16:10 Initial X-rays 16:41 Stress tests, L & R ankles 17:12 Dx lateral talus fracture displaced 17:33 Physical Exam of the Foot and Ankle Video 18:32 Lateral Ankle Pain Soft Tissue 19:13 14 YO Female •Soccer athlete •Left ankle •Acute lateral talar dome fracture •Documented by plain films and bone •edema on MRI 19:16 Initial X-Rays 19:46 1 Month after Initial presentation 20:27 Talar Dome Fracture 20:45 Osteochondral Talar Lesions 21:11 Mechanism of injury of medial border of the dome of the talus. 22:08 Soft Tissue Lesion Location 24:32 Physical Exam of the Foot and Ankle Video 25:12 Think About Peroneal Tendon Involvement If: •Recurrent Ankle Complaints •Sprain Not Getting Better •Pain, Swelling Higher in Peroneal Tendon Sheath 25:37 In Acute Ankle Sprain, Assess Peroneal Function 25:58 17 YO WM High school Baseball/Football Player C/O Repeated Inversion Ankle Sprains 26:14 Peroneal Tendon Subluxing Video 27:42 Physical Exam of the Foot and Ankle Video 28:50 19 YO basketball player Os vesalianum bilateral feet. 29:20 Os peroneum 29:33 Medial Ankle Pain Differential Diagnosis 30:25 Posterior Tibial Tendon Dysfunction Stages 31:12 "Too Many Toes" Sign 34:16 18 YO Freshman Div. I basketball athlete 34:55 Navicular 37:06 Posterior Ankle Pain Differential Diagnosis 37:48 Bony Impingement of the Ankle Motion & Contact Areas 38:09 Anterior Tibiotalar Impingement Syndrome "Footballers" Ankle 38:32 FHL Tendinitis 39:19 Witherspoon MOI Video 40:27 Thompson Test Video 41:15 Achilles Tendon Video 43:20 Ankle Fracture Dislocations Video 44:40 Fractures Maisonneuve Fracture 48:46 Fracture blisters Leave alone. Do not lance unless they look infected. 49:33 Football athlete: Twists ankle on Astroturf Video 50:22 On-site Physical Treatment Video 52:38 Fractures Dislocation 53:19 Radiographs 54:08 14 YO Male •Left ankle •Tillaux fracture with displacement 54:44 Physical Exam Video 56:13 CT Scan 56:37 16 YO WM Basketball Athlete •Injury: Left Ankle •8 months prior to KSM visit •Continued ankle pain and swelling 56:55 Radiographs in ER post injury Casted for 3 months 57:35 2 weeks post injury 58:40 2 months post injury 59:13 Surgery – 9 months post injury 1:00:41 1 month post surgery 1:01:40 Don’t miss a Lisfranc midfoot fracture dislocation 1:02:56 Will require ORIF 1:03:43 Claw Toes Flex:ed PIPJ/DIPJ: Think Neurologic Involvement 1:04:29 Freiberg’s Infraction 1:05:16 Turf Toe: Football Athlete 1:05:56 Heel Pain 1:07:10 13 YO White Male •Right midfoot pain for 1 month •No specific injury •Baseball athlete •Rapid growth phase PE: •Tenderness over medial arch and midfoot •Stable normal ankle exam •Tenderness over posterior tibialis tendon 1:07:53 13 YO White MaleWorkup: •Plain xrays – negative •MRI scan – medial cuneiform stress fracture Treatment •Boot •Nonweightbearing 4 weeks •Full weightbearing 4 weeks •Improved •Cleared for return to baseball 1:08:26 Films in early summer 2009 1:09:44 Followup 1:10:08 RIGHT FOOT 1:10:29 RIGHT ANKLE 1:10:51 MRI Scan 1:11:29 Foot and Ankle Consult Recommended 1:12:19 1 Year Later 1:13:16 Diagnosis •Enthesistis Related Arthritis •HLAB 27 Positive •No clinical evidence of ankylosing spondylitis Treatment: •Medications: •Methotrexate, Naprosyn •Home Rehab program •Returned to baseball wearing AFO 1:14:41 15 YO Male •Right ankle •6 Months of Pain •Initial x-ray: 1:15:16 1 month followup 1:19:08 14 months post op 1:19:18 17 YO Male •Left ankle pain x3 weeks •Trying to get in shape, played more basketball than usual •Possible stress fracture of the medial malleolus 1:19:56 3 months after initial presentation 1:20:11 5 Months after initial presentation 1:20:53 7 months after initial presentation 1:21:13 Small Blue Cell Tumor 1:21:23 A good History and Physical is Key 1:22:07 Thank You
Views: 2146 UKyOrtho
Ankle Fractures & X Rays - Everything You Need To Know - Dr. Nabil Ebraheim
 
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Dr. Ebraheim’s educational animated video describes about fractures of the ankle X - rays, ankle fracture classification,ankle fracture dislocation, it also describes ankle fracture treatment and ankle fracture surgery and ankle fracture recovery. The Mortise view is about 15° of internal rotation. The medial clear space should be 4-5 mm or less, and it should be equal to the superior clear space which is between the talus and the distal tibia on the mortise view. If the medial clear space appears widened before surgery, then there is a deltoid injury. If the medial clear space does not appear widened, then make sure that you do not have a supination- external rotation type 4 injury. You may need to do stress view x-rays before surgery in order to prove that the deltoid ligament is or is not injured. The tiblofibular clear space should be less than 6 mm on the mortise view and it is the distance between the medial border of the fibula and the tibial Incisura notch. If the tiblofibular clear space is widened and the ankle mortise is unstable, this allows the talus to shift because the syndesmosis is unstable. 1 mm of talar shift will give a 42% decrease in tibiotalar contact area. This will cause future, accelerated arthritis. The tiblofibular overlap is about 10 mm in the AP view and you measure that from the medial border of the fibula. In the mortise view, the tibiofibular overlap should be more than 1 mm. Talo-Crural Angle I don’t use this and find not much value in this measurement except on exam questions! The lateral malleolus is longer than the medial malleolus, if the fibula is short, I can rely on two other x-ray measures that can help me: 1- Shenton’s Line: The subcondylar bone of the tibia and fibula should form a continuous line around the talus, so if the fibula is short then the spike of the fibula will too proximal. - If the fibula is long then the spike of the fibula will too distal. - Always look for the broken line from the lateral part of the articular surface of the talus to the distal fibula. 2- Dime Test - Look for the sprung mortise. - Look for the spike of the fibula to proximal. - Look for the broken Shenton’s Line. - Look for the Dime Test. - Look for medial clear space widening. - Get a lateral x-ray to see if there is a posterior malleolus fracture. - See if there is any talar subluxation. - See if there is any other associated Injuries from the talus and the calcaneous. The most important thing you will see on the lateral view x-ray of the ankle is the type of fracture: is it a Pronation - External rotation or Supination - External rotation Injury. - you will see that from the direction of the fracture. or Is the fracture comminuted? So you can say this is Pronation - Abduction Injury. Become a friend on facebook: http://www.facebook.com/drebraheim Follow me on twitter: https://twitter.com/#!/DrEbraheim_UTMC Donate to the University of Toledo Foundation Department of Orthopaedic Surgery Endowed Chair Fund: https://www.utfoundation.org/foundation/home/Give_Online.aspx?sig=29
Views: 23561 nabil ebraheim
Ankle Palpation
 
