Uhlelo Lokuzivocavoca Ukulungiselela Ukuhlinzwa Kwe-ACL

Uma une- anterior cruciate ligament (ACL) izinyembezi futhi ucabangela ukuhlinzwa, ungase uzuze ekuzivocavoca umzimba ngaphambi kokuhlinzwa. Ukulungiselela ukuhlinzeka kwakho nomhlinzeki wakho wenyama kuye kwaboniswa ukuze kuthuthukiswe imiphumela jikelele ngamadolo emva kokukhanda kwe-ACL yakho.

I-ACL sprain ingabangela izimpawu ezihlukahlukene, futhi umhlinzeki wakho wezinto ezingokwenyama angakusiza ukuba ubuyele emsebenzini omuhle ngemva kokulimala. Izimpawu zengxube ye-ACL zingabandakanya:

• Ubuhlungu obukhulu
• Ukuvuvukala kwe-Knee
• Ukuhamba kwamadolo okulinganiselwe (ROM)
• Ukulahlekelwa kwamandla kumathambo wakho we- quadriceps noma ama- hamstring muscles
• Ukuzwa ukungazinzi okuzungezile emadolweni akho
• Kunzima ukwenza imisebenzi eyisisekelo efana nokukhwela izitebhisi, ukuhamba noma ukugijima

Uma usola ukuthi unezinyembezi ze-ACL, kufanele uvakashele udokotela wakho ukuze uthole ukuxilongwa okunembile. Udokotela wakho cishe uzokwenza izivivinyo ezikhethekile ukuze anqume ukuthi unezinyembezi ze-ACL , futhi i-MRI ingalawulwa ukuqinisekisa ukuxilongwa okusolakala. Uma unayo izinyembezi ze-ACL, ukuhlinzwa kunganconywa.

Ukwelashwa ngokomzimba ngaphambi kokuhlinzekwa kwe-ACL ukukhanda kuboniswe ukuthuthukisa umphumela wakho jikelele ngenqubo. Ngakho-ke yiziphi izingxenye nokuzivocavoca ezivame ukufakwa ohlelweni lwe-PT lokunakekelwa kwangaphambi kwe-ACL?

Imigomo ye-PT ngaphambi kokuhlinzwa kwe-ACL ingafaka:

• Buyisela i-ROM yamadolo evamile
• Thuthukisa i-quadriceps futhi unqande amandla
• Thuthukisa amandla we-hip nokuzinza
• Khulisa ibhalansi kanye nokwakheka
• Lawula ubuhlungu nokuvuvukala emadolweni akho

Umhlinzeki wakho womzimba angasebenzisa izindlela ezehlukene zokusiza ukulawula ubuhlungu bakho emadolweni nokuvuvukala nokuthuthukisa umsebenzi wemisipha njengengxenye ye-ACL prehab yakho. Kodwa ukuzivocavoca kuyithuluzi lakho eliyinhloko ekukhuliseni umsebenzi wegciwane ngaphambi kokuhlinzwa kwe-ACL.

Nasi uhlelo lokuhlola lwesampula ukuthi umhlinzeki wakho ongokwenyama angabeka kuwe ngaphambi kokuhlinzwa kwakho kwe-ACL. I-PT yakho ingakubonisa ukuthi ungayisebenzisa kanjani kahle.

Qiniseka ukuhlola nodokotela wakho ngaphambi kokuqala lokhu, noma enye enye, uhlelo lokuzivocavoca lwamadolo akho.

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Iziqu ze-Quad kanye ne-Arc Quads emfushane

Ngemva kokulimala kwe-ACL, ungathola ukuthi imisipha yakho ye-quadriceps ngaphambili kwethanga lakho ayisebenzi kahle. Enye yemigomo eyinhloko ye-pre-op ye-ACL yokwelashwa ukubuyisela umsebenzi ovamile kanye namandla kumfutho wakho we-quad ukuze isekele kahle idolo lakho.

