Achilles Tendon Sprain Case Study

Achilles Tendon Sprain Case Study Name: Lani Thompson Age: 26 Sex: Female Occupation: Merchandiser Height: 179 Weight:77.8, BMI: Diet: Mixed Family: She lives with her partner, no kids. Medical History: No history of Hypertension, Cardiovascular, Diabetics mellitus, pulmonary or any chronic disease. Footwear: A comfortable, properly fitted footwear should be used. Avoid High heels. Daily activities: Usually she goes to Gym thrice in a week, occasionally she goes for swimming. Balance: Muscle performance: No muscle wasting. Posture: Circumferential measurement: Alignment: There is no difference in alignment while she walks. History: Lani Thompson is a hockey and rugby player. About 4 months back, while she was training rugby she had a right ankle sprain. The Incident was happening around 7 in the night. Soon after she was shifted to the hospital and consulted with the doctor. On the same day she had undergone several investigations and examinations, including X-Ray and ultrasound. No evidence of any fracture on the x-ray and was diagnosed as an Achilles tendon sprain. Initial 2 weeks she was in a brace, subsequently she started ankle exercises. Later she exercised with Theraband and had started physiotherapy treatment for 2 weeks, eventually continued her exercises at home. Past Medical History: She has never been hospitalized for any chronic diseases. No history of Diabetes mellitus, Hypertension, Heart diseases, Asthma, Hepatitis, Sexually transmitted diseases or Tuberculosis. She regularly takes medications for depression/anxiety and for contraception. Medication: Venlafaxine, Quitiepine and a contraceptive pill. Surgical Intervention: No surgical interference. Gait pattern: Altered, limping of right leg. Range of Motion (ROM): Normal on left side, right ankle ROM is slightly altered, No muscle stiffness. Palpation: No tenderness or any abnormalities. Anatomy of the Ankle joint: The ankle joint mainly consists of two joints, the subtalar and the true ankle joint. The subtalar joint comprises three bones, the tibia, the fibula and the talus. The mechanism of the ankle joint is very complex. True ankle is responsible for the up and down movements of the foot. The subtalar joint is positioned under the true ankle joint and consists with two bones, the calcaneus and the talus. This joint is responsible for the side to side movement of the foot. The joint is covered with a cartilage known as articular cartilage. The articular joint is lubricated with synovial fluid. Many ligaments connect the ankle bones together, they are anterior fibular ligament, which attaches the fibula to the tibial bone. The second ligament is known as the lateral collateral ligament, which connects calcaneus bone with the fibula and the tibial bone and the third one is deltoid ligament, it connects calcaneus and the talus bones together to the tibia. Many tendons attach the muscles of the lower limb and the bones of the ankle, they are the Achilles, the flexor hallicus longus, the flexor digitorium, the peroneal tendons, the posterior tibialis and the anterior tibialis tendons. Among these tendons the Achilles tendon is considered to be the strongest tendons in the human body. It is located at the posterior of the leg and connects the calcaneus bone to the gastrocnemius ,solens and plantarius muscles. The Achilles tendon is about six inches long and can withstand around four time of body mass during walking and almost eight times while running. Achilles Tendonitis: It is the inflammation of the calcaneus tendon.Over use of the tendon causes pain and stiffness, for instance running up hill or climbing up stairs. Achilles Rupture: asdf†¦Ã¢â‚¬ ¦.. Exercises: Group 1 Exercise: Evertion/ Invertion isometric exercises. Evertion: This exercise can be performed by placing the injured foot adjacent to a door or the leg of a table and gradually push extremely to the lateral side of the foot. Inversion: This exercise can be done by placing the medial aspect of the foot to any fixed objects such as a table leg or a door, then to push gently outward –in for two to three seconds. Evertion/Invertion with an exercise band: Evertion: The client has to sit and fix the leg straight, with the help of an elastic band One end of the elastic band is attached to a table leg and other to the foot and then gradually turns the foot outwards. Invertion: Rotate the foot inwards by reversing the position of the band .The movement of the foot should be apart from the leg of the table. The client can proceed to the group two exercises, if he tolerates to do group one exercise. Group 2 exercises: Gastrocnemius stretch: The patient has to bend forward and push the wall with his hands. The injured leg should be placed just behind the other