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https://www.p2sportscare.com/ankle-pain-runners/ Huntington Beach CA 714-502-4243 to learn prevention methods. We specialize in sports injuries and getting athletes back to their sports fast (running injuries, shoulder tendonitis, IT Band, Runners Knee, Hip Flexor tightness). We see athletes anywhere from baseball, triathletes, golfers, basketball, cyclist, runners and so on. We provide Active Release Techniques (ART), chiropractic care, strength training and corrective exercises. The Performance Place Sports Care is located in Huntington Beach, CA. 714-502-4243 Ankle impingement by an osseous growth, spur, can be the main source of pain with many biomechanical and functional movements. Anatomically the ankle is composed of three joints: talocrural joint, subtalar joint, and inferior tibiofibular joint. The ankle joint is special in that all surfaces of the joint are covered in articular cartilage, which can be a mechanical disadvantage if injured. Cartilage as a whole does not have neural or vascular supply, therefore any injury to the cartilage will not be able to heal properly. If enough cartilage damage is done to the level of the subchondral bone, an area of vascularity, it is possible that some of the articular cartilage may be healed with fibrocartilage. Although fibrocartilage indicates healing in the ankle joint, it has decreased biomechanical benefits and can lead to impingement. Typically articular cartialge will not induce pain, due to the lack of neural input. However, if pain is felt after the ankle swelling has reduced, it is likely the pain is referred from another source such as an osseous spur. The ankle joint is surrounded by many ligaments that hold all of the boney attachments together. Functionally speaking, the ankle is a joint of mobility and is the key player in determining the functionality for all the other major joints of the body. Athletes who have difficulty moving their ankle through ranges of motion or have pain upon movement can possibly have a restricted ankle joint, but the main cause is due to poor biomechanics from a previous overuse injury and fatiguing of the soft tissue. Among the ligaments found in the ankle, the strongest ligament of the ankle joint is the deltoid ligament, found on the inside. The other three ligaments, anterior and posterior talofibular ligaments, and calcaneofibular ligaments are found laterally and the area of insult with a classic inversion ankle sprain. Once the ankle is malpositioned, the ligaments become lax and unstable in efforts of preventing dysfunctional movement. Ankle sprains are usually caused by intense, repetitive movements applying too much pressure to the muscles and joints. The ankle is found to be most stable in the closed pack position, dorsiflexion, and most injuries are attained with plantar flexion. Running, ice skating, plyometric exercise are all activities with repetitive ankle motion and can lead to injury. When observing the ankle for motion, the patient may experience pain through the ranges of motion, which is a good indicator of an impingement and there is some sort of restriction in the soft tissue or in the joint. To fully diagnose a healed ankle with dyskinesis or pain imaging should also be considered in diagnosis to rule out any osseous fracture, joint degeneration, impingement from an osseous structure, or arthritis in the joint. The best source of imaging for the ankle joint is an arthroscopy. If a sprain is concluded another source of imaging would be a musculoskeletal ultrasound to further evaluate the scar tissue in the soft tissue preventing full range of motion in addition to pain upon exertion. Possible treatments for ankle impingement: - Active Release Technique - Graston - Eccentric rehabilitative exercises - Stretching - RICE (rest, ice, compress, elevate) - Surgery based on the severity of the tear to reattach the muscle tendon - Steroid injections - Non-Steroidal Anti-Inflammatory medications ankle impingement, impingement of ankle, impingement syndrome, ankle pain, pinch in ankle, ankle sprain, sprained ankle, rolled ankle, ankle therapy, ankle treatment, ankle physiotherapy, physiotherapy, chiropractic, sports chiropractor, huntington beach chiropractor, physiotherapist, peroneal tendonitis, atfl, ligament tear, tibialis positerior, tibialis anterior
Views: 41222 Sebastian Gonzales
The Talar Tilt Test | Lateral Ankle Sprain
 
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Enroll in our online course: http://bit.ly/PTMSK DOWNLOAD OUR APP: 📱 iPhone/iPad: https://goo.gl/eUuF7w 🤖 Android: https://goo.gl/3NKzJX GET OUR ASSESSMENT BOOK ▶︎▶︎ http://bit.ly/GETPT ◀︎◀︎ This is not medical advice. The content is intended as educational content for health care professionals and students. If you are a patient, seek care of a health care professional. The Talar Tilt Test may be used to assess a lateral ankle sprain and the integrity of the talofibular and deltoid ligaments. Article: www.ncbi.nlm.nih.gov/pubmed/10589849 Visit our Website: http://bit.ly/29xmSzV Like us on Facebook: http://bit.ly/29GyogP Follow on Instagram: http://bit.ly/29HN0Lp
Views: 179076 Physiotutors
Common Foot And Ankle Injections - Everything You Need To Know - Dr. Nabil Ebraheim
 