Ukuzivocavoca ukuthi i-PT yakho ingase ibeke umyalelo wokuthuthukisa umsebenzi we-quad ingafaka:

• Ukuzivocavoca kwama-Quad: Lala ngemuva kwakho bese ubeka ithawula elincane ngaphansi kwegolo lakho. Qinisekisa ama-quads wakho ngokucindezela ngemuva kwegceke lakho ethawula. Bamba imizuzwana engu-5, bese uphumule.
• I-arc quads emfushane (i-SAQ) : Lala ngemuva kwakho bese ubeka ibhola ngaphansi kwegceke lakho. Gxilisa idolo lakho ngokugcwele, ugcine emuva emadolweni akho ngokumelene nebhola.
• Umlenze oqondile uphakamisa : Qinisekisa isidumbu sakho se-quad phezulu kwethanga lakho bese kancane kancane uphakamise umlenze wakho oqondile cishe ngamasentimitha angu-12 kuya kwangu-15. Bamba imizuzwana engu-2, bese wehlisa kancane umlenze wakho phansi.

Ukuzivocavoca kufanele kwenziwe ngokunyakaza okungenabuhlungu; vimbela noma yikuphi ukuvivinya kwe-quad okubangela ubuhlungu obukhulu emadolweni akho.

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Ukwenza ngcono ukuhamba komgudu wokuhamba

Ukubuyisa ibanga lokuhamba kufanele libe enye yemigomo yakho eyinhloko ngaphambi kokuhlinzwa kwe-ACL. Uma amadolo akho eguqa futhi eqondisa ngokugcwele ngaphambi kokuhlinzwa, kungenzeka ukuthi ngokushesha alulame i-ROM egcwele ngemva kokuhlinzwa. Ukuzivocavoca okungenziwa kungabandakanya:

• I-sliel esithende: Ulale emhlane wakho bese ugoqa uguqa wakho bese ugoqa isithende sakho emahlombe akho.
• I-hang ye-hang for knee extension : Lala esiswini sakho bese ulenga umlenze wakho ngaphezu kombhede, uvumele idolo lakho lixhomeke ngokugcwele.
• Ukuhamba ngebhayisikili: Sebenzisa ibhayisikili ejimini noma emtholampilo we-PT ukuze uthole ngobuso ukuguqa nokuguqa.

Qiniseka ukuhambisa idolo lakho ngokulawula futhi kancane kancane nangenhloso, futhi umise ukuvivinya umzimba uma uzizwa ubuhlungu.

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Ukuqiniswa kwe-Hamstring

I-ACL yakho iyasiza ekuqiniseni imadolo yakho ngokuvimbela phambili ukuthungatha kwesifuba sakho ngaphansi kwethambo lakho lesitheni. Ama-hamstrings akho, ngokwemvelo yamaphoyinti abo okunamathiselwe ngemuva kwethanga lakho namadolo, angasiza futhi ukwengeza ukuqina emadolweni akho.

Umhlinzeki wakho wenyama angase anikeze ama-hamstring umzimba wokuqinisa ngesikhathi sakho se-ACL prehab. Ukuzivocavoca kungafaka:

• Ama-hamstring isethi: Lala ngemuva kwakho ngebhande lakho. Cindezela kancane kancane isithende sakho, ugcizelele insika yakho njengoba wenza kanjalo. Bamba indawo eqinile imizuzwana engu-5, bese uphumule.
• Amadolo adonsa phansi: Ulale esisu sakho futhi ugobe kancane kancane ibhuloho lakho elimele, usebenzisa isando sakho ngemuva kwethanga lakho.
• Uhlezi ngezingqimba ezinamathelethi: Uthola ukumelana, futhi uhlale esihlalweni nebhokisi elizungeze isisindo sakho umlenze wakho olimele. Olunye uhlangothi lungabanjwa ngumngani noma uxhunywe kumsebenzi wesikole. Bese uguqa kancane, uvumele ibhanti lokumelana ukunikeza ukumelana. Bamba ngamadolo ambalwa wakho phansi, bese ubuyela kancane lapho uqala khona.

Ukuqinisa izintambo zakho akufanele kubangele ubuhlungu; Uma uzizwa ubuhlungu ngesikhathi sokuvivinya umzimba, yima bese uhlola nge-PT yakho.