foot, keeping the foot firmly to the floor for about 30 seconds. Soleus Stretch: Place the non injured foot behind the injured foot and bend the other knee joint. The heel should be raised while stretching. Weight bearing exercises: The client should stand on the floor with the affected leg and bend the other leg, so that the whole body weight should bear on the injured leg for 30 seconds and then lift the heel up and down. Injured leg stand with a cloth: The client is asked to stand on a 2inches thick cloth with the injured leg for 30 seconds. The client can proceed to the group three exercises, if he tolerates to do group two exercises. Group 3 exercises: Lateral step and bound exercise. This exercise is performed by placing a folded towel on the floor and to stand beside the towel and client steps on the folded towel. Other foot should be placed firmly on the floor. Repeat the same exercise with other leg. As the pain allows, increase the repetitions and speed accordingly. Hop exercise: It is performed by placing a folded towel on a floor and the client is asked to stand beside the towel and bound over the folded towel and to rest on the other foot. Then reverse the entire exercise with the other leg.As the pain allows, slowly raise the speed and hops. Rehabilitation: Range of movement: Stretching of the calf muscle: When the patient will be able to sand comfortably with an injured leg, he is asked to move back the injured foot and move the hip gradually forward, so that the calf muscle is stretched. Hold for 20 seconds and repeat for at least 2 times per day. Alphabet writing: The patient has to write alphabets with his greater toe at least 2 times per day. Balance training exercises: By holding a fixed object firmly with one hand and stand on a single leg, keeping the other knee folded. Repeat the same with the other foot as well. As the patients balance improves, he is encouraged to repeat the same exercise with eyes shut. GOALS: Short term: Phase 1 and 2 Improve joint range of motion and flexibility Increase ankle strength Gain normal gait pattern Progressive Proprioception and motor coordination Long term: Phase 3 and 4 Improve cardiovascular endurance Return to complete sports activity Rehabilitation program involves: Stretching of the calf muscle and around the ankle muscle Strengthening exercise Deep massage techniques Cardiovascular endurance exercise Agility training Phase 1: T o gain range of motion Stretching- Calf plantar fascia stretch: Sit on the floor with leg extended and knees straight Loop a towel around the affected leg and grip the end of towel on each hand. Affected leg should be in straight and pull the towel near the body Hold the position as same for 30 seconds and relax Repetition: 3 to 5 Calf muscle stretching: Open kinetic chain exercise: Toe curls Marble pickups Four-plane surgical tubing exercises Sub maximal Isokinetics in short arc Strengthening exercise: Plantar flexion exercises with Theraband Inversion and eversion exercise isometric exercise Flexibility: Grade 1 and 2 mobilization Alphabet ROM Proprioceptive: Stork standing Single plane tilt board Biomechanical ankle platform system in non-partial Weight bearing position. Cardiac endurance exercise: Pool therapy Stationary cycling. PHASE 2: Stretching: Achilles stretches in sitting and standing positions Open kinetic chain exercise: full –arc ISO kinetics Close kinetic chain exercise: Shuttle squats Heel raises Toe raises Tubing lunge steps Proprioception: Wobble board work Walking on uneven surface Biomechanical ankle platform system with partial Cardiac endurance training: Treadmill Stairmaster PHASE 3: Program in this phase should be considered according to the Strength and progression of the client. The program involves dynamic and functional tolerance of the patient. Start up with increase weight bearing force on the ankle joint Stretching of Achilles tendon in a supinated position Eccentric heel drop with knee straight Eccentric heel drop with knee bent Lunges and squats Step ups Side step ups with weight bearing To focus on lateral stability –up and down sideways movement Back pedalling exercise Caricos Plyomettric drills Proprioception: Ladder drill Netball throwing and catching with Standing on the affected leg moving to catch the ball and return to land on the same leg. Four square hopping drills Agility training: Shuttle running with changing the direction Zigzagging or figure of 8 runs Phase 4: functional rehabilitation activities such as tip toe walking. Polymeric progressions –hopping, bounding, depth jumps and box drills Sport-specific training Unstable surface training Stationary cross country skier Ensure normal plantar to dorsiflexion strength ratios and muscle balance Careful increase in training regimens