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Dr. Ebraheim’s educational animated video describes injection techniques for painful conditions of the foot and ankle. Conditions which cause pain and inflammation are treatable with the use of diagnostic and therapeutic injection. Ankle joint The ankle joint is formed by the articulation of the tibia and talus. Injection is done to alleviate pain occurring from trauma, arthritis, gout or other inflammatory conditions. Anterolateral ankle impingement •Can occur due to the build-up of scar tissue in the ankle joint or from the presence of bony spurs. •With the ankle in a neutral position, mark the injection site just above the talus and medial to the tibialis anterior tendon. •The injection site is disinfected with betadine. •The needle is inserted into the identified site and directed posterolaterally. •Injection of the solution into the joint space should flow smoothly without resistance. •Pulling on the foot to distract the ankle joint is helpful. First metatarsophalangeal joint •The MTP joint is a common injection site frequently affected by gout and osteoarthritis. •The injection site is disinfected with betadine. •The needle is inserted on the dorsomedial or dorsolateral surface. •The needle is angled to 60-70 degrees to the plane of the match the slope of the joint. •Injection of the solution into the joint space should flow smoothly without resistance. •Pulling on the big toe is sometimes helpful in distraction of the joint. Peroneal tendonitis •Peroneal tendonitis is an irritation to the tendons that run on the outside area of the ankle, the peroneus longus and peroneus brevis. •The injection site is disinfected with betadine. •Insert the needle carefully in a proximal direction when injecting the peroneus brevis and longus tendon sheath. •Advance the needle distally to inject the peroneus brevis alone at its bony insertion. Achilles tendonitis •Achilles tendonitis is irritation and inflammation of the large tendon in the back of the ankle. Achilles tendonitis is a common overuse injury that occurs in athletes. •Injection of steroid should be given around the tendon, not through the tendon. •Injections directly into the tendon is not recommended due to increased risk of tendon rupture. •Platelets injection can be done through the tendon with needling and fenestration. Tarsal tunnel syndrome •The condition of pain and paresthesia caused by irritation to the posterior tibial nerve. •Feel the pulse of the posterior tibial artery, the nerve is posterior, find the area of maximum tenderness, 1-2 cm above it will be the injection site that is marked on the medial side of the foot and disinfected with betadine. •The solution is injected at an angle of 30 degrees and directed distally. •Warn the patient that the foot may become numb. •Care should be taken In walking an driving. •Usually performed after a treatment program which can include rest, stretching and the use of shoe inserts. Plantar fasciitis •The plantar fascia is a band of connective tissue deep to the fat pad on the plantar aspect of the foot. •Patients with plantar fascia complain of chronic pain symptoms that are often worse in the morning with walking. •The injection site is identified and marked on the medial side of the foot and betadine used. •Avoid injecting through the fat pad at the bottom of the foot to avoid fat atrophy. •The needle is inserted in a medial to lateral direction one finger breathe above the sole of the foot in a line that corresponds to the posterior aspect of the tibia. •The solution is injected past the midline of the width of the foot.
Views: 124546 nabil ebraheim
Lateral Sprained Ankle Stretches & Exercises - Ask Doctor Jo
 
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Lateral ankle sprains can be very painful and cause your ankle to become unstable. These stretches and exercises should help the healing process. See Doctor Jo’s blog post about this at: http://www.askdoctorjo.com/lateral-sprained-ankle The first stretch will be a calf stretch. Start off with your legs out in front of you. You can bend up the leg you aren’t using towards you in a comfortable position. Keep the leg you want to stretch out in front of you. Take a stretch strap, dog leash, belt, or towel and wrap it around the ball of your foot. Relax your foot, and pull the strap towards you stretching your calf muscle. You should feel the stretch under your leg. Hold the stretch for 30 seconds, and do three of them. Now prop your ankle up on a roll or hang your foot off the bed or table so your heel doesn't touch the floor. Put the band around the ball of your foot for good resistance. First, push your foot down and up. This is called ankle plantarflexion. Next you are going to cross your foot over the foot with the band as seen in the video, and pull your foot inward. This is ankle inversion. Now you want to wrap the band around your other foot. This time you will have resistance pulling out. This is ankle eversion. The next exercise will be standing up. You want to lean against a wall or something sturdy. Place the foot you want to stretch behind you. Make sure to keep your heel down and your toes forward pointing towards the wall. With the other foot in front of you, like you are in a lunge position, bend your knee towards the wall until you feel a stretch through your back leg. Try to keep your back leg as straight as possible. Hold the stretch for 30 seconds, and do it three times. Now is a heel raise off the ground. Stand with your feet about shoulder width apart, come up on your toes as high as you can. Try not to lean forward, but bring your body straight up and slowly come back down. Push off as much as you can so your heel leaves the ground. Start off with ten and work your way up to 20-25. The last exercise will be a balance series. Stand on one foot, but hold onto something sturdy. Try to balance for 30 seconds to a minute. When that becomes easy, just use one finger one each side. Then just one finger for balance, and finally try balancing without holding on at all. Related Videos: Sprained Ankle Treatment with Ankle/Foot AROM: https://youtu.be/UYM-_k_dWZw?list=PLPS8D21t0eO9JGYS958XUh2mkV8Sa2sAq Sprained Ankle - How to Wrap an Ankle Sprain: https://youtu.be/BPbUH4rdKPo?list=PLPS8D21t0eO9JGYS958XUh2mkV8Sa2sAq =========================================== SUBSCRIBE for More Videos: http://www.youtube.com/subscription_center?add_user=askdoctorjo ======================================= Doctor Jo is a Doctor of Physical Therapy. http://www.AskDoctorJo.com http://www.facebook.com/AskDoctorJo http://www.pinterest.com/AskDoctorJo https://www.instagram.com/AskDoctorJo http://www.twitter.com/AskDoctorJo http://plus.google.com/+AskDoctorJo ======================================= Lateral Sprained Ankle Stretches & Exercises: https://www.youtube.com/watch?v=3JJayVC0-20 DISCLAIMER: This content (the video, description, links, and comments) is not medical advice or a treatment plan and is intended for general education and demonstration purposes only. This content should not be used to self-diagnose or self-treat any health, medical, or physical condition. Don’t use this content to avoid going to your own healthcare professional or to replace the advice they give you. Consult with your healthcare professional before doing anything contained in this content. You agree to indemnify and hold harmless Ask Doctor Jo, LLC and its officers for any and all losses, injuries, or damages resulting from any and all claims that arise from your use or misuse of this content. Ask Doctor Jo, LLC makes no representations about the accuracy or suitability of this content. Use of this content is at your sole risk.
Views: 126859 AskDoctorJo
Ankle Joint Arthroscopy-Therapeutic : Ankle Arthroscopic Surgery, Examination, Treatment
 
