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3rd Degree Lateral Ankle Sprain |
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You snap ‘em, We wrap ‘em! Kristin Schaefer & Lori Woodard |
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Acute Inflammatory Phase |
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The acute inflammatory phase is the primary response to tissue injury. It occurs upon injury and up to three days post-injury. Injury Response · Rupture of blood vessels and other tissues (ligaments) · Inflammation/Swelling · Increased histamine, and other chemical reactions. · Decreased range of motion/Loss of function Treatment · RICE– rest, ice, compression, elevation - This technique is applied immediately following the injury to decrease the formation of edema, and decreases secondary tissue destruction. · Cold (ice bags, ice immersion: cold whirlpool & Soken, reusable cold pack, Cryo Cuff) -Tissue response~ decreased cell metabolism, vasoconstriction, decreased pain, decreased inflammation, decreased muscle spasm -Treatment time should last 18-20 minutes. · Electrical Stimulation (E-Stim)~ High frequency and low phase duration. · Iontophoresis · Pulsed Ultrasound (day 2 & 3) - use a 20-25% duty cycle with normal intensity (0.5 watt/cm^2) - this is used to stimulate phagocytosis and cavitation within the affected tissues, which leads to the removal of debris, and also increases cell membrane permeability - helps the body reach the proliferation phase sooner Contraindications · Cold -open wounds, cold allergies, Raynauds phenomenon, Lupus, circulatory insufficiency · E-stim -current flow through heart and pharynx, severe obesity, epilepsy, heart monitor, cancerous tumors, pregnancy, menstruation, site of infection, exposed metal implants, areas of particular skin sensitivity · Iontophoresis -allergies to medicine, abnormal skin sensation, skin irritation, sensitive skin -also see contraindications for E-stim · Pulsed Ultrasound -cancerous tumors, pregnancy, impaired circulation, deep vein thrombosis, active infection, sensory nerve damage, exposed metal implants, menstruation What Not to Use · Heat (heat pack, hot whirlpool, paraffin, and Fluidotherapy) · Light Therapy · Continuous Ultrasound · Contrast Bath *These will not be used because they increase the blood flow to the injured area (by vasodilation), thus creating increased swelling and secondary tissue damage. |
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Ankle 24 hours post-injury. |
