If swelling and edema is successfully reduced and it can be determined that the athlete is not in the acute phase of injury, thermotherapy will be used prior to performing exercises/activities. The use of moist heat packs can increase cell metabolism and blood flow aiding in the reduction of edema, allow for tissue elongation reducing joint contractures and increasing range of motion. Also, it will promote relaxation by reducing muscle spindle sensitivity, allowing for patient motivation, pain and relaxation to be better. Another heating modality that can be used is Therapeutic Ultrasound. Ultrasound has thermal and non-thermal effects that could be beneficial to the athlete depending on the amount of edema and swelling still present. In the case of a Maisonneuve fracture, the thermal effects of ultrasound could be more beneficial. The use of thermal ultrasound will increase nerve conduction velocity, increase extensibility of collagen-rich structures, increased blood flow, and increased macrophage activity. These primary effects will allow for greater stretch in the patient’s tissues and a reduction of any edema present. To get the desired effects, thermal ultrasound should be applied at 1MHz with a 100% duty cycle, allowing for depth of penetration reach up to 5cm below the skin. Although and output of 1MHz takes longer to heat deeper tissues, it retains tissue heat twice as long …show more content…
It is highly recommended and supported by many articles. Early surgery allows for the structures involved to be set properly and for debridement and/or clearing of torn tissue to be removed, allowing for a quicker return to play rehabilitation treatment plan. Post-surgery, the treatment plan and protocol discussed should be initiated for optimal results. When there is no rupture of the deltoid ligament, interosseous ligaments or medial malleolus fracture, non-operative management should be used (9). The best treatment plan for this incidence would mirror the plan described above. To reiterate, the athlete should immobilize the injured limb for six to eight weeks. This allows for the structures, such as, bones and ligaments to realign and heal properly. Following immobilization, a rigid and aggressive treatment plan would be initiated. This plan would be a three phase program that includes an acute, subacute and advanced training stage. Each stage will allow for the structures involved to heal, removal of any swelling and/or edema, reduction in pain, restoration of strength and function, and for the athlete to return to play as soon and safely as