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Source: https://www.epainassist.com Watch How Ankle Joint Therapeutic Arthroscopy is Performed? Procedure is performed to eliminate cause of ankle joint pain, remove loose fragments of cartilages and ligaments, treat fracture of medial malleolus, repair tendon tear or ligament tear. Here we explain about the Ankle Joint Arthroscopy Therapeutic; Ankle Arthroscopic Surgery, Examination, and Treatment What Is Therapeutic Ankle Joint Arthroscopy? Arthroscopy is an excellent diagnostic and therapeutic technique for management of joint disorders. Therapeutic ankle joint arthroscopy can be useful in treatment of a variety of intraarticular disorders, which may have been caused by injury or by degenerative, inflammatory, or other pathologic conditions. The loose fragments of bone and pathologic tissues are removed in the ankle joints using arthroscopic methods. The modern arthroscopic instrumentation and ankle distraction techniques availability has allowed orthopedic surgeons to manage a growing list of ankle disorders with therapeutic ankle joint arthroscopy. How Is Ankle Arthroscopic Surgery Done? Ankle arthroscopic surgery is a procedure that uses a fiber-optic viewing tiny camera and small surgical tools to operate in and around the ankle joint through tiny incisions. Arthroscopy is performed for the surgical evaluation and treatment of a variety of ankle disorders. One may need ankle joint arthroscopy if one has debris in their ankle from torn cartilage or fractured bone chip. An orthopedic surgeon may choose to do an arthroscopy to evaluate the extent of damage and possibly try to repair it. The patient will be brought to the operating room, prepped and draped for anesthesia and surgery. An IV line will be placed. The whole leg will be exposed, cleaned, and sterilized. The ankle will be numbed with a regional anesthetic block. Once patient is anesthetized, small incisions will be made for the portals to be inserted. The portals will be placed in different areas around the ankle for the instruments and camera to be inserted in. The surgeon will then perform the ankle arthroscopic procedure. Once the procedure is completed, the surgical instruments and portals will be removed. The small incisions will be closed and bandaged appropriately. What Are The Risks of Ankle Arthroscopy? Risks of Ankle Arthroscopy Include: •Ankle arthroscopy is generally a very safe procedure with low complication rates. •As with any surgical procedure involving the use of instruments to a normally sterile area, there is a risk of infection. •Bleeding may occur from cut blood vessels. •There is a risk of local nerve damage in some people from this ankle joint arthroscopic surgery making the overlying skin numb. •There is also risk of anesthesia, depending on the kind of anesthesia that is chosen. Watch Related Videos for Health Information: How is Shoulder Joint Arthroscopy Done?: https://www.youtube.com/watch?v=Cj7DnAzhnyo Elbow Joint Arthroscopy (Diagnostic) - To Identify The Cause Of Elbow Pain: https://www.youtube.com/watch?v=lCWNFdxmYSQ&t=17s What is Knee Arthroscopy & How is it Done?: https://www.youtube.com/watch?v=8Ue_u3i3Lws&t=237s Related Articles: Ankle Joint Ligament Injury: http://www.epainassist.com/sports-injuries/ankle-injuries/ankle-joint-ligament-injury Ankle Joint Tendonitis or Tendinitis: http://www.epainassist.com/joint-pain/ankle-pain/ankle-joint-tendonitis-or-tendinitis Treatment Of Footballer's Ankle: http://www.epainassist.com/sports-injuries/ankle-injuries/what-is-footballers-ankle-know-its-symptoms-causes-treatment Physical Therapy for Sprained Ankle: http://www.epainassist.com/manual-therapy/physical-therapy/how-to-treat-a-sprained-ankle-with-physical-therapy Understanding Ankle Joint: http://www.epainassist.com/joint-pain/ankle-pain/understanding-ankle-joint-know-about-the-supporting-ligaments-tendons-muscles Follow us: Facebook: https://www.facebook.com/Epainassistcom-370683123050810/?ref=hl https://www.facebook.com/painassist/?ref=aymt_homepage_panel Twitter: https://twitter.com/ePainAssist G+: https://plus.google.com/+Epainassist Linkedin: https://www.linkedin.com/in/epainassist Subscribe for more Health & Fitness Related Videos: https://www.youtube.com/user/epainassist1?sub_confirmation=1
Views: 17926 ePainAssist
Scanning Technique: Ultrasound-Guided Foot Injection - SonoSite
 
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Visit http://www.sonosite.com/education/ Demonstration of aspiration or injection of the ankle under ultrasound guidance, including probe type, probe position, projected needle path and key anatomy viewed during the exam. Visit http://www.sonosite.com/education/
Views: 63110 SonoSite
KT Tape: Peroneal Tendonitis
 
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Peroneal Tendonitis The three peroneal muscles, now called the fibularis muscles, are muscles at the surface of the outside of the lower leg. They serve to turn the foot out (evert) and push the foot down (plantarflex). The tendons run behind the anklebone and connect the muscles to the boney structures of the foot and ankle. They can become inflamed or torn during acute trauma or during periods of overuse. Rarely do these tendons become inflamed or torn without damage to other tendons and ligaments, so please assess other issues as well. Common causes include inversion ankle sprains, breaking into a sprint while off balance, or simply overusing these muscles resulting in inflammation. Other causes include poorly fit or worn footwear, excessive pronation, habitually running on embanked surfaces, excessive twisting of the ankle, and poor circulation along with malnutrition during activity. Older individuals become more susceptible to these injuries as the tendons lose their elasticity with age. Peroneal tendonitis typically results in pain on the outside of the foot below and behind the anklebone. Symptoms also include stiffness, swelling, or a burning sensation around the back of the ankle and outside edge of the foot. KT Tape can be a great help with pain and speeding the healing process by increasing circulation, providing stability, and relieving the pressure on this inflamed and painful tendon. Make sure to rest the ankle and ice after any activity as well as take anti-inflammatories during the worst times. Consider using this application in combination with the ankle stability application in order to avoid further injury and provide excellent stability without the downside of wearing a brace. If pain becomes severe or the ankle becomes discolored or very swollen, please seek additional care. For additional resources, please visit the KT Tape website at www.kttape.com
Views: 1179686 KT Tape
KT Tape: Distal Posterior Tibial Tendonitis
 
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The posterior tibial tendon serves as one of the most important supporting structures for the foot. It runs behind the ankle bone on the inside of the foot, across the instep, and connects to the bottom of the foot. It is crucial in the function of walking and running and helps to build the arch of the foot. A condition called Posterior Tibial Tendon Dysfunction (PTTD) is a breakdown or change in this tendon that causes flat feet. Irritation and overuse can cause the area behind the ankle bone to become inflamed and painful. Other symptoms of tendonitis in this tendon are pain at the instep, swelling along the tendon, general weakness in the ankle, or flattened feet. Knots can form in the tendon due to scar tissue and have the possibility of eventually rupturing. This makes it very important to relieve the stress and cause of inflammation as soon as possible. Standing, walking, or running for long periods of time, degeneration of the tendon due to age, obesity, poor nutrition, traumatic injury, and severe overuse can all contribute to problems with this tendon. Rest, massage, anti-inflammatory medication, and arch supports are non-surgical treatments used to help relieve the stress and continued degradation of the tendon. KT Tape provides much needed support and relief for the tendon. Increased blood flow to the area will help to provide nutrients and healing agents to the inflamed areas, as well as help to "cool" them down. During the healing process KT Tape will relieve the inevitable stress most individuals continue to put on their feet. Recovery times can be dramatically reduced and compensation injuries can be avoided when the pain relief is combined with support.
Views: 553407 KT Tape
Anterior Drawer Test of the Ankle | Chronic Ankle Laxity & Anterior Talofibular Ligament Rupture
 
