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Judo Therapist Training Facilities, Junior Colleges and Universities
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¡¡¡¡¡¡¡¡¡¡¡¡ ¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡Iida Osteopathic Hospital ¡¡Yukio Hara
Dear Sir or Madam, I hope that your school is prospering more and more.
Please forgive me for the rudeness of writing to you so suddenly. My name is Yukio Hara and I am the director of Iida Osteopathic Clinic in Iida City, Nagano Prefecture. I am writing to you to ask if you would give me the opportunity to practice the "Achilles Tendon Rupture Preservation Walking Therapy (Yoshizawa Method)" (hereinafter referred to as "this method") at your school in order to spread the method.
-This method is a treatment method originated by judo therapists (a qualification to practice at an osteopathic clinic or osteopathic clinic).
¡¡This treatment method was created by Dr. Katsuki Yoshizawa, head of Yoshizawa Osteopathic Clinic in Anami-cho, Shimoina-gun, Nagano Prefecture (Yoshizawa Osteopathic Clinic address: 686-3 Saijo, Anami-cho, Shimoina-gun, Nagano Prefecture, phone: 0260-22-3669) and has been refined over 40 years. It is a revolutionary and original treatment method that allows patients to walk without a cane immediately after immobilization for the first time in the world, and the immobilization period is as short as 4 weeks.
As you know, existing gait therapies (whether spectator or conservative) require the ankle joint to be in a strong plantar flexion position to keep the Achilles tendon from coming close to the rupture, so the fixed limb position is the pointed foot position (although it is no longer as strongly pointed as before). Therefore, a cane is used to float on the affected limb, and after a certain period of time, a high heel with a wedge is used to start loading the limb.
In this method, the patient is immobilized with the ankle joint in the spontaneously drooping position (mild plantar flexion), the toes facing outward (hip external rotation), and the right and left feet slightly open (resting position).
I have more than 300 cases under the guidance of Dr. Katsuki Yoshizawa, the founder of this method. I have also had cases of so-called re-tears (I believe the correct term is "pre-union tears" because most tears occur less than three months after the tear and before complete fusion). Most of the re-tears are now treated with the use of the hemoperfusion method, which has healed without problems. Some of the re-tear cases are after surgical treatment or conservative therapy at other hospitals in addition to ours. There is also one case of re-tear in our clinic. All of these have healed without problems.
We have also treated a patient with irritable bowel syndrome who was taking steroids and ruptured his Achilles tendon under mild stress, which was inoperable. There have been several cases where the injury was left untreated for a long period of time, up to 5 weeks. 1 week left untreated is no problem at all and healed well after about 5 weeks of immobilization. In cases left untreated for a long period of time, the period of immobilization is extended depending on the state of fusion.
-Comparison of the Yoshizawa Method: Blood Spray Therapy, Conservative Therapy, and Conservative Walking Therapy
¡¡In Japan, there have been many papers published in the field of orthopedics that show that conservative therapy is not inferior to blood therapy, and the number of such papers is increasing. There is no difference between conservative and open treatment. In the future, conservative treatment will be the mainstay of treatment for Achilles tendon ruptures. However, there are many problems with the existing treatment method of just keeping the tendon in a cast, and we want to promote this method that solves those problems.
It is believed that Achilles tendon rupture treatment should be as close to the rupture as possible (in some surgical treatments, the ruptured tendon is tightly brought together and tightly sutured, which may cause the Achilles tendon to stiffen after healing), and apex foot immobilization in a strong plantar flexion position of the ankle joint is This is considered the standard. In the past, immobilization extending from the MP to the thigh was used, but in recent years it is no longer used (although we rarely see it done), as it is no longer considered problematic for tendon fusion without immobilization of the knee joint. Maximal plantar flexion immobilization is prone to joint contractures and loss of function, and also has the major problem of not being able to apply load to the lower extremity. Walking with crutches is a hardship for patients, especially women with weak arms, many of whom cannot walk with crutches and use chairs with wheels in their daily lives. They are delighted when they switch to walking therapy.¡¡
We believe that the gap between the transected ends is not completely approached even with conventional conservative therapy with immobilization in the maximum plantar flexion position. The triceps side of the triceps muscle may move downward as the muscle tone relaxes immediately after the tear, but the calcaneus side of the triceps does not approach the triceps, and the gap between the transection edges remains. In addition, we believe that there may not be much difference in the gap between the transected ends when immobilized in maximum plantar flexion and in mild plantar flexion, but in our past cases, even if the gap is large or the transected ends are far apart, they fuse without problems (on the contrary, they fuse quickly), and no dysfunction occurs. We speculate that the healing machinery is working to restore the tendon to its original length during fusion and regeneration.
¡¡The cause of poor Achilles tendon fusion and long rehabilitation time is the circulatory disturbance and functional deterioration of muscles, joints, and nerves (recently, brain atrophy has also been pointed out) caused by the non-weight bearing during immobilization that has been performed until now. By nature, Achilles tendon ruptures are easily fused and motor function recovers quickly. We believe that the conventional treatment method is the cause of the delay in recovery of Achilles tendon rupture.
