The article describes therapeutic effects in case of ankle joint injury in gymnast.
Introduction
Ankle joint injuries are the most frequent lower limb injuries in both amateur and professional sports. With respect to the ankle joint itself, injuries in the extreme supination leading to the injury to collateral ligaments of the ankle joint are most frequent. In sports, in professional sports particularly, the fast regeneration of the injuries is essential and it is important to introduce kinesitherapy and specialist training as early as possible, which allows the patient to return to sports activity quickly. An increasing amount of research confirms the effect of the high power laser therapy on speeding up the regeneration of soft tissues. It seems it may become widely used in the treatment of motor organ injuries, particularly in competitive sports.
Purpose
The aim of the study was to evaluate the effects of the high power laser therapy in a handball player after the injury to ankle joint ligaments.
Description
The study was on a handball player with a third degree injury (tear) of the anterior talofibular ligament (ATFL) and second degree injury (considerable partial rupture) of the calcaneofibular ligament (CFL) as assessed in the ultrasound examination.
Fig. 1: Ultrasound image of the anterior talofibular ligament: 24 hours after the injury
Fig. 2: Ultrasound image of the calcaneofibular ligament: 24 hours after the injury
Fig. 3: Follow-up examination twenty five days after the ATFL injury: scar formed without any excess blood flow
Fig. 4: Follow-up examination twenty five days after the injury: CFL healed without any oedematous lesions
Cooling, pressure and rising of the affected limb was undertaken directly after the injury. Since the second day after the injury, the high power laser therapy was given. Twelve sessions were performed every two days; furthermore, deep transverse massage was done and central stabilisation training and proprioception training were introduced after one week. The high power laser therapy used the Polaris HP equipment made by Astar with wavelengths of 808 nm and 980 nm; power from 1 to 5 W for every source at a dose from 10 to 30 J/cm2; duty cycle from 20 to 80%, grading the power as well as dose and duty cycle. The first four sessions used the frequency of 3,000 Hz and then 700 Hz was applied. The procedure was performed dynamically in the areas of oedema and injured ligaments. The orthopaedic sources assume six weeks to be the basic healing period which allows for initiating the process and adhesion formation, particularly in complete tears involving the breaking of the ligament continuity; the period from the injury to the complete fibre integration may take even more than six weeks. That period was much shorter in the case as presented. The first examination showed the third degree ATFL injury but another examination performed after two weeks showed the integration of stumps into an efficient scar and scar modelling while effusion resorption and oedematous lesions took further nine days. The process was generalised: it applied to the entire area undergoing the therapy; a similar process was observed with respect to the CFL injury. The partial ligament tear (second degree) healed considerably and it presented the reduction of oedematous lesions as early as fourteen days after the injury. The player returned to full sport activity five weeks after the injury; he did not exhibit any joint oedema and did not feel pain.
Conclusions
The high power laser therapy considerably reduced the regeneration period, which allowed the player to return faster to his sports activity after the injury to ankle joint ligaments.
