Ahilova Tetiva Upala, Povreda, Vežbe – Šta Savetuje Vaš Fizijatar? | Tendo
1. Ahilova tetiva – snažna struktura našeg tela
njuring your anterior cruciate ligament (ACL) is a common problem in the world of sport, amateur or professional. Not even the elite sporting environment can completely stop an ACL injury from occurring. Some of the biggest names have suffered a ruptured ACL, including Virgil Van Dijk, Zlatan Ibrahimovic, Anne Keothavong, Beth Cobden and Tiger Woods.
Research has shown that despite advances in ACL rehabilitation, there are still biomechanical differences between limbs across jump tasks in the general population. This suggests insufficient rehabilitation at nine months post-surgery.
However, the sport science world is evolving fast and one of the latest tools to be developed to measure an athlete’s performance is a force plate. It is designed to detect the amount of force exerted when a person hits the ground. But how are force plates revolutionising ACL rehabilitation?
WHAT IS A FORCE PLATE?
In simple terms, a force plate is a device, or platform, that is used to measure the forces exerted on the ground by a person as they perform a movement, like running or jumping. There can be more than one force plate that are connected together. Each force plate has a network of sensors that detect movement and measure various parameters, such as posture stability, explosive force, power and the reaction force from the ground.
Broken down, the force plate will indicate direction, strength and reaction time of muscles, and motor patterns. The results allow physiotherapists to analyse the person’s performance and the specific movements involved in a particular sport.
This information is used by physiotherapists to identify asymmetrics in someone’s movement during sporting activity, detecting weaknesses in strength and plyometric insufficiencies, i.e. areas where the reactive and explosive movements are lacking, indicating a deficiency of power.
HOW ARE FORCE PLATES USED?
In most cases, force plates are used for jump and strength testing. Let’s look at these tests in more detail.
JUMP TESTING
A person will be asked to perform a range of ‘jumps’ on the force plate to test their bilateral and unilateral strength. For bilateral tests, the jumps include squat, drop and countermovement jumps. For unilateral tests, the jumps include single leg drop, hop and return, and countermovement jumps.
STRENGTH TESTING
To measure an athlete’s performance output, force plates test bilateral and unilateral strength. For bilateral tests, a person will be required to hold an isometric squat and an isometric mid-thigh pull. Unilateral strength tests include a single leg isometric mid-thigh pull and a single leg squat hold.
Using what’s called a ForceDecks system which calculates the relevant test metrics, physiotherapists are able to see how the person is moving and how they generate power, vertical force and velocity. They are also able to identify the weaker areas that require more focused treatment.
HOW DO FORCE PLATES HELP WITH ACL REHABILITATION?
The benefit of force plates is that they provide information that may be missed by the human eye, which allows for better, more thorough rehabilitation.
At Mint Wellbeing, our force plates assessment is revolutionising the rehabilitation process from sports related injuries, particularly for ACL injuries, as well as other strains and stresses experienced by sports people.
The data generated by the force plates is combined with other physiotherapy tests. We are then able to identify asymmetries or weaknesses in a person’s movement, power, rate of force production or eccentric control, allowing us to tailor their rehabilitation treatment and accelerate the recovery process.
In addition, we can identify more accurately when a person is ready to move on to the next phase of their rehabilitation, when they can return to their sport and when they are most likely to be at risk of re-injury during their training regime.
This means that physiotherapists are able to guide athletes in how they can improve their performance, as well as where they need to change their training programme to avoid re-injury in the future.
If you’re suffering from a sports related strain or an ACL injury, we would highly recommend our force plate assessment. Not only will this help us in tailoring a rehabilitation treatment and recovery programme, our force plate trained physiotherapists will be able to identify areas where performance can be improved, and future ACL injuries prevented.
Call Mint Wellbeing on 0208 987 8026 or email us at info@mintwellbeing.co.uk and we will arrange for you to see one of our force plate trained physiotherapists for an assessment.
Ahilova tetiva je najjača tetiva u telu. Ona prenosi snagu mišića lista na stopalo i apsorbuje višestruku telesnu težinu pri svakom koraku. Posebna otpornost na kidanje i debljina omogućavaju ekstremna opterećenja, kao što su trčanje i skakanje.
Problemi sa Ahilovom tetivom često se javljaju postepeno. Obično su uzrokovane prekomernim i nepravilnim naprezanjem – često usled prekomernog bavljenja sportom. Kod hronočnog toka ili velikog akutnog opterećenja može doći do pucanja Ahilove tetive.
