Ukwelashwa ngokwemvelo kwe-posterior tibial tendonitis (PTT) kungakusiza ukuthi uphinde uphinde uhambe ngezinyawo ezijwayelekile nezinyawo zezinyawo zokuhamba (ROM) , amandla nokuhamba. Lokhu kungasiza ekuqedeni izinyawo zakho kanye nobuhlungu bezinyosi bese ubuyela emsebenzini wakho ojwayelekile nemisebenzi yokuzilibazisa.
I-tendonitis yangemva komzimba isimo esithinta unyawo lwakho nengxenyeni yangaphakathi ye-ankle yakho.
Lesi simo sibhalwe ubuhlungu ezinyaweni nasezinyaweni, futhi kungakuvimbela ukuba uhambe futhi usebenze kahle. Izimpawu zingaphinde zinciphise imisebenzi yakho evamile yansuku zonke.
Ngezinye izikhathi, i-PTT ibizwa ngokuthi i-posterior tibial tysal functional or post-tibial tendonopathy. Kungakhathaliseki ukuthi kungani isimo, isimo sakho somzimba singakusiza ukuthi uphinde uhambe ngokujwayelekile uma ungahambi.
Iyini i-Tendon Posterior Tibial?
Ithendononi ye-posterior tibial yi-tendon evela e-muscle ebizwa ngokuthi i-tibialis posterior. Le misipha ihlala engxenyeni yangaphakathi yomlenze wakho ophansi, ngaphansi komzimba wakho wezinyane . Izifundo ze-tendon phansi emlenzeni wakho nasengxenyeni yangaphakathi yonyawo lwakho. Ihlanganisa phansi phansi unyawo lwakho.
Umsebenzi wethenda ye-posterior tibial i-double fold. Imisipha ishukumisela unyawo lwakho ngaphakathi, ikakhulukazi uma unyawo lwakho nezinzwane zikhonjiswa phansi. I-tendon iphinde isekele ukusekela umcibisholo wezinyawo zakho.
Izimpawu Ze-Tibial Tendonitis Ephansi
Uma une-tendonitis yangemva kwe-tibial, cishe uzothola izimpawu ezihlukile. Lokhu kungafaka:
- Ubuhlungu engxenyeni yangaphakathi yesonto lakho
- Ubuhlungu emgqeni wonyawo lwakho
- Kunzima ngokuhamba noma ukugijima
- Inyawo eliphansi noma umcibisholo owile
Ngokuvamile, izimpawu ziza kancane kancane ngaphandle kwesizathu esicacile futhi ngaphandle kokulimala noma ukuhlambalaza okuqondile.
Ngenxa yalesi sizathu, ukukhubazeka kwe-PTT ngokuvamile kubhekwa njengokulimala okuphindaphindiwe; ubuhlungu buvela ngenxa yokudonswa ngokweqile nokucindezela ngokweqile ithoni ye-posterior tibial. Inselelo ngokuthola nokuphatha lesi simo ukucacisa ukuthi kungani lokhu kubangelwa futhi kubalungise. Umhlinzeki wakho wenyama ungumqeqeshi ophelele wezempilo ukuze enze lokhu.
Ukuxilongwa kwe-Posterior Tibial Tendonitis
Ukuxilongwa kwe-PTT ukungasebenzi kusenziwa ngokuyinhloko ngokuhlolwa komtholampilo. Udokotela wakho noma PT uzobheka izimpawu ezithile. Lokhu kungafaka:
- I- palpation ebuhlungu yesici sangaphakathi se-ankle yakho, eduze kwethenda le-posterior tibial
- Ubuhlungu lapho ukhomba unyawo lwakho nezinzwane noma ukuhambisa izinyawo zakho ngaphakathi, ikakhulukazi uma uphonsela ukumelana nokumelene
- Ukutholakala kwezinyawo ezinyaweni noma ukuwa phansi
- Iphethini lokuguqula i-gait nokuhamba
Udokotela wakho angase acabange ukubuka izifundo zokuxilonga ezifana ne-X noma i-MRI ukuqinisekisa ukuxilongwa nokulawula noma yimuphi omunye umbandela. Lezi zifundo azidingekile noma ezidingekile uma uthola ukutholwa. Bavele baqinisekise ukuxilongwa kwemitholampilo. Iningi labantu liyazuza ngokuqala ukwelashwa ngokomzimba ngaphambi kokuthola noma yiziphi izifundo zokuhlola .