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Ukuqinisa i-Hip

Ucwaningo lubonisa ukuthi izinkalo zakho zilawula isikhundla samadolo akho uma uhamba, ugijima, futhi uqaqa. Ukugcina izintambo zakho ziqinile-okuyizinhlanzi zakho ze- gluteus medius- zingasiza ukuguqa ngamadolo endaweni enhle kakhulu kungenzeka ngenkathi usebenza futhi ugoqa. Lokhu kungasiza ukunciphisa ukucindezeleka nokucindezela nge knelo yakho kanye ACL.

Ukuzivocavoca kwama-Hip ukuqala kungase kuqale ngomlenze oqondile, kepha ezinye izinto ozisebenzisayo i-PT zingabonisa njengengxenye yohlelo lwakho lwe-AC pre-op lungabandakanya:

• Ithimba le-Lateral liyahamba: Faka ibhande elincanyeni elizungezile emaceleni akho bese uhamba kancane uhamba eceleni kwegumbi.
• Abagibeli be-Hip: Hlala ngomlenze owodwa esiteji futhi omunye umlenze ulinge ngokukhululekile phansi, bese uhlisa kancane kancane isikhumba sakho phansi, uqiniseke ukuthi ukuhamba okuvela emadolweni akho.
• Amabhuloho omlenze ongashadile. Yenza ukuzivocavoca ngebhande elilodwa ligobile futhi elinye liguqe ngqo bese liphakamisa phansi.

Ngokusebenza ukuze ugcine izinyathelo zakho ziqinile ngaphambi kokuhlinzwa kwakho kwe-ACL, ungakwazi ukwandisa amandla we-hip ngemuva kokuhlinzwa kwakho.

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Ukulingana nokuPhathwa

Ukwakheka yigama elisichaza ikhono lomzimba wakho ukuqonda ukuthi ikuphi endaweni yakho. Ibhalansi elungile nokuhlelwa kwendawo kubalulekile ukugcina amadolo akho ukulungiswa okulungile uma usebenza futhi uqaqa, futhi lokhu kungasiza ukugcina ukucindezeleka nokucindezela i-ACL yakho. Ukusebenza ku-proprioception yakho cishe kuyoba ingxenye enkulu ye-rehab yakho emva kokuhlinzwa, ngakho ukwenza ingxenye ye-ACL yakho yangaphambili kungaba umqondo omuhle.

I-PT yakho kungenzeka ukuthi wenze amabhalansi ahlukahlukene kanye nokuzivocavoca okumele ukwazi ukulungiselela ukuhlinzwa kwakho kwe-ACL. Lokhu kungafaka:

• Ukuma komlenze owodwa: Mane nje ume emlenzeni owodwa bese uzama ukubamba ibhalansi yakho imizuzwana engu-30 kuya kwangu-60.
• Ukuvivinya kwe-BOSU: Sebenzisa ibhola le-BOSU ukuze lime phezu kwalo ukuze inselele ibhalansi yakho.
• Ibhodi le-BAPS : I-PT yakho kungenzeka ukuthi usebenzise idivayisi ebizwa ngebhodi le-BAPS ukuze inselele ukutholakala kwakho kanye nokulinganisela.
• Ukuvivinywa kwe-T-Stance: Hlala ngomlenze owodwa ngomunye umlenze wakho ngemuva kwakho. Bamba izingalo zombili zombili ohlangothini, njengencwadi "T", bese ugoba kancane kancane esikhweni, ugcine ibhalansi esitebeleni.

Khumbula, ukuthuthukisa ibhalansi yakho okudingayo ukuze inselele ibhalansi yakho. Lokhu kungase kube nzima emgqeni omele i-ACL ngaphambi kokuhlinzwa, ngakho-ke qaphela lapho ukhetha ukulinganisela nokuzivocavoca okuzimele ozenzayo. Umhlinzeki wakho womzimba angasiza ekunqumeni ukuzivocavoca okungcono kakhulu okumele ukwenze ngenkathi ulungiselela ukuhlinzwa kwakho kwe-ACL.