2. Povreda Ahilove tetiva usled prekomernog opterećenja
Povrede Ahilove tetive usled prekomernog opterećenja (tendinopatija) su znatno češće kod muškaraca nego kod žena. Za sportiste rizik raste sa godinama i brojem pređenih trenažnih kilometara, na primer u sportovima kao što su trčanje, fudbal, tenis i dr.
Simptomi povrede ove tetive mogu biti akutni ili hronični.
3. Ahilova tetiva – zašto nastaju bol, upala i oštećenje funkcije?
Tendinopatija Ahilove tetive kod sportista može imati raličite uzroka.
Najčešći okidač problema je nagla promena opterećenja.
4. Akutna upala Ahilove tetive (tendinitis) – simptomi
Upala Ahilove tetive prepoznaje se po tipičnim simptomima:
• otečena, bolna tetiva koja je osetljiva na opterećenje
• difuzni bol u različitim delovima tetive, uglavnom u blizini pete (ahilodinija)
• tetiva bolna na dodir
• ograničena pokretljivost skočnog zgloba
Povređenoj Ahilovoj tetivi treba 6 – 8 nedelja pre nego što ponovo može da se optereti.
5. Hronična upala Ahilove tetive (tendinopatija) – simptomi
U slučaju hronične tendinopatije Ahilove tetive, oštećena tetivna vlakna se zamenjuju manje elastičnim ožiljnim tkivom. Pored toga, sićušni sudovi i nervna vlakna mogu urasti u tetivu. Obično je zahvaćena srednja trećina tetive, ređe pripoj Ahilove tetive na petnu kost. Zbog ožiljnog tkiva može doći do parcijalne rutpure Ahilove tetive
Tipični simptomi tzv. rupture:
• iznenadni jak bol u Ahilovoj tetivi ili donjem delu lista
• zvuk kidanja ili pucanja
• stajanje na prstima na oboleloj nozi uopšte nije moguće ili samo uz jak bol
• šepajući hod
5. Upala Ahilove tetive lečenje – značaj fizikalne terapije
Fizikalna terapija kod većine pacijenata sa upalom Ahilove tetive predstavlja terapiju izbora.
Prvi korak je uvek pregled specijaliste fizijatra. On može uključiti ultrazvučni pregled Ahilove tetive.
Kod pregleda pacijenta sa upalom Ahilove tetive ključni su provokacioni testovi.
Težina upale Ahilove tetive određuje se putem provokacionih testova
Nakon detaljnog pregleda napraviće se plan lečenja koji zavisi od težine simptoma i proceniti dužina trajanja lečenja.
Kod akutne upale Ahilove tetive cilj terapije je da se smanji bol i upala. To se na prvom mestu postiže fizikalnim agenasima (elektroterapija, tekar terapija, HILT).
Kada se smanji bol i kod hronične tendinopatije, uvode se vežbe snage. One stimulišu ćelije tetiva da proizvode kolagen i proteine. To omogućava da se tetiva oporavi.
Vežbe za jačanje Ahilove tetive predstavljaju ključ oporavka! Kod hronične upale vreme izlečenja je najmanje tri meseca, uspešnost je 90 odsto.
6. Ahilove tetiva oporavak – da li treba da prestanete da se bavite sportom?
Sa akutnom upalom Ahilove tetive, potrebna je kratka pauza od sporta. Lekar koji vas leči treba da odredi trajanje.
Kod hronične upale Ahilove tetive važna je modifikacija opterećenja. To znači da treba obustaviti sve aktivnosti koje provociraju bol ili ih modifikovati (smanjiti brzinu, učestalost treninga i dr.) na način da ne provociraju bol. Najčešći problem su sportovi koji preterano opterećuju Ahilovu tetivu, kao što su skakanje, trčanje, tenis ili fudbal.
7. Ahilove tetiva oporavak – ulošci
Meko podstavljeni ulošci i podignute potpetice skidaju opterećenje sa Ahilove tetive i time ga oslobađaju.
8. Shockwave terapija – kako pomaže oporavku?
Shockwave terapija ima za cilj da promoviše oslobađanje faktora rasta i drugih biološki aktivnih proteina, čime se aktiviraju i podržavaju procesi samoizlečenja u telu. Oštećeno tkivo tetiva se „regeneriše“, a bol smanjuje. Poboljšanje simptoma ne može se očekivati odmah.
9. Injekcije kortikosteorida – uloga u lečenju?
Injekcije kortikosteroida mogu brzo da ublaže probleme sa tetivama, ali uspeh često traje samo nekoliko nedelja. Međutim, kortikosteroidi utiču na kvalitet tkiva tetive. Što se kortikosteroid češće ubrizgava, to je veći rizik od rupture Ahilove tetive.