Kunezinyathelo ezine zokungasebenzi komsebenzi we-PTT, ngayinye enezici zayo.
Isigaba I ukucasuka nje kwe-PTT engenaso ukuqina kwesinyawo esicacile. Esigabeni sesibili II, i-PTT ihlukumezekile noma ihlukaniswe, futhi unyawo lubekwe phansi kodwa luhlala lungaguquguquki. Isiteleka sesi-III senzeke uma i-PTT yakho ibonakalisiwe noma iphukile futhi unyawo lwakho luqinile, ngokuyinhloko luyanqanyulwa endaweni yalo ehlelwe phansi. Isethulo esinzima kunazo zonke se-PTT ukungasebenzi yi-IV yesigaba, lapho i-PTT yakho ihlukumezekile khona futhi imigqa yakho ye-ankle isetshenziswe kuze kube yilapho kukhona ukukhubazeka okuhlala khona isikhathi eside.
I-Therapy Physical Assessment Components
Uma uqala ukuya ekwelapheni ngokomzimba, uzohlolwa. Phakathi nalokhu kuhlolwa, i-PT yakho izoqoqa ulwazi mayelana nesimo sakho.
Uzokwenza futhi izivivinyo ezithile ezingafaka phakathi:
- Ukulinganisa (ukuhlolwa ngokomzimba ngokuthinta izakhiwo ezithintekayo)
- Izinga lezilinganiso zokuhamba
- Izisindo zamandla emisipha, amaviki, kanye nezinsipho
- Hlola ukuhlaziywa
- Ukuhlolwa kwesimo sezinyawo nokuhlolwa kwezicathulo
- Ukulinganisa nokuhlolwa kokuzimela
Uma zonke lezi zivivinyo seziqedile, i-PT yakho kufanele ikwazi ukucacisa ukuthi kungenzeka yini ukuthi i-PTT ayisebenzise, futhi ukwelashwa kungaqala. Qiniseka ukuthi ubuza imibuzo yakho ye-PT mayelana nesimo sakho uma unayo. Ubuhlobo obunakho nomthandi wakho kufanele uzizwe njengobumbano wezokwelapha; bobabili kufanele nisebenze ndawonye ukuze niphathe kahle ukukhubazeka kwakho kwetonal posterior tbial.
Ukwelashwa Kwemithi Yokwelashwa Kwe-Tibial Tendonitis Ephansi
Ukwelashwa kwe-PTT kungahle kuhilele izingxenye eziningi ezihlukene, futhi lezi zingahluka ngokuya ngesimo sakho kanye nezidingo zakho. Ungalindela ezinye izifo ezivamile ezivela kumthandi wakho wezitho zomzimba we-posterior tibial tendonitis.
Ukuzivocavoca kufanele kube yithuluzi lakho eliphambili lokuphatha ukungasebenzi kwakho kwe-PTT. Kungani? Ngoba ucwaningo lubonisa ukuthi ukwenza izivivinyo ezifanele-ngesikhathi esifanele-kungakusiza ukulawula izimpawu zakho futhi ufunde ukuwagcina.
Umhlinzeki wakho womzimba kufanele anikeze izivivinyo ezithile eziqondene nesimo sakho nezidingo zakho. Kungenzeka ukuthi usebenze emtholampilo, futhi cishe uzobe uhlelelwe uhlelo lokuzivocavoca ekhaya ukwenza ngokuzimela. Ukuzivocavoca kwe-tenderior post-tibial ukungasebenzi komzimba kungabandakanya:
- I-Ankle ilula : I-PT yakho ingase ibe nemisebenzi ehlukahlukene ukuze uthuthukise i-ROM yangasese. Lokhu kungasiza ukubuyisela ukuhamba okujwayelekile ezinyaweni zakho futhi kusize ukunciphisa ukucindezela emthonjeni wakho we-tibial.
- Izenzo zokuqinisa u-Ankle: Izindlela zokuqinisa i-Ankle zingasetshenziswa ukusiza ukuthuthukisa amandla ezinsizwa ezihlukahlukene ezisekela unyawo lwakho nezinyawo. Lokho kungenza ukulinganisela kwemisipha ezinyaweni zakho, kuqinisekiswe ukuthi ithenda lakho le-posterior tibial aligcini ngokweqile.
