Programme sportif en période de guérison d'une fracture fatique tibiale

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Programme sportif en période de guérison d'une fracture fatique tibiale par (invité) (92.171.139.xxx) le 08/03/17 à 12:11:50

Bonjour à toutes et tous,
A toute fin utile, je vous fais part d'un programme médicale en phase de traitement d'une fracture de fatigue tibiale. Ce programme est élaboré médicalement pour les personnes souhaitant reprendre au plus vite, en minimisant les risques. Evidemment, ça ne se substitue pas à un conseil médical, mais ça reste intéressant pour les personnes privées de course plusieurs semaines...


Basic rehabilitation program for low risk tibial stress fracture

Phase 1: Cross training: Typical duration 2 weeks
* Wear long air splint continuously while standing and during cross training, but not needed for sleep
* Apply ice to fracture site 2-3 times daily for 10 to 20 minutes; may repeat if swelling increases and after training sessions
* Calcium 1500 mg and vitamin D 800 IU supplementation daily throughout rehabilitation
* 45 minutes stationary cycle daily
Heel raises, toe raises, and squats with weight every other day: 25 to 30 percent of body weight is used for three sets of 15 repetitions for each exercise
Advance to Phase 2 when patient can jog 50 steps with no pain in a long air splint


Phase 2: Initiation of weight bearing exercise: Typical duration 2 weeks
Perform all weight bearing activity in long air splint
* Every other day, run 400 m/walk 400 m for eight laps (lap = 400 m) on a soft track; perform three sessions
Next, run 500 m/walk 300 m for eight laps; perform three sessions, one session every other day
Continue progression, performing three sessions at each level, as follows: run 600 m/walk 200 m; run 700 m/walk 100 m; total of eight laps for each session, one session every other day 
* 45 minutes stationary cycle on alternate (non-running) days
Apply ice after activity as above 
Perform weight exercises as described in Phase 1 on non-running days
Advance to Phase 3 when patient can complete 8 laps of 700M run/100 M walk without limp or pain

Phase 3: Initiation of protected training: Typical duration 2 weeks
* Perform all weight bearing activity in long air splint
* 45 minutes stationary cycle on alternate days
Run 2 miles (3.2 km) every other day for three sessions
Run 2.5 miles (4 km) every other day for four sessions
Continue strength exercises as described in Phase 1 on non-running days 
* Apply ice after activity as above
* Advance to Phase 4 if running for Phase 3 is completed without limp or pain; fracture site is non-tender; and, patient is able to hop 10 times and to jog without limp with air splint off

Phase 4: Weaning from long air splint: Typical duration 2 to 3 weeks
* Begin running 2.5 miles (4 km) every other day
* Run without splint on first day and with splint on second day; thereafter, alternate splint use every other day
Continue strength exercises as described in Phase 1
Advance to Phase 5 when pain free on all run days without splint

Phase 5: Progressive training: Typical duration 4 weeks
Increase run duration by five minutes after two workouts at each level; no air splint
Five runs per week during weeks 9 and 10
Six runs per week during weeks 11 and 12
When tolerating 40 continuous minutes of running without significant pain, resume normal training
Protocol guidelines
If patient has problems at any stage of rehabilitation, move back one level for an additional week and then try to advance

Continue all training for the first 12 weeks on a soft, level surface, the softer the better.

Evaluate patient in the office every two weeks for evidence of healing and signs of injury until they reach phase 5

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