Analysis of Massachusetts’ Health Care System :: essays research papers

Analysis of Massachusetts’ Health Care System Merna Chung   Ã‚  Ã‚  Ã‚  Ã‚  Massachusetts is located in the northeastern section of the United States with a land area of 7 ,838 sq. miles. It is nicknamed the Bay State. The total population of Massachusetts is 6,016,425. Massachusetts has a white majority with the protection of the rights of minorities. There is no single body responsible for making and enforcing health care policy. The majority of the population is White 5,405,374 ( 89.8 % ) ; Blacks 300,130 ( 5.0 % ) ; Hispanic 287,549 ( 4.8 % ) ; Asian 143,392 ( 2.4 % ) ; and the American Indian 12,241 ( 0.2 % ). The median age is 33.4 years. 22.5 % is under 18 and 13.6 % is over 65 years.   Ã‚  Ã‚  Ã‚  Ã‚  The major industries are Health Care , tourism, education , farming , and fishing making this state more rural than urban. It is not economically depressed because tourism has become an important factor in the economy.   Ã‚  Ã‚  Ã‚  Ã‚  Health care is a major industry in Massachusetts. It has seen a rapid growth in managed care organizations in recent years. These organizations strive to deliver high quality health care in a cost – effective manner by using our health care premiums to contract with doctors and hospitals. Two – thirds to three quarters of Massachusetts residents receive their health care through managed care organizations.   Ã‚  Ã‚  Ã‚  Ã‚  There are many health care systems and managed care organizations in Massachusetts. To name a few - Caregroup Health Care System ; Northeast Health Systems ; Partners Health Care Systems , Inc. Aetna Health Care ; Cigna Health Care of Massachusetts ; ConnectiCare of Massachusetts ; Fallon Community Health Plan ; Harvard Pilgrim Health Care , Inc. ; Health New England , Inc.   Ã‚  Ã‚  Ã‚  Ã‚  In general the population of Massachusetts is very healthy considering that there are so many health care organizations. Massachusetts General Hospital was founded in 1811 and is the third oldest general hospital in the United States and the oldest and largest in New England. This medical center has 820 beds and offers highly sophisticated diagnostic and therapeutic care in every specialty and subspecialty of medicine and surgery. Massachusetts General Hospital Admits approximately 35,000 in patients each year and handles more than 1 million visits in its outpatient programs at the main campus and at its four health centers. Annually the emergency department at the main campus handle about 80,000 visits.