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Enroll in our online course: http://bit.ly/PTMSK DOWNLOAD OUR APP: 📱 iPhone/iPad: https://goo.gl/eUuF7w 🤖 Android: https://goo.gl/3NKzJX GET OUR ASSESSMENT BOOK ▶︎▶︎ http://bit.ly/GETPT ◀︎◀︎ This is not medical advice. The content is intended as educational content for health care professionals and students. If you are a patient, seek care of a health care professional. The anterior drawer test has limited diagnostic ability for chronic ankle laxity but performs well in an acute situation to diagnose ruptures of the anterior talofibular ligament commonly injured after ankle inversion trauma  HELP TRANSLATE THIS VIDEO  If you liked this video, help people in other countries enjoy it too by creating subtitles for it. Spread the love and impact. Here is how to do it: https://youtu.be/b9cKgwnFIAw  SUPPORT US  : http://bit.ly/SPPRTPT  ARTICLES: Croy (2013): https://www.ncbi.nlm.nih.gov/pubmed/24175608 Van Dijk (1996): https://www.ncbi.nlm.nih.gov/pubmed/9065068 Miller (2016): https://www.ncbi.nlm.nih.gov/pubmed/26660862 Visit our Website: http://bit.ly/web_PT Like us on Facebook: http://bit.ly/like_PT Follow on Instagram: http://bit.ly/IG_PT Follow on Twitter: http://bit.ly/Tweet_PT Snapchat: http://bit.ly/Snap_PT
Views: 112140 Physiotutors
Ankle Manipulation ( AS Talus ) for reduced Ankle Dorsiflexion and Pain
 
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Ankle Manipulation by an Orthopedic Physiotherapist on a patient with reduced Ankle Dorsiflexion associated with pain while walking while weight bearing non the affected side. This video is for educational purposes only, make sure you are a Qualified Physiotherapist trained in Manual Therapy before attempting this. Follow my Facebook page : https://m.facebook.com/faiyaz.khan123?refid=7 Follow my Clinic page : https://m.facebook.com/faiyazkhan.manualmedicine/ Follow my blog : truehealthnutriphysio.blogspot.com
Views: 583 The Human Mechanic
Talus Fracture Types - Everything You Need To Know - Dr. Nabil Ebraheim
 
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Dr. Ebraheim’s educational animated video describes fracture types of the Talus. Anatomy of the talus •Head •Neck •Body •Lateral process •Posterior process •Medial & lateral tubercle Posterior view of the ankle & hindfoot: Posterior process of the talus is made up of a smaller medial tubercle and a larger tibial tubercle that is separated by a groove for the flexor hallucis longus muscle. Fractures of the talus •Head fracture •Neck fracture •Body fracture •Lateral process fracture •Posterior process fracture •Osteochondral fracture The main blood supply of the talus is the artery of the tarsal canal. It comes from the posterior tibial artery and supplies the majority of the talar body. The deltoid branch from the posterior tibial artery is an important branch involving badly displaced fractures. It supplies the medial part of the talar body. Interruption of the blood supply causes death of the bone, AVN and nonunion. Head fracture: 5-10% of all talar fractures are head fractures. Neck fracture: the fracture line exits inferior surface anterior to the lateral process. There are four types of talar neck fractures. •Type I: non-displaced. 15% AVN •Type II: fracture with subtalar dislocation or subluxation. 50% AVN. •Type III: fracture with subtalar and tibiotalar dislocation. 90% AVN. •Type IV: fracture with subtalar and tibiotalar dislocation and talonavicular subluxation. 90-100% AVN. Body fracture The fracture line exists inferior surface behind the lateral process. 25% AVN & 25% AVN with subtalar dislocation. Lateral process fracture •CT scan is helpful for lateral process fractures. There are three types of lateral process fractures that are called “snowboarder’s injuries” . •Type I: avulsion •Type II: large fragment: especially involving the joint needs surgery. •Type III: comminuted. Small and comminuted fragments treated with a cast. Posterior process fracture •Rare injury •Usually missed on initial x-rays •Misdiagnosed as an ankle sprain •Mechanism of injury: usually forcible plantar flexion of the ankle (nutcracker injury). •Differential diagnosis: Os Trigonum. •Treatment: if fracture is missed, painful nonunion and instability of the subtalar joint may result. CT scan is helpful. Lateral view in 30 degrees external rotation may show the fracture. Larger fragment involving the joint requires surgery. Smaller fragment; immobilize in a cast or a boot. Osteochondral lesion: •Osteochondral lesions can occur in the talus. It may require surgical treatment. Can occur in severe trauma to the ankle or severe ankle sprain. Become a friend on facebook: http://www.facebook.com/drebraheim Follow me on twitter: https://twitter.com/#!/DrEbraheim_UTMC
Views: 54831 nabil ebraheim
Injections Around The Shoulder - Everything You Need To Know - Dr. Nabil Ebraheim
 
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Dr. Ebraheim’s educational animated video illustrates injection techniques of the shoulder rotator cuff muscles tear. Injection of the shoulder could be part of the treatment of shoulder pain, especially if the pain is more than what the patient can handle. Shoulder pain will probably hinder the progress of therapy. Which patient is the one who we should inject? 1- Patient has pain with restricted shoulder movement. 2- Patient that has nighttime pain. 3- Patient cannot lie on the shoulder due to pain. Injection is predominantly used for elderly patients with rotator cuff tears or patients with impingement syndrome. Injection usually reduces the pain and inflammation. It can be done either blind or ultrasound guided for injection around the shoulder itself. If the injection being done is for the scapulothoracic joint, give the injection either fluoroscopic or blind. The injection could be done by a posterior, lateral, or anterior approach. I use the lateral and posterior approach. The posterior approach is done 1-2 cm below the posterolateral acromion. I mark the spot for the injection, then I introduce the needle and inject the fluid. The blind injection usually not accurate. Some of the data reports that the accuracy is between 65%-75% is probably not true (probably worse than that). Make sure you do not inject the rotator cuff tendon itself with steroids. When you do blind injection, you probably are injecting to the tendon and you do not know it because you cannot see the tip of the needle. When you use ultrasound guidance, you must see the bursa and find the tip of the needle and distend the bursa. You may do manipulation of the patient’s shoulder manually after administering the injection. When do I give a blind injection? I usually do blind injection the first time that I see the patient, especially if the patient is elderly or if the patient has an impingement syndrome. I will use ultrasound guided injection when patient has severe pain and some restriction of shoulder movement, or if the patient has had previous shoulder surgery. There are multiple points of pain, especially in the shoulder itself such as biceps tendon and AC joint. I personally examine the patient before and after injection. It is a very rewarding experience to see that the patient’s condition improved after ultrasound guided injection. I usually inject steroids, 40 mg kenalog with about 10 mg lidocaine. Cortisone will give short term yet, reasonable relief in some patients. The numbing medication will cause the patient to feel less pain immediately. However, the steroids can negatively affect the tendon and cartilage, causing tendon damage and rupture. The shoulder is not flat. The shoulder is a ball and socket joint and when you inject above the ball (humeral head), you are controlled by the shape of the ball. You may be injecting the tendon despite any good intention of only injecting the subacromial area. You may be unable to reach the area of the subacromial space due to the shape of the proximal humerus. Even with ultrasound guidance, I still have to make multiple modifications to see that the needle actually in the bursa. How many times do I give the patient an injection of steroids? Usually about 3-4 times a year. PRP: has a high level of concentrated growth factors which may help in healing the tissue. A blood specimen is taken from the patient, centrifuged, and then platelet concentrate is obtained and activated before injected in the target area. PRP: is probably good for young, active patients who play sports. These patients may have partial or intrasubstance rotator cuff tears that causes pain which limits activity. PRP may help these patients to avoid surgery and allow for healing of the rotator cuff tear. PRP is usually injected with ultrasound guidance because we can’t afford to do this blindly. We need to be able to see where the problem area is and inject the PRP into the area of this problem. Follow me on twitter: https://twitter.com/#!/DrEbraheim_UTMC Donate to the University of Toledo Foundation Department of Orthopaedic Surgery Endowed Chair Fund: https://www.utfoundation.org/foundation/home/Give_Online.aspx?sig=29
Views: 134179 nabil ebraheim
Friction the Deltoid Ligaments: Unraveling the Mystery of Ankle Pain Series Preview
 
