Anterior Compartment Syndrome - PowerPoint PPT Presentation

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Anterior Compartment Syndrome

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Anterior Compartment Syndrome By Marie and Molly History 20 year old female soccer player Midfield Position During one of the last practice sessions of the season was ... – PowerPoint PPT presentation

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Title: Anterior Compartment Syndrome


1
Anterior Compartment Syndrome
  • By Marie and Molly

2
History
  • 20 year old female soccer player
  • Midfield Position
  • During one of the last practice sessions of the
    season was kicked in the shin by another player
  • Athlete was not wearing shin guards

3
Signs and Symptoms
  • Pt. c/o pn w/passive plantar flexion
  • Pn along ant. Aspect of lower leg
  • Palpation reveals hardness and tension w/soft
    tissue
  • Shiny or pallor skin
  • Distal pulse diminished
  • Numbness and tingling radiating to toes

4
Diagnosis
  • Pt. has Anterior Compartment Syndrome
  • What is it?
  • There are 4 compartments in the lower leg
  • Each compartment holds fascia and muscle
  • Pressure becomes too great and there is no room
    for expansion
  • Vascular structures and neural structures can be
    damaged
  • Anterior compartment most commonly injured

5
Treatment
  • Surgery must be performed
  • A fasciotomy is performed to release pressure in
    the compartment
  • 95 success rate

6
Treatment
  • Muscles invloved
  • Tibiallis Ant.
  • Ext. digitorum lungus
  • Ext. hallicus lungus

7
Surgery
Fascial release
Cut distally
injection
Close up of cross section
Release of peroneal nerve
8
Surgery Cont.
9
Treatment Post Op
  • Must be place on crutches w/non-weight bearing
    for 7-10 days
  • Friction massage by incision for soft-tissue
    mobility
  • Gait training
  • NSAIDS

10
Goals for Post-Op
  • Full ROM
  • Biking/Swimming 2-4 weeks
  • Swimming when wound heals
  • Jogging at 4-6 weeks
  • Sports participation 6-8 weeks
  • Athlete should be able to run 2-3 miles pn free
    before returning to play

11
Modalities
  • Milk Massage
  • Myofascial release
  • Release scar tissue
  • Ice Bag/slush bucket
  • Heat
  • Start 3rd week

12
Week 1
  • Non-weight bearing
  • Check wound dressing daily

13
Week 2
  • Partial weight-bearing
  • 2 point gait
  • Isometric exercises
  • Inversion
  • Eversion
  • Planter flexion
  • Dorsiflexion
  • Toe Exercises
  • Towel rolls

14
Week 2 cont.
  • Alphabet
  • Weight-scale exercise
  • Stretching
  • Gastroc stretch
  • Soleus stretch
  • Achilles stretch
  • Dorsiflex stretch

15
Week 3/4
  • Arm Bike/Elliptical
  • Gait training
  • POOL
  • Single leg stance
  • Grapevine
  • Step ups
  • Gastro/soleus stretch
  • Heel raises

16
Week 3/4 Cont.
  • Ankle Walking
  • Double knee bend
  • Seated knee extension
  • Team core work-out

17
Week 5/6
  • Underwater treadmill
  • BAPS board
  • Two legs
  • Closed kinetic chain
  • 4 Lunges
  • Squats both legs
  • Leg presses

18
Week 5/6
  • Terminal knee ext.
  • Heel raises
  • Lower leg and foot stretches
  • Rubber Tubing
  • Inversion/eversion
  • Plantar/dorsiflexion

19
Week 7/8
  • Warm up walking on treadmill
  • Stair climber
  • Treadmill jogging ½ mile to 1 mile
  • Lower leg stretches
  • BAPS board
  • One leg
  • 4 Lunges w/tubing
  • Leg press-
  • More weight

20
Week 7/8 cont.
  • Heel raises
  • Tubing exercises w/increase resistances
  • Lunges w/tubing

21
Week 9/10
  • Running on the field
  • Swimming
  • Box jumping
  • Dot drills
  • Long/short passing
  • Ball Juggling
  • Backwards running w/ball kicking
  • Z-lines w/ball
  • Corner Kick drills

22
Week 9/10
  • During last week they must pass functional tests
    before moving to functional exercises
  • Must be pain free
  • Functional exercise
  • Scrimmage

23
Practice
  • Return to play w/shin guards
  • Athlete may participate in
  • Upper Extremity Weight Lifting
  • Practice drills as tolerated w/lower ext.
  • Any upper extremity drills
  • Core work outs

24
Considerations
  • Watch for
  • Increase swelling
  • Increase pain
  • Numbness or tingling
  • If any apply, modify the rehab
  • Everything is as tolerated
  • May need to continue rehab longer than expected
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