ΠΑΠΙΜΙ INTERNATIONAL CONGRESS ON SPORTS MEDICINE
         MARCH 18-21 1999 - ATHENS, GREECE

Translated by Lydia Nousia.

ACCELERATED TREATMENT OF ANKLE SPRAIN BY APPLYING PAPIMI 600P BIOMAGNETIC GENERATOR, WITH CRYOTHERAPY AND PHYSICAL EXERCISES FOR FOOTBALL PLAYERS.

BY

HOMIROS EMMANOUILIDIS
Medical Doctor for Sports Injuries
104 Kifisias Ave, Athens, Greece
tel.:+301-6984321.

Summary

In the present report, we show a method we developed by applying the PAP IMI Device - Bio Pulse Generator, for professional football players with ankle sprain, the time of recovery for the injured players is significantly reduced. The method allows the players to come back to their athletic obligations, in a significantly shorter time, which is usually before their next athletic meeting or activity.

(Short presentation is given below)

INTRODUCTION

The ankle arthrosis as well as the knee arthrosis are those that are exposed to the biggest danger in a football match.

The reasons, which create sprains of the ankle, are due to the direct contact with the opponent, due to wrong balance during racing on rough surface or even due to a loose arthrosis. Football players usually during their training, but, mainly at the matches, back up their arthrosis with bandage or with self-adhesive elastic bandages using the appropriate fascia.

The goal of this research is to reduce the time of return to the match for professional football player that was subject to an automatic second grade sprain or after direct contact with an opponent had a second grade sprain.

Sprain is the partial or the full brake of the fiber of one joint and particularly of their outer portions, more specifically at the front portion which is known as the perone ankle joint. It is an injury of resupination, adduction and is mainly due to the anatomy of the foot end, because the internal melleolus is shorter than the exterior melleolus and the arthrosis is less supported during an ectropic (with the foot inwards) injury, forcing the outer sprain to accept all the weight of the load.

Fewer times the opposite is happening - ectropia (with the foot outwards) affecting in that way the outer elements of the ankle.

The sprains are distinguished according to that gravity of the injury: a) to the first grade or light sprain, b) to the second grade or heavy sprain with full joint rhexis, c) third grade with full rhexis which concerns the medium of the joint, which may have the form of detachment either from the gemma or from the sertion, either with or without osteal fragma. With the rhexis of the conjunction, rhexis of the synovial bursa occurs.

Rhexis alone of the peroneal joint of the leg if not treated on time, it may end to instability of the arthrosis. The same is true for the rhexis alone of the outer later jont which can end to relapse sprain of the ankle , which implies astasia of the arthrosis and it may end to possible degenerative arthritis.

The active athlete after an injury has to terminate immediately the athletic activity and should undertake medical and radiological check ups in order to determine the gravity of the sprain.

Clinically after some hours, the arthrosis is characterized by a huge edema as well as by a huge hematoma. After such injury, intense pain and walking inability occurs.

For the second grade of sprain the proposed treatment is as following:

• Applications of cold compresses for 15-20 minutes at frequent time intervals for the first 48 hours.
• Functional fasciation with elastic bandages or functional splint, "Air Castle" type, for 8-10 days.
• Upstream place of the leg.
• Avoidance of walking and tension of the part.
• Pharmaceutical treatment with anti-inflammatory and anti-edema medication.
• At least 10 sessions of physiotherapy treatments after the 5^th day which include vortex bath, ultrasound, electrotherapy, massage cryotherapy, reinforcement exercises of the ankle, proprietor exercises.

Total time for gradual coming back at the athletic activities is 15-20 days.

For our pilot research we finally selected 20 football players who had second grade sprain, either automatic or because of an "opponents’ contact".

Clinically the injured players under our study, presented a tense edema and hematoma. The x-rays analysis was negative for fracture. For 3 occasions that was determined necessary they were examined under "static movement" check up, which resulted negative for a fully break of the joint.

METHOD

The ankle was immobilized with “Air castle splint" and cold compresses were applied for 24 hours. The second 24 hours they received treatments with a PAP-IMI 600P Magnetic Pulser Device. The PAPIMI treatments were twice every morning as well as every evening for 20 minutes’ duration each.

The device produces:

• Complex magnetic induction field as it is shown in the oscillogram with continuously reducing intensity during every complex pulse, with an initial instantaneous peak of 10,000 ampere-turns max, which corresponds to 125 gauss, modulated from oscillations of excited gaseous plasma with PAP- IMI method.
• The overall duration of every complex pulse is 10 microseconds, repeated every 500ms.
• The energy at every complex pulse is of the range of 54 Joules.
• The average potential of the field 2x54 Joules/or 108 watts.
• The frequency consists of continuous harmony Fourier components from 0.3 MHZ to 250 MHZ.
• Effective penetration is 15 cm at full potential, reduced proportionally with the third power of the distance.

After the treatment, cold compresses were applied for 15 minutes and the functional splint was placed back. The edema was reduced greatly after the second treatment. The football players began light running exercises on the fourth day after the injury, with their splints completely removed.

The same day, they started special reinforcement exercises for the ankle.

RESULTS

60% of the football players recovered completely the 6^th day and returned to their athletic obligations.
Recovery reduction time was down to 30%.

30% of the football players recovered the 8^th day after the injury.
Recovery reduction time was down to 44%.

10 % of the football players were feeling annoyance at the 10^th day.
In this case, the two players remaining (20x10%=2) recovered the 13^th and 14^th day accordingly.
Recovery reduction time was down to 75%.
Pharmaceutical treatment was not given at all.

Conclusively: We have proven that the method -by applying the PAP IMI Device - Bio Pulse Generator - for football players with second grade sprain of the ankle, the time of recovery was significantly reduced and allowed the players to come back to their athletic activities in a much shorter time and before the next weekly match.

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Notice 1.

We have distinguished the injuries in four different categories

• In the first category we distinguished the type of the injury (automatic muscle injury from cicatrices, injury of arthrosis).
• In the second category we determined the point of trauma to establish whether some parts of the body are more fender.
• In the third category we distinguished the time periods that the injuries were occurred (preliminary training, climate conditions, tense match obligations)
• In the fourth category we noted the number of the pathological cases during the match period.
• The total number of the football players that were included at this research was 68.
• Due to the longer time of non-participation to local matches during the last summer period, because of the World Championship, there was enough time to most chronic injuries to cure. The time of the preliminary training was prolonged. So the training period was increased smoothly and there were no actual new injuries.
• For a team that worked less hard at the beginning, giving friendly matches more sprains occurred later during the championship.

Notice 2.

• For teams that had more matches’ participations (championships, links, national obligations) more muscular injuries and knee’s injuries occurred, mainly at the period of the increased matches’ obligations.
• For a team that is trying to remain at one category and which does not have a permanent area of training, more injuries are observed to occur for the ankle during the rain period when stadiums are usually in bad conditions. Also an increase of automatic muscle injuries occurs after the change of the coach or after the change of the training type.