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Ukuqeqeshwa Neuromuscular

Ukuqeqeshwa kwe-neuromuscular kwenziwa izinkulumo ezithile ezenzelwe ukuthuthukisa indlela umzimba wakho ohamba ngayo uphendule emibuthanweni ehlukahlukene ebeka kuyo. Ngemuva kwezinyembezi ze-ACL, ucwaningo lubonisa ukuthi ukwenza umzimba wokuqeqeshwa kwe-neuromuscular kungasiza ekuthuthukiseni umsebenzi jikelele wegciwane futhi kunganciphisa ithuba le-ACL inkinga yesikhathi esizayo.

Ukuzivocavoca ukuthi i-PT yakho ingahle ibeke ukuqeqeshwa kwe-neuromuscular ingafaka:

• Ukuzivocavoca kwe-drop drop : Hlala esitokisini esingu-12 kuya ku-18-intshi, bese usuhla phansi, ufika phansi ngamadolo akhokile. Khona-ke, ngokushesha gxuma phezulu phezulu ngangokunokwenzeka.
• Ukufunda ukugxuma nokuhleleka kahle komhlaba : Ukuzivocavoca ugijimise uphinde ufike ezinyaweni zakho ububanzi be-shoulder kanye nobude bakho emadolweni akho. Land ngokunciphisa ngokuguqa ngamadolo akho njengoba wehla ekudumeni kwakho.
• Ukuhamba komlenze owodwa : Hlala ngezinyawo ezintathu futhi uqhube phambili phambili ngezintambo ezintathu. Qinisekisa ukuthi uhamba ngamadolo akho kancane kancane futhi ngqo phezu kwezinyawo zakho nezinyawo.

Lezi zindlela zokuzivocavoca nezokuzivocavoca zinzima, futhi kungase kube nzima ukukwenza ngamadolo akho ayenayo i-ACL. Isihluthulelo salezi zivivinyo ukuqinisekisa ukuthi amadolo akho ahambisana nokulungiswa okufanele uma wenza. Qinisekisa ukuthi ungangena nomuthi wakho wenyama ukuze uqiniseke ukuthi lolu hlobo lokuqeqesha lukulungele wena nesimo sakho esithile.

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Ukubeka konke ndawonye

I-anterior cruciate ligament sprain ingaba ukulimala okuphazamisayo okukuphela kwezinyanga. Ukukhetha ukuhlinzwa kungakusiza ukubuyisela ukuhamba okuvamile nokusebenza kumadolo akho alimele.

Ukuhlanganyela ekwelapheni kokusebenza kwangaphambi kokusebenza lapho ulungiselela ukuhlinzwa kwakho kwe-ACL kungaba nomthelela omuhle ekutholeni kwakho konke. I-prehab yakho kufanele igxile ezintweni eziyisisekelo zokubuyiselwa kokuqala kokuhamba kwegceke elivamile le-quad kanye ne-hamstring amandla. Uma idolo lakho lihambela kahle, ukungeza ibhalansi ephakeme nokuzivocavoca kwemvelo nokuqeqeshwa kwe-neuromuscular kungakusiza uzizwe ulungele ngokugcwele ukuhlinzwa kwakho kwe-ACL.

Indlela engcono kakhulu yokuqonda ukuthi yini okufanele uyenze ngenkathi ulungiselela ukuhlinzwa kwakho kwe-ACL ukusebenzisana eduze nodokotela wakho kanye nodokotela wezempilo. Bangakusiza ukukuqondisa ohlelweni lwakho lokuzivocavoca futhi uqinisekise ukuthi idolo lakho lilungele ukuhamba lapho ukuhlinzwa kwakho kwe-ACL ukulungisa ekugcineni kufika. Ngaleyo ndlela, ungakwazi ukwandisa amathuba akho okuvuselela okugcwele futhi okusheshayo ngemva kokuhlinzwa.

> Imithombo:

> Failla, MJ, etal. Ingabe Iminyaka Eyiminyaka Engu-2 Ngemuva Kokuvuselelwa Kwama-ACL? Ucwaningo Lokusebenza Lokuqhathanisa Phakathi kwama-coorts MOON ne-Delaware-Oslo ACL. Am J Sports Med. 2016 Oct; 44 (10): 2608-2614.

> Shaarani, i-SR, ne-etal. Umphumela wokuvuselela umphumela we-anterior cruciate ligament reconstruction. I-AM J Sports Med. 2013 Sep; 41 (9): 2117-27.