- Ukuzivocavoca nge-Hip kanye namadolo : Ngezinye izikhathi, ubuthakathaka emisipha yakho noma emadolweni akho kungabangela ukuba unyawo lwakho luphenduke, ubeke ukucindezeleka emthonjeni wakho we-posterior tibial. I-PT yakho kungenzeka ukuthi uyenze ukuqinisa izinkalo zakho namadolo ukuze usize ugcine lawo majoyina (nonyawo lwakho nezinyawo) ngokuvumelana kahle. Lokhu kunganciphisa ukucindezeleka emthonjeni wakho we-posterior tibial.
- Ukuzilinganisa nokuzivocavoca: Ukuthuthukisa ukulinganisela nokuqwashisa umzimba kungasiza ekuthuthukiseni indlela unyawo lwakho nezinyawo zakho ezisebenza ngayo. Lokhu kunganciphisa ukucindezeleka emthonjeni wakho we-tibial.
- Ukuqeqesha okuzuzayo: Uma unenkinga enzima ukuhamba noma ukugijima ngenxa yokungasebenzi komsebenzi we-PTT, i-PT yakho ingahle ibeke umzimba wokuzivocavoca othize ukuze uthuthukise umthamo wakho.
- Izivivinyo ze-Plyometric (phakathi nezigaba zokugcina ze-rehab yakho): Uma izinto seziphulukisiwe, i-PT yakho ingase iqale ukugxuma nokuhlehlela ukuze kuthuthukiswe ukubekezelelana kwemithwalo kwethenda le-posterior tibial. Ukuqeqeshwa kwe-Plyometric kubaluleke kakhulu uma uhlela ukubuyela ezingeni eliphezulu.
Okunye ukuzivocavoca kungase kube buhlungu ukukwenza kanti abanye bangase kube lula. Uma unemibuzo mayelana nokuzivocavoca kwakho, qiniseka ukuthi ubuza isazi sakho somzimba.
Ngenkathi ukuvivinya umzimba kufanele kube yingxenye eyinhloko yephenyo yakho ye-PT rehab for PTT ukungasebenzi, ungase uhlangabezane nezinye zokwelashwa ngesikhathi ukwelashwa. Ezinye izindlela zokwelapha kanye nesimo se-posterior tibial tendonitis singafaka:
- Ukufakwa kwezicathulo noma izincomo ze-orthotic: I-orthotic noma yokufaka ingasiza ukugcina unyawo lwakho lulungele ukulungiswa, ukunciphisa ukucindezeleka nokuhlukumeza isithoni sakho se-posterior tibial.
- I-Ultrasound : I-Ultrasound yindlela yokushisa ejulile okucatshangwa ukuthi ithuthukise ukusakazwa kwendawo kanye nokugeleza kwegazi kumathenda akho.
- Ukuvuselela kagesi : Le ndlela yokwelashwa ingasetshenziswa ukuthuthukisa ukugeleza kwegazi kwendawo noma ukunciphisa ubuhlungu obuzwayo.
- I-Kinesiology ethinta : Ukwelashwa okusha kufaka phakathi ukubeka itekisi emzimbeni wakho eduze noma eduze nonyawo lwakho nesikhumba. Itheyipu ingasetshenziselwa ukuthuthukisa ukuphazamiseka kwemisipha noma ukuvimbela imisipha ukuba ingangeni ngemvume ngokungalungile. Kungasetshenziswa futhi ukusiza ukunciphisa ubuhlungu.
- Ukukhwabanisa : Uma unyawo lwakho nezinyawo zakho ziphendukile kakhulu, ungase uzuze ngokusebenzisa i-brace brace ukugcina ukulungiswa okuphansi kokuphela komkhawulo.
- Iontophoresis : Leli fomu lokuvuselela kagesi lisetshenziselwa ukuphatha imithi elwa nokuvuvukala emathangeni akho esikhumbeni sakho.
- Ukushisa: I-PT yakho ingasebenzisa amasu ahlukahlukene wokusiza ukusiza ukunciphisa ubuhlungu, ukuthuthukisa ukugeleza kwegazi, nokugqugquzela ukuguquguquka komfutho wezintuthwane nezicubu ezungeze unyawo lwakho nesikhumba.
Khumbula, eziningi zalezi zonyango zihamba emvelo; awukwenzi lutho ngenkathi uchwepheshe ephethe ukwelashwa kwakho. Ucwaningo lubonisa ukuthi ukuthatha indima ephathekayo ekunakekeleni kwe-PTT ukungasebenzi kwakho kuyindlela engcono yokuthatha. Imithi yokwelashwa ingase ijabule, kepha umphumela wabo wonke uvame ukubhekwa njengento engadingekile.