When patients are fixed with this method, orthopedic surgeons sometimes tell them, "If you do that, it will not fuse, and even if it does, it will prolong the fusion," but just as Copernicus was subjected to the Inquisition for his "geocentric theory" but said, "Still the earth is turning," I say, "Still the Yoshizawa method is the best way to heal. I say, "You will heal faster and better. This treatment method is a paradigm shift in Achilles tendon rupture. Please help spread the word about this revolutionary treatment method.
-Advantages of the Yoshizawa Method
¡¡There are, of course, none of the risks of open therapy (intraoperative risks and post-fusion scarring, Achilles tendon contracture, skin adhesions, etc.).¡¡
This method of immobilization does not merely stop the ankle joint from moving; it is a thoughtful immobilization that prevents swelling and makes it easier to walk. Only two pieces of Plyton are used to make a thin, sandwich-like fixation in the front and back, and an elastic bandage is wrapped over the bandage to provide adequate pressure and prevent loosening of the fixation. This makes it easy to walk with moderate elasticity, and the mild compression prevents swelling and circulatory disturbance (there is literature showing that moderate compression increases the speed of blood flow), and it is a treatment method that quickly heals the Achilles tendon rupture and prevents disability after immobilization (this is something that existing cast-only conservative therapies and existing walking therapies do not have). (This is a point not found in existing conservative therapies that only cast the tendon or in existing gait therapies).
Dr. Yoshizawa has conducted EMG studies comparing walking with heels and heel-loaded walking with this method in the hip externally rotated position. He has shown that the triceps femoris muscle during walking shows muscle contraction with the existing heel-applied method but not with this method, and he has published 3DCT images of the tendon fusion state with this method.
There are many advantages of this method, such as: full load can be applied to the affected limb immediately after immobilization, there is no need to use crutches, so daily life is less disturbed, there is less functional loss due to no load in existing treatment methods because the limb is loaded, and immobilization can be removed in as little as 4 weeks because circulatory disturbance is unlikely to occur.
I have experienced the difficulties of using crutches myself. Four years ago, I suffered spiral fractures in both lower legs from landing a paraglider. The treatment was conservative therapy and immobilization was a prine. I walked with crutches, fell three times in two days, and immediately switched to a wheelchair. I could not use crutches. Many of the women who came to our clinic for this method during their existing treatment expressed their joy when they started walking after immobilization. This is the joy of being free from the hardships of using crutches and the pain in their knees and wrists from crawling on all fours indoors. Many men who have had a previous Achilles tendon rupture and who have suffered an Achilles tendon rupture on the opposite side come to our clinic because they do not want to have to go through that pain again and they want to use this method. In this procedure, we ask the patient to walk a lot during the immobilization. Those who work in sales, who are on the road, or who have always been a walker and walked a lot during the fixation period heal well. Some housewives, office workers, and those who do not walk much may have poor progress. We believe this is largely related to worsening swelling.
Fixation is not only front-to-back fixation, but also a clean fusion as the Achilles tendon area is prepared by pinching it from the inside and outside with cotton wool so that it regenerates and fuses close to its original state. It has been reported that moderate compression helps to align the tendon fibers during tendon regeneration.
Please help us spread the use of this method!
We would like to spread this method as a standard for the treatment of Achilles tendon rupture not only in Japan but also in the world. However, the spread of this method has been slow. Last year, with the help of Dr. Tetsuo Kudo, former president of the Japan Judo Therapy Association, we were about to start a plan to provide education on this method to judo therapists this year, but Dr. Kudo resigned his position, so the future is uncertain.
¡¡We would like to ask you if you would allow us to conduct a practical training course on this method at your school in order to spread this method. We would appreciate your kind consideration. The audience is not limited to students, but also includes alumni and teachers who are practicing in the area. We would be grateful if you would consider our request.
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¡¡¡¡Contact information
¡¡Yukio Hara
¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡1270-4 Kitagata, Iida City, Nagano Prefecture, 395-0151 Japan
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If you have any questions about the treatment of Achilles tendon rupture
ä 026525-1008 to Iida Osteopathic Clinic
Achilles tendon rupture treatment
In curing your ruptured Achilles tendons, our unique method involves no surgical operations, allowing you to recover your abilities to walk over the course of about 4-5 weeks’ treatments. Thus you have no need to consider taking a variety of risks that may accompany surgical operations. During the 4-to-5-week-period of the treatment, you only need to visit our clinic twice. On your first visit, the doctor examines the condition of your feet and applies plastic bandages as needed. You can walk without crutches immediately after the first visit, and certainly over the following 4-5 weeks before your second visit. On the second visit, the bandage will be removed and the treatment will be completed. The total cost of the treatment is 150,000 yen. We have successfully treated patients from all over Japan and USA, CANADA, CHINA, VIETNAM, HONG KONG, GERMANY etc. For further information and to make reservations, please call 0265-25-1008.Iida Seikotuin¡ÚIida office¡Û
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