スポーツにおける足関節靱帯損傷とリハビリテーション

Abstract

Injuries of the ankle joint, especially those involving lateral ligamentous structures are the most frequent type of acute injuries in sports activities. The purpose of this study is to present the specificities and rationale of rehabilitation in these injuries. The forced supination of the ankle joint in plantar flexion will tear the anterior talofibular ligament which is located nearly vertical to the line of stress. If the force is excessive, the calcaneofibular and posterior talofibular ligament will also be torn, and marked instability of the ankle joint will be aggravated. Conservative treatment is usually chosen for the first and second degree of injury according to DePalma's classification, and operative reconstruction of ligaments is performed for the third degree of injury which is routinely confirmed by X-ray studies. Primary care in the acute stage consisting of proper immobilization, icing and elevation of the ankle joint is essential for better results in conservative treatment. The rehabilitation process after reconstruction of ligaments in athletes consists of three steps: 1) medical care 2) medical rehabilitation and 3) athletic rehabilitation. The athletes return to athletic competition after rehabilitation with some type of preventive external support to the ankle joint and with instruction to prevent recurrent injury.