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Did you know that 25,000 people sprain their ankle every single day? After the low back, the ankle is probably the second most common area of injury. In most cases, ankle sprains do not heal well without some treatment. That's a lot of clients who need you. Unraveling the Mystery of Ankle Pain 4-part webinar series worth 6 CE hours is available at: http://www.benbenjamin.com/webinarDescrip.php?id=S_881958787 When an ankle sprain does not heal properly, it can become a chronic problem. The ligament may have been stretched or may have developed poorly formed (and therefore weak) adhesive scare tissue, causing instability at the joint. Strenuous activities continually re-tear the scar tissue, resulting in a seemingly endless cycle of pain that comes and goes, with intermittent swelling. This can continue for many years if the injury is not properly treated. Learn to assess & treat 8 varieties of Ankle Sprains in this 4-part webinar series by Dr. Ben Benjamin. You'll come away understanding the relevant anatomy and assessment for each of these conditions, as well as therapeutic techniques for those you can treat and referral guidelines for those you cannot.
Views: 27630 Ben Benjamin
Talocrural Distraction Thrust Manipulation
 
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If you want to practice thrust manipulation, an effective and less nerve wracking (i.e. not spinal) technique is the talocrural distraction thrust. This is an older video, but in it, I also review how dorsiflexion should be measured - in supination with no eversion. Eversion is the common compensation for lack of dorsiflexion and leads to other inefficient patterns up the closed chain. Preferably, I would test and re-test in the lunge or half kneel ankle dorsiflexion test. http://modernmanualtherapy.com http://edgemobilitysystem.com http://themanualtherapist.com
Views: 3075 Modern Manual Therapy
Ankle instability: ligament rupture
 
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Ankle instability: ligament rupture demonstrated on physical tests and with live ultrasound scan footage
Views: 791 David fraser
Making Strides With an Ankle Fusion
 
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"It started when I had a motorcycle accident when I was 18 years," says Robert Werschky. Now 67, Werschky still felt the results almost 50 years later. The catastrophic crash left him with 23 breaks below his knee. This is an x-ray of his ankle taken last year. "The ankle was more or less crushed. And the doctors at the time told me I would have a lot of problems later on in life. And sure enough it came true," says Werschky. An active guy, an avid golfer, walking was always a pain. When it became uncontrollable Werschky took steps to fix the problem. "That's when I called Dr. Nemitz and he came forth with the only permanent solution: to have my ankle fused. You know, a patient really doesn't want to hear that. They really don't," says Werschky. "When they're getting to the point of needing a fusion to begin with, they have lost so much of their motion. They may have a few degrees left but it's mostly painful motion. And what I tell them is 'I'm going to take away the pain and maybe stiffen the joint a little bit more'," says Dr. Jason Nemitz, foot and ankle orthopedic surgeon on Lee Memorial Health System's medical staff. There is a lot of misconception surrounding ankle fusion. People fear a total loss of mobility in the foot. Fact is, there are three joints that affect motion. The other ones will compensate and provide some flexibility. "So the foot can go up and down around that joint as well as side to side," says Dr. Nemitz. Here's a view of Werschky ankle as it looks today. "You fix the two joints with a series of screws. If you compress those two joints together, you're trying to convince those two surfaces that they're actually a broken bone, that they're going to heal to each other," says Dr. Nemitz. And that's exactly what happened. In the months since, Werschky has made great strides. Now he walks for the pure pleasure. "Just simply going for a walk in the morning with my wife. I could actually walk 18 holes of golf now. It's just changed my life tremendously," says Werschky. Once he got over the stumbling block. View More Health Matters video segments at leememorial.org/healthmatters/ Lee Memorial Health System in Fort Myers, FL is the largest network of medical care facilities in Southwest Florida and is highly respected for its expertise, innovation and quality of care. For nearly a century, we've been providing our community with everything from primary care treatment to highly specialized care services and robotic assisted surgeries. Visit leememorial.org
Views: 106190 Lee Health
HVLA Extremity Manipulation - Left Fibula Anterior / Talus Supine
 
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HVLA Extremity Manipulation - Left Fibula Anterior . Talus Supine Manipulations Structurelles - Fibula Gauche Antérieure /Talus Décubitus http://www.manualtherapies.online 👉 JOIN US TO OUR NEXT SEMINARS : https://www.manualtherapiesonline.com/mto-seminars 👉 HVLA SEMINARS : https://www.manualtherapiesonline.com/hvla-seminars 👉 FASCIA SEMINARS : https://www.manualtherapiesonline.com/fascia-seminars Manual Therapies Online : the best website for all the manual therapists Manual Therapies Online : Le meilleur site pour tous les thérapeutes manuels Musiques / Musics: The Secession - Move Forth Fargo - Riot Réseaux Sociaux Facebook : https://www.facebook.com/ManualTherapiesOnline/ Twitter : https://twitter.com/MTOnline3 Youtube Channel : https://www.youtube.com/channel/UCekaZ_vBS1h2BTELCeG4bBg Google+ : https://plus.google.com/u/0/108237416079250045369 Pinterest : https://fr.pinterest.com/mantheonline/ Instagram : https://www.instagram.com/mantheonline/?hl=fr
Anterior Talofibular Ligament Active Release
 
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A soft tissue technique effective for ankle sprains. Learn more at www.zaccupples.com
Views: 2571 Zac Cupples
Subtalar Joint Range of Motion With Foot Skeleton
 
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Dr. Kirby demonstrates the gliding articular motions of the talus and calcaneus during subtalar joint pronation and supination. The maximally pronated position of the subtalar joint occurs when the lateral process of the talus drops down into the floor of the sinus tarsi of the calcaneus and is stopped by interosseous contact forces. Subtalar joint supination causes an increase in the volume of the sinus tarsi since the lateral process of the talus is moving away from the floor of the sinus tarsi of the calcaneus. Sinus tarsi syndrome occurs when the interosseous compression forces between the lateral process of the talus and the floor of the sinus tarsi of the calcaneus are increased in patients with more severe medial subtalar joint axis deviation and/or with painful scar tissue within the sinus tarsi from inversion ankle sprains or other traumatic pathologies.
Views: 15625 Kevin Kirby
KT TAPE  Lateral Ankle sprain
 