Admissions to Montclair State University

â€Å"By learning you will teach, by teaching you will learn†. This is a Latin proverb that has echoed in my mind when I experience the joy of sharing my knowledge and whenever I feel the urge to search for answers to my endless questions.Early in life I have developed a keen interest in the field of biology. My fascination to know how living things survive, reproduce, and change in time led me to ask questions, read books, perform observation, and view documentary shows about science.I could vividly recall spending my childhood leisure hours in the garden to observe the different species of butterflies, how a caterpillar transform into pupa and later into an adult butterfly. Then, in my high school freshman days, I performed a five week experiment to determine how plants grow. This experiment has further awakened my interest as I learn to test the quality of the soil, and the right amount of water, light and temperature to sustain the life of the plants.My endless quest for k nowledge has led me to search for answers through the use of various sources of information. Whenever I have found the answers to my nagging questions, I could not resist sharing the information to my family, friends and classmates.The satisfaction that I have gained in imparting my knowledge is immeasurable. I enjoyed the exchange of ideas, the transfer of knowledge, and the acquisition of new knowledge. There is joy in seeing their faces light up as they understand and appreciate what I was discussing. All these experiences have confirmed my interest to be an educator in the field of biology.I decided to major in Biology as I believe that the study of life is the most important subject in the world. The field of biology deals with the meaningful and profound knowledge of the existence of all living things. Studying life and the processes involved in sustaining it goes beyond the teaching of evolution.For me, biology allows me to explore the world as I study nature closely and unde rstand the diversity of life. However, it is not sufficient to gain knowledge of the subject matter. What would matter most is how students would learn through self discovery while teachers keep their goals in mind and allow room for improvement. This is an area that I need to learn as I have observed some of my classmates regard biology as a subject that often require memorization of scientific words related to classification and phylum.By pursuing an Education degree major in Biology in Montclair State University, I would learn about educational strategies and classroom management in order to keep students engage in their task, awaken their interest about the life on earth, and link their activities to the understanding of biological concepts as they acquire scientific knowledge. In addition, I intend to be committed in an experimental research or independent project so I could contribute to the field of Biology.As a high school student in (write the name of your school), I have a cquired a 3.050 cumulative GPA. I have received the William P. Orr scholarship for Fall 2007 and was given an award for being an active member in the SSS Star Program in the Spring of 2007.After completing my Bachelor degree in Education, I intend to teach high school junior and senior students while pursuing a graduate study. I also aim to get a doctorate degree in the same field so I can teach college students. Although I plan to study continuously while I am teaching, my passion to educate the learners will not begin and end with acquiring knowledge and earning degrees.My passion is focused in teaching the unknown and in facilitating the students’ understanding on the benefit of learning biology as applied to their daily life. I strongly believe that with my determination to succeed together with MSU’s excellent program, diverse faculty and student body combined with the individual attention of a small college, I will become an effective teacher who is deeply commit ted to serve the community of learners.

The Election A Good Day For The Nation s Oldest Third...

The interesting event known as the 2016 election has offered a good day for the nation’s oldest third party. The Prohibition Party has had its biggest national election results since 1988. The Prohibition Party has received over 5,500 votes from the current ballot results, and will likely have a higher total once write-in ballots from other states are reported. The results are already more than 10 times the party’s national vote in 2012. It is a sign of the hard work the Prohibition Party’s members and their advocacy, and is something to offer hope to those who advocate for temperance and for government in service of family and community. To give some background. The Prohibition Party is the oldest existing third party in the United†¦show more content†¦The Party selected James Hedges as its presidential nominee and William Bayes as its vice-presidential nominee. James â€Å"Jim† Hedges is a 78-year-old renaissance man, living in Pennsylvania, with a long history of party involvement. He was born in Iowa, and has a bachelor’s degree in music, as well as a masters in geology. He had spent 20 years in the U.S Marines, in the U.S. Marine Band. He spent 11 years as editor-in chief for the National Speleological Society Bulletin, is a community volunteer, a historian of Prohibition Party history and literature, and runs a print shop in a living history museum. He became interested in the Prohibition Party as a teenager, began his significant involvement with it in the 1980’s, and over time rose to become one of its leaders. He bears the distinction of the first Prohibition Party member to win elected office in the twenty first century. He was elected to two terms as the Assessor for Thomson Township, Pennsylvania. William â€Å"Bill† Bayes is a musician and businessman, living in Mississippi. He was born in Amsterdam New York. He grew up in a military family, and lived in many places before settling Mississippi. He acquired a music degree from the University of Mississippi, and spent many years as a high school band director and a salesman. He currently is the owner of a small manufacturing business. He has been involved in politics for many years, and has participated in manyShow MoreRelatedThe Electoral And Electoral College993 Words   |  4 PagesAmendment in 1804 which is one of the two major contemporary political parties in the United States, combine with the Republican Party to its right. Tracing to its origins returns to Thomas Jefferson s and James Madison s Democratic-Republicans. The modern-day Democratic Party was founded around 1828, making it the world s oldest operational party. 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