Kanti futhi ezinye izindlela zokwelashwa kwe-PTT ezifana nokugqugquzela ugesi, ukuchofoza kwe-kinesiology, ne-ultrasound akusekelwa isifundo sezesayensi esiqinile. Lezi zokwelapha angeke zikulimaze, kodwa ucwaningo lubonisa ukuthi angeke kube yingxenye ewusizo ye-rehab yakho. Uma i-PT yakho ikhombisa ukwelashwa okuthile ngesimo sakho, qiniseka ukuthi uqonda umgomo wokwelashwa futhi uma kuyingxenye edingekayo yohlelo lwakho lokubuyisela kabusha.
Izinyathelo Zokuqala Zokuphatha Ukukhubazeka Kwangemva Kwesikhashana
Uma usola ukuthi une-tendonitis yangemva kwe-tibial noma ukungasebenzi, kunezinto ezimbalwa okufanele uyenze ngaso leso sikhathi. Okokuqala, xhumana nodokotela wakho, ukuze uqiniseke ukuthi ubuhlungu akuyona into engathí sina. Ungase futhi ushayele i-PT yakho ngokushesha; iningi lamazwe ase-US likuvumela ukuthi ubone umhlinzeki ngaphandle kokuthola udokotela kadokotela ngokufinyelela okuqondile. Okusheshayo ongaqalayo ekwelapheni, okusheshayo ubuhlungu bungasuswa.
Uma ulawula ukungasebenzi komsebenzi we-PTT, umqondo omuhle ukugwema imisebenzi ephuthumayo. Uma ungumgijimi, mhlawumbe ukugwema ukugijima okwesikhashana umqondo omuhle. Ukuqeqeshwa esiphambanweni ngebhayisikili noma echibini lokubhukuda kungakusiza ugcine izinga lakho lokuzivocavoca kwamanje.
Ingabe i-PTT Dysfunction ihlala isikhathi eside kangakanani?
Iziqephu eziningi ze-posterior tibial tendonitis zigcina cishe amasonto amane kuya ku-6. Amasonto ambalwa okuqala abonakaliswa ubuhlungu obunzima, kanti ubuhlungu buya kancane kancane phakathi nenyanga noma ngaphezulu. Ezinye iziqephu zifushane, kanti ezinye zide. Wonke umuntu uphulukisa amazinga ahlukene, futhi isimo somuntu wonke sihlukile, ngakho qiniseka ukuthi ukhuluma ne-PT yakho ngokubikezela okuqondile nge-posterior tibial tendonitis.
Uma izimpawu zakho ziqhubeka ngemva kwamasonto angu-8, kungadingeka ucabangele ezinye izindlela zokwelapha. Lezi zingabandakanya izilonda ze-cortisone ukuphatha inqubo yokuvuvukala ku-tendon noma inqubo yokuhlinzeka lapho ithethoni ishukunyiselwa endaweni ehlukile ezinyaweni zakho, ukucindezeleka ku-tendon ngenkathi usisekela umdwebo wonyawo lwakho.
Uma unesifo sokungasebenzi komthamo we-posterior tibial, ungase uzuze ku-PT ngemuva kwenqubo ukukusiza ukuthi uphinde uphinde utholakale.
Izwi elivela
Uma une-tendonitis posterior tysal noma i-tendonitis, umqondo omuhle ukuqala ukwelashwa ngokushesha. Ungavumeli izinkinga ezincane zibe izimo ezingapheli okungase kube nzima ukuphatha. Amacala amaningi athathwa kalula yizinsizakalo ezinamakhono zophiko lomzimba. Ngokwenza izinto ezifanele ngesimo sakho, ungakwazi ngokushesha futhi ngokuphepha ukubuyela ezinyaweni zakho futhi ubuyele emisebenzini yakho evamile.
> Imithombo:
> Espinoza, N, ne-Maurer, M. Stage I no-II Posterior Tibial Tendon Ukungasebenzi: Buyela ku-Running? Imitholampilo e-Sports Med. Okthoba 2015, 34 (4): 761-768.
> Guelfi, M. etal. I-anatomy, i-pathophysiology, nokuhlukaniswa kwe-tenderior post-tibial tysonction. I-Eur Rev Med Pharmocol Sci. 2017; 21: 13-19.