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ATFL, lateral ankle sprain or strain, inversion sprain This video is the property of and copy written by ergasiaPT. It may be shared but not duplicated with the intent of monetary gain without the expressed written permission of the publisher.
Views: 571536 ergasia PT
Ankle Pain Relief Exercises
 
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Ankle Pain Relief Exercises. http://zhealtheducation.com/episode-127-ankle-pain-relief-exercises/
Views: 98520 ZHealthPerformance
Ankle Exercises For Arthritis
 
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The fourth video in our four-part series shows exercises targeting arthritis pain in your ankles. Stop exercising if you feel deep joint pain or bone-on-bone grinding. Talk to your doctor or physical therapist if you experience sharp pain while exercising.
partial rupture atfl  13 54 56 hrs   0004143 new
 
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Ultrasound guided ATFL stress test. Acute ankle inversion trauma: partial tear visualised, clinically firm end feeling, no instability symptoms. Useful differential test.
Exercises for Ankle Joint Ligament Injury & It's Recovery Period
 
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For the Ankle Joint Ligament Injury to heal completely and in the fastest possible time, it is imperative to do the following exercises, which is shown in the video diligently. In post ankle joint ligament injury, there is substantial swelling and reduced range of motion of the ankle. Learn about the exercises and recovery time for ankle joint ligament injury. Also Read: https://www.epainassist.com/sports-injuries/ankle-injuries/ankle-joint-ligament-injury Follow us: Facebook: https://www.facebook.com/Epainassistcom-370683123050810/?ref=hl Twitter: https://twitter.com/ePainAssist G+: https://plus.google.com/+Epainassist Linkedin: https://www.linkedin.com/in/epainassist
Views: 68424 ePainAssist
Kinesiotaping for Medial Ankle Instability
 
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http://riseabovestrength.com In this segment of the Sports Performance Series I asked expert physical therapist Jeff Lam of Move Well Physical Therapy about kinesiotaping for rehabilitation and sports performance. Jeff explains what the tape is for and demonstrates how to tape an ankle suffering from medial instability. Check out more of Jeff at http://movewellphysicaltherapy.com
Ankle Arthroscopic Surgery - Houston foot and ankle Surgeon - Dr Robert J Moore III
 
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If you have ankles that ache, give out, swell, 'catch', or simply feel unstable from previous accidents or factures, then an arthroscopic examination is the best diagnostic and treatment tool for you. This is an actual arthroscopic examination with resection of joint pathology (removal of damaged cartilage and bone). To see more surgery instruction videos or for more information, log on to http://www.www.MyFootFix.com or our blog at http://www.Dr-Robert-J-Moore-III.com to watch the surgery, listen to patient testimonials, see patient reviews, ask Dr Moore a question, or make an appointment. Stay Healthy and One Step Ahead!
Ankle Fracture Stretches & Exercises - Ask Doctor Jo
 
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These ankle fracture stretches and exercises should only be done after your broken ankle has healed, and you are cleared by your doctor to start physical therapy. See Doctor Jo’s blog post about this at: http://www.askdoctorjo.com/ankle-fracture-stretches-exercises Often after an ankle fracture, your ankle becomes very stiff and weak. These stretches and exercises should help. The first stretch will be a calf stretch. Start off with your legs out in front of you. You can bend up the leg you aren’t using towards you in a comfortable position. Keep the leg you want to stretch out in front of you. Take a stretch strap, dog leash, belt, or towel and wrap it around the ball of your foot. Relax your foot, and pull the strap towards you stretching your calf muscle. You should feel the stretch under your leg. Hold the stretch for 30 seconds, and do three of them. Now prop your ankle up on a roll or hang your foot off the bed or table so your heel doesn't touch the floor. Put the band around the ball of your foot for good resistance. First, push your foot down and up. This is called ankle plantarflexion. Next you want to wrap the band around your other foot. This time you will have resistance pulling out. This is ankle eversion.Now cross your foot over the foot with the band as seen in the video, and pull your foot inward. This is ankle inversion. The next exercise will be standing up. You want to lean against a wall or something sturdy. Place the foot you want to stretch behind you. Make sure to keep your heel down and your toes forward pointing towards the wall. With the other foot in front of you, like you are in a lunge position, bend your knee towards the wall until you feel a stretch through your back leg. Try to keep your back leg as straight as possible. Hold the stretch for 30 seconds, and do it three times. Then you will bend your back knee, and do the same stretch. This is to stretch the Soleus muscle which is underneath your gastroc. Hold the stretch for 30 seconds, and do it three times. Now is a heel raise off the ground. Stand with your feet about shoulder width apart, come up on your toes as high as you can. Try not to lean forward, but bring your body straight up and slowly come back down. Push off as much as you can so your heel leaves the ground. Start off with ten and work your way up to 20-25. If this becomes easy, then you can do one foot at a time. The last exercise will be a balance series. Stand on one foot, but hold onto something sturdy. Try to balance for 30 seconds to a minute. When that becomes easy, just use one finger one each side. Then just one finger for balance, and finally try balancing without holding on at all. Related Videos: Ankle Strengthening Exercises & Stretches: https://youtu.be/g-iXYapbuqk?list=PLPS8D21t0eO9JGYS958XUh2mkV8Sa2sAq Sprained Ankle Treatment: https://youtu.be/UYM-_k_dWZw?list=PLPS8D21t0eO9JGYS958XUh2mkV8Sa2sAq =========================================== SUBSCRIBE for More Videos: http://www.youtube.com/subscription_center?add_user=askdoctorjo ======================================= Doctor Jo is a Doctor of Physical Therapy. http://www.AskDoctorJo.com http://www.facebook.com/AskDoctorJo http://www.pinterest.com/AskDoctorJo https://www.instagram.com/AskDoctorJo http://www.twitter.com/AskDoctorJo http://plus.google.com/+AskDoctorJo ======================================= Ankle Fracture Stretches & Exercises: https://www.youtube.com/watch?v=-FmJLBlBlNU PRODUCT PLACEMENT DISCLAIMER: This video represents the honest opinions of Doctor Jo. Thank you to King Athletic for providing Doctor Jo with free loop bands to use. DISCLAIMER: This content (the video, description, links, and comments) is not medical advice or a treatment plan and is intended for general education and demonstration purposes only. This content should not be used to self-diagnose or self-treat any health, medical, or physical condition. Don’t use this content to avoid going to your own healthcare professional or to replace the advice they give you. Consult with your healthcare professional before doing anything contained in this content. You agree to indemnify and hold harmless Ask Doctor Jo, LLC and its officers for any and all losses, injuries, or damages resulting from any and all claims that arise from your use or misuse of this content. Ask Doctor Jo, LLC makes no representations about the accuracy or suitability of this content. Use of this content is at your sole risk.
Views: 85789 AskDoctorJo
Osteonecrosis, AVN Of The Talus - Everything You Need To Know - Dr. Nabil Ebraheim
 
