Physiotherapeutic procedure after injuries of soft tissues of tarsal-crural joint

Physiotherapeutic procedures in soft tissues injuries of tarsal joint are presented in this paper. Meaning of the early procedure “RICE” and the extended procedure “PRICEMM” in acute injuries of tarsal joint is underlined. Rules of physiotherapy in directed conservative or operative treatment procedures are presented. Procedure was adapted to the kind and degree of soft tissues injuries. After termination of standard immobilization of the limb or during immobilization in orthesis, it is necessary to start physiotherapy, isometric exercises, techniques of lymphatic drainage, education of walking with crutches at partial or total load of the limb in dependence on the kind and degree of injury of soft tissues of joint and coexistent injuries. In the second stage, after basic period of healing of soft tissues and after removal of immobilization, exercises directed on return to function of joint and then the whole limb are recommended. Exercises of proprioception play particular role. Massage and mobilization of soft tissues around joint are carried out. Kinaesthesia of the joint, then the limb and the whole body is restored. Restoration of walking is an important element of rehabilitation. In the third stage it is necessary to rebuild the strength of muscles especially muscles of shank in static conditions, then isokinetic, with use of concentric-eccentric training. It is necessary to make many equivalent exercises, exercises in one, then two and then three plane of movement. For persons, who want to return to physical activity, the forth stage of physiotherapy is realized, in which additionally it is necessary to restore specific physical efficiency for a sport discipline practiced by a patient. Endurance, overall and directed efficiency are restored as well as strength training is continued. Restoration of agility, flexibility, rapidity and adaptation of level of those traits to age is important.