Lower limb muscle tear protocol

Stage 1 2 sessions • ACUTE INFLAMMATORY NECROTIC PHASE • Day 03 • Immobilisa7on, ice and rest helps control ini7al bleeding and inflammatory response, protects from further mechanical insult • I session is required for acute care. A second followup session if imaging is required or DVT risk • Followup call to pa7ent next day or review app. Statement of advice emailed to pa7ent next day if necessary. • Management Complete rest, non weigtbearing if possible, boot?, Strapping, ice, compression, immobilise muscle in painfree lengthened posi7on if possible. Adust painfree lengthened posi7on day 2. Stage 2 23 sessions • LATE PART OF INFLAMMATORY PHASE BEGINNING OF PROLIFERATIVE PHASE • Day 4 • Early mobiisa7on promotes more capilliary ingrowth as well as bePer muscle fibre orienta7on • 2 3 supervised sessions are required to teach exercises, ensure that volume is appropriate and technique is correct. Some support tape may be required. • Management Teach pain free stretch, exercises to maintain fitness, incuding upper body and core strength program, massage to uninvolved part of muscle, strapping , unassisted ambula7on if painfree, stretching to uninjured musles Stage 3 23 sessions • REGENERATIVE/REPAIR/PROLIFERATIVE PHASE • Approximately day 710 • No pain with moderate stretch and normal amula7on • Early mobilisa7on promotes more capilliary ingrowth as well as bePer muscle fibre orienta7on • Visits 23 are required for exercise prescrip7on to ensure volume is appropriate and to ensure technique is correct, massage to affected muscle, • Basic concentric and eccentric strengthening for involved muscle including use of pilates bed, general strengthening and more advanced cardiovascular condi7oning, stretching to uninjured muscles. Stage 4 3 sessions • CONTINUATION OF THE REGENERATIVE PHASE AND START OF THE REMODELLING PHASE • Approximately day 14 21 • Progression of weight training to func7onal and ac7vity specific ac7viites including coordina7on drills and plyometrics • 3 visits are required for exercise prescrip7on to ensure volume is appropriate and to ensure technique is correct, massage to affected muscle Stage 5 1 session • FITNESS TEST • Approximately day 21 35 • 1 visit is required for fitness test check range, concentric/eccentric strength, func7onal strength, sports specific ac7vity LOWER LIMB MUSCLE TEAR PROTOCOL

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Transcript of Lower limb muscle tear protocol

Stage 1 2 sessions

• ACUTE INFLAMMATORY NECROTIC PHASE • Day 0-‐3 • Immobilisa7on, ice and rest helps control ini7al bleeding and inflammatory response, protects from further mechanical insult

• I session is required for acute care. A second followup session if imaging is required or DVT risk • Followup call to pa7ent next day or review app. Statement of advice emailed to pa7ent next day if necessary. • Management -‐ Complete rest, non weigtbearing if possible, boot?, Strapping, ice, compression, immobilise muscle in painfree lengthened posi7on if possible. Adust painfree lengthened posi7on day 2.

Stage 2 2-‐3 sessions

• LATE PART OF INFLAMMATORY PHASE BEGINNING OF PROLIFERATIVE PHASE • Day 4 • Early mobiisa7on promotes more capilliary ingrowth as well as bePer muscle fibre orienta7on •  2 -‐ 3 supervised sessions are required to teach exercises, ensure that volume is appropriate and technique is correct. Some support tape may be required.

• Management -‐ Teach pain free stretch, exercises to maintain fitness, incuding upper body and core strength program, massage to uninvolved part of muscle, strapping , unassisted ambula7on if painfree, stretching to uninjured musles

Stage 3 2-‐3 sessions

• REGENERATIVE/REPAIR/PROLIFERATIVE PHASE • Approximately day 7-‐10 • No pain with moderate stretch and normal amula7on • Early mobilisa7on promotes more capilliary ingrowth as well as bePer muscle fibre orienta7on • Visits 2-‐3 are required for exercise prescrip7on to ensure volume is appropriate and to ensure technique is correct, massage to affected muscle,

• Basic concentric and eccentric strengthening for involved muscle including use of pilates bed, general strengthening and more advanced cardiovascular condi7oning, stretching to uninjured muscles.

Stage 4 3 sessions

• CONTINUATION OF THE REGENERATIVE PHASE AND START OF THE REMODELLING PHASE • Approximately day 14 -‐ 21 • Progression of weight training to func7onal and ac7vity specific ac7viites including co-‐ordina7on drills and plyometrics

• 3 visits are required for exercise prescrip7on to ensure volume is appropriate and to ensure technique is correct, massage to affected muscle

Stage 5 1 session

• FITNESS TEST • Approximately day 21 -‐ 35 • 1 visit is required for fitness test -‐ check range, concentric/eccentric strength, func7onal strength, sports specific ac7vity

LOWER LIMB MUSCLE TEAR PROTOCOL