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Dr. Ebraheim’s educational animated video describes osteonecrosis of the talus – AVN. fractures of the talar neck. Osteonecrosis is death of a segment of bone that interrupts the blood supply. This is the blood supply of the talus: • Artery of the tarsal canal: The artery of the tarsal canal is the dominant blood supply. • Deltoid branch of the artery of the tarsal canal: the only remaining blood supply with displaced fracture. • Posterior tibial artery • Artery of the sinus tarsi. Talar neck fractures are classified into four types. Hawkin’s classification • Type I: nondisplaced. 10% AVN. • Type II: fracture with subtalar dislocation or subluxation. 50% AVN. • Type III: fracture with subtalar and tibiotalar dislocation or subluxation. 90% AVN. • Type IV: fracture with subtalar and tibiotalar dislocation and talonavicular subluxation. 100% AVN. The fracture is usually reduced and fixed with the patient followed up clinically and radiologically for healing of the fracture and the development of avascular necrosis. The status of talar vascularity can be checked by the Hawkin’s sign. The Hawkin’s sign helps in the diagnosis of AVN. What is the Hawkin’s sign? The Hawkin’s sign is a subchondral osteopenia (lucency) seen at six to eight weeks on the mortise view x-ray of the ankle on the dome of the talus. Look for the radiolucent line below the subchondral bone. Radiolucent line is more commonly seen on the medial side of mortise view. The Hawkin’s sign is a good indication of intact vascularity with resorption of the subchondral bone following fracture of the talar neck. It is 100% sensitive and 58% specific. It indicated that the talus is alive and good prognosis. Its absence does not rule out intact vascularity. Once the fracture heals, begin weight bearing. Restricting weight bearing beyond that which is needed for healing of the fracture does not decrease the risk of osteonecrosis. At 3-6 months post operatively, AVN can be seen on the plane x-ray as sclerosis. MRI is sensitive for detecting AVN as it shows decreased signal on T1 but it does not guide the treatment. In MRI studies, titanium implants have better visualization that stainless steel. Osteonecrosis does not usually involve the entire talar body. Treatment is conservative. Surgical treatment includes tibiotalar fusion (ankle fusion). In cases of excessive osteonecrosis, tibiocalcaneal fusion or Blair fusion may be useful. Become a friend on facebook: http://www.facebook.com/drebraheim Follow me on twitter: https://twitter.com/#!/DrEbraheim_UTMC Donate to the University of Toledo Foundation Department of Orthopaedic Surgery Endowed Chair Fund: https://www.utfoundation.org/foundation/home/Give_Online.aspx?sig=29 Background music provided as a free download from YouTube Audio Library. Song Title: Every Step
Views: 8979 nabil ebraheim
Dorsiflexion External Rotation Stress Test | Syndesmosis Injury
 
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Enroll in our online course: http://bit.ly/PTMSK DOWNLOAD OUR APP: 📱 iPhone/iPad: https://goo.gl/eUuF7w 🤖 Android: https://goo.gl/3NKzJX GET OUR ASSESSMENT BOOK ▶︎▶︎ http://bit.ly/GETPT ◀︎◀︎ This is not medical advice. The content is intended as educational content for health care professionals and students. If you are a patient, seek care of a health care professional. The External Rotation Stress Test assesses for syndesmosis injury at the lower limb/ankle. Pain over the Anterior/posterior fibular ligament or the interosseous membrane indicates a positive test.  HELP TRANSLATE THIS VIDEO  If you liked this video, help people in other countries enjoy it too by creating subtitles for it. Spread the love and impact. Here is how to do it: https://youtu.be/b9cKgwnFIAw  SUPPORT US  : http://bit.ly/SPPRTPT  ARTICLES: Sman et al. (2013): https://www.ncbi.nlm.nih.gov/pubmed/23222193 Visit our Website: http://bit.ly/web_PT Like us on Facebook: http://bit.ly/like_PT Follow on Instagram: http://bit.ly/IG_PT Follow on Twitter: http://bit.ly/Tweet_PT Snapchat: http://bit.ly/Snap_PT
Views: 29475 Physiotutors
Ankle injection 06/16/11
 
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This video was uploaded from an Android phone.
Views: 1000 73Rizzle
Ankle Strengthening: Top 3 Exercises (by Physical Therapists)
 
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Famous Physical Therapist's Bob Schrupp and Brad Heineck demonstrate the top 3 exercises one can do to strengthen their weak ankles. No equipment is needed to perform these exercises. Make sure to like us on FaceBook https://www.facebook.com/Physical-Therapy-317002538489676/timeline/ Check out the Products Bob and Brad LOVE on their Amazon Channel: https://www.amazon.com/shop/physicaltherapyvideo Follow us on Twitter https://twitter.com/PtFamous Our book “Three Simple Steps To Treat Back Pain” is available on Kindle http://www.amazon.com/Three-Simple-Steps-Treat-Back-ebook/dp/B00BPU4O5G/ref=sr_1_1?ie=UTF8&qid=1444092626&sr=8-1&keywords=3+simple+steps+to+treat+back+pain
Views: 33596 Bob & Brad
Ankle Sore after Walking? What's Wrong and How to Fix it
 
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Dr Centeno discusses what can cause ankle soreness after walking and how this could be a sign of more serious issues.
Views: 10917 Chris Centeno, M.D.
How to visualise the anterior talofibular ligament on ultrasound
 
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How to visualise the anterior talofibular ligament on ultrasound, a brief tutorial on how to ultrasound the lateral ankle ligaments.
Views: 5991 Stuart Wildman
Ultrasound Guided Steroid Injection
 
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Ultrasound Guided Steroid Injection - Knee Dr. Edmond Cleeman http://manhattanorthopedic.com/doctors/edmond-cleeman/ This is an educational video about Ultrasound Guided Steroid Injections to the knee. Steroid injections for arthritic joints were first used more than 50 years ago, and are commonly used by physicians to reduce knee pain. What exactly is a cortisone injection: It’s typically a cocktail of 2 medications, an anesthetic called lidocaine and the other is the steroid. How does it work? Knee Arthritis is essentially a wearing of the cartilage – But – another major contributing factor to knee arthritis pain is inflammation in the knee. Steroid injection reduces the inflammation in the knee and thereby reduces knee pain and increases ROM.
Views: 2567 Orthopedic Updates