Sports clinic Paris
Metro: Saint Marcel
Parking 6 rue test
The information provided on this website is provided by medical professionals: sports doctors, rheumatologists, functional rehabilitation doctors, orthopedic, clinical surgeons sport, podiatrist sports meeting within the group "chirurgiedusport.com"
All histological and animal studies have demonstrated the value of a measured mechanical stress for a ligament scar quality. However, in practice, resin and orthosis can partner effectively!
Here is the story of a sporty and dynamic patient, who suffered a severe ankle sprain. Brave and eager, he is unable to limit the use of his ankle. He takes off his splint few days after injury, when the pain has decreased. After a bit of therapy, her therapist overworked her program immediately in charge of the proprioception and abandons teetering on a freeman tray. The ankle still swollen and painful. However, without waiting for the approval of his doctor, he resumed running, tennis or football. A five or six weeks of the sprain, a possible control ultrasound shows a broken ligament structure embedded in connective magma without functional interest. Ankle appears quite lax and her therapist a good command hopes to limit recurrences proprioceptive! Two months later, he finished an exhausting tennis match, articulation twists violently again. To cause instability or microlaxit├ę in a few years, it will take over his ankle osteoarthritis!
Of course, the functional treatment is not therapeutic abandonment but there are cases where human nature brings some risks to the protocols from histopathological research! The field doctor knows that. Sometimes it proposes to begin 6 weeks of joint mobility reduction through strict asset. In practice, when the sprain includes many severity criteria at the end of the GREC, we begin treatment with 10 to 21 days of rigid or flexible resin. Obviously the support and walking are permitted. This type of care helps limit inflammation and excessive traction on the ligaments. This method does not exclude the muscular work and stress on stabilizing reflexes to avoid the loss of strength and coordination. The new joints from trauma mobilized without limitation.
To comply with these principles, the boot is irremovable. It does not rise above the lower terrain calf and did not cover all of the metatarsals. The sural triceps and side stabilizers can contract. Our sport has easily drainage massages, stimulations excitomotrices well as distal and proximal mobilizations. Proprioceptive work by gradually increasing load begins early without risk. The injured is invited to ride a bike because this activity perfectly tolerates ankle locked at 90 ┬░. This way, it keeps good cardiovascular shape. Isometric contractions or short strokes of the muscles of the leg and foot reduce the risk of adhesion. It can also do weight training of the lower limbs without support (open chain) emphasizing the braking load (eccentric predominance). Thus, our athlete is not embarrassed by its resin and suffer fewer aches for the resumption of the race.
After 10 to 21 days, the resin removal, we often pleased to see that the ankle is fine; often less swollen, less painful after three weeks of tracking poorly functional treatment! To achieve the relative 6 weeks of immobilization, we prescribe an ankle orthosis Bauerfeind kind AirLoc 20 to 35 days. That allows more actively pursue mechanization. An inflatable brace adjusts to better restraint to the morphology of each and residual wheelbase of the joint. By removing the orthosis during rehabilitation sessions, the therapist works directly ligament scar. The dynamic building starts without difficulty. The proprioceptive orthosis is done with binding exercises and without orthosis for less complex techniques.
Equipped with his brace, our sports can now use devices requiring flexion / extension ankle. The orthosis is less troublesome when his lower extremities are fine and do not deform the sports shoe. Many simulators exist in all fitness and are frequently found in physiotherapy room. And rower, stepper and ellipteur gradually enroll in the program. The gesture is similar to that little bit of running. Far from irritating the ligament structure, this work contributes effectively to mechanize the scar. At approximately 4 weeks of trauma, our patient trots minutes with his brace on carpet or even ground. Initially, it is more of rehabilitation to the race as a workout. Meanwhile, it can work intensively on other devices
With braces, the footings are faster and more prolonged. An orthosis comprising an elastic sole seems better tolerated. Gradually, if the ankle has no pain or swelling, the brace is removed for the race on mats or on regular ground. back sessions in the field begin parallel. While sharpening the physical condition of our sport, this step is a real physiotherapy proprioceptive scale. The ligament completes its mechanization and acquires the tissue characteristics essential to its specific mission. The side trips begin on condition of orthosis. The latter is retained to perform new exercises, it is gradually removed when the movements are controlled.
Finally, our patient returns to his favorite sport at about 6 weeks of the trauma ... when histological scar ends. If our sport is concerned, wear a brace quality, well tolerated, allows the first drives with more security. In the heat of the moment, she informed teammates and opponents that player returns from injury. The back trust in our sport quickly forgets to put her brace. Because he is fit, he returned to competition in stride: he won the time! Moreover, his ankle is not swollen or lax. It is painless and stable. In severe sprain, the resin cocktail then brace associated with early rehabilitation and physical maintenance is often very effective!
Rodineau J., G. Saillant 2003
Ligament recent peripheral lesion
The aim of this operation is to achieve anatomic ACL reconstruction using autologous (patient's tendon) under arthroscopic control. The principle of TLS is to use a single hamstring tendon in short graft (transplant economy). The half tendon tendon is one of two hamstring tendons (hamstring). It is thin (3-4 mm) and long (about 25 cm). It is the termination of the semitendinosus that ends on the bridle. The harvesting the graft is carried out by a short nearly horizontal incision of 2 cm to the surface of the tibia, is removed only the semitendinosus tendon over its entire length with a stripper. He bent over backwards to get a transplant ACL bundles 4 or 4 strands with diameters ranging from 7 to 9 mm. It's ashort 50 mm average length graft (Fig.8). At both ends of the graft are passed two textile strips for fixing the graft in tunnels. A traction table is used to make a claim to the graft to 500 Newtons
The shoulder dislocations and recurrent anterior instability is a common problem among young athletes making up 90% of shoulder dislocations. Surgical indication can be provided in these cases of glenohumeral dislocations previous recurrent, but also in cases of painful and unstable shoulders. A question now arises, should we offer it immediately after the first dislocation or should we expect one or more recurrences? (Read more ...)
Meniscus - Arthroscopic knee surgery is the gold standard of meniscal lesions of the knee. The goal is to treat meniscal tear (tear, crack, tongue, bucket handle ...) being the least traumatic possible for the knee and the most conservative to the meniscus.
Patient, 58, sporting good level with chronic tendinitis of the Achilles tendon of the left.
chronic Achilles tendon pain lasting for more than a year after a triathlon.
The patient has received medical treatment (necessary before any surgical decision): rehabilitation, Stanish stretching, shock wave, orthopedic soles. (read more...)
While muscle injuries of the posterior region of the thigh are common in athletes, the proximal hamstring rupture is a rare disease. A study published in 2003  analyzed in a consecutive series of 170 patients, 179 trauma hamstrings occurred over a period of 3 years. MRI and / or ultrasound showed that only 12% of the injuries were fractures of the proximal and 9% complete ruptures. It is also little known, the first cases described in the literature from 1988 . Clinically the patients describe a violent pain in the buttock (stab printing) followed by leg weakness. ( To be continued..)
The aim of this operation is to achieve anatomic ACL reconstruction using autologous (patient's tendon) under arthroscopic control. The principle of TLS is to use a single hamstring tendon graft in short. Parameters of ACL reconstruction with hamstring TLS.
Surgery: The principle of operation is to repair the anterior cruciate ligament (ACL) with a broken bone autograft bone tendon taken from the patellar tendon. Intervention performed under local or general anesthesia with a tourniquet.