Anal Model 18

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Affiliations
1 Department of * Kinesiology, University of Virginia, Charlottesville.
2 Department of Orthopaedic Surgery, University of Virginia, Charlottesville.
Jay Hertel et al. J Athl Train. 2019 Jun.
Affiliations
1 Department of * Kinesiology, University of Virginia, Charlottesville.
2 Department of Orthopaedic Surgery, University of Virginia, Charlottesville.
Lateral ankle sprains (LASs) are among the most common injuries incurred during participation in sport and physical activity, and it is estimated that up to 40% of individuals who experience a first-time LAS will develop chronic ankle instability (CAI). Chronic ankle instability is characterized by a patient's being more than 12 months removed from the initial LAS and exhibiting a propensity for recurrent ankle sprains, frequent episodes or perceptions of the ankle giving way, and persistent symptoms such as pain, swelling, limited motion, weakness, and diminished self-reported function. We present an updated model of CAI that aims to synthesize the current understanding of its causes and serves as a framework for the clinical assessment and rehabilitation of patients with LASs or CAI. Our goal was to describe how primary injury to the lateral ankle ligaments from an acute LAS may lead to a collection of interrelated pathomechanical, sensory-perceptual, and motor-behavioral impairments that influence a patient's clinical outcome. With an underpinning of the biopsychosocial model, the concepts of self-organization and perception-action cycles derived from dynamic systems theory and a patient-specific neurosignature, stemming from the Melzack neuromatrix of pain theory, are used to describe these interrelationships.
Keywords: ankle sprains; anterior talofibular ligament; calcaneofibular ligament; diagnosis; rehabilitation.
The updated model of chronic ankle instability (CAI). The outcome is determined at…
The updated model of chronic ankle instability (CAI). The outcome is determined at least 12 months after the initial ankle sprain. Abbreviations: ATFL, anterior talofibular ligament; CFL, calcaneofibular ligament; HRQOL, health-related quality of life.
Adaptation of the model to illustrate the specific impairments of a 15-year-old female…
Adaptation of the model to illustrate the specific impairments of a 15-year-old female high school basketball player who has chronic ankle instability (CAI). The enlarged circles and text indicate specific impairments that are contributing to her condition and health status. Abbreviations: AT, athletic trainer; BMI, body mass index; HRQOL, health-related quality of life.
Adaptation of the model to illustrate the specific impairments of a 35-year-old male…
Adaptation of the model to illustrate the specific impairments of a 35-year-old male construction worker who has chronic ankle instability (CAI). The enlarged circles and text indicate specific impairments that are contributing to his condition and health status. Abbreviations: BMI, body mass index; HRQOL, health-related quality of life.
Adaptation of the model to illustrate the specific impairments of a 22-year-old graduating…
Adaptation of the model to illustrate the specific impairments of a 22-year-old graduating female collegiate athlete who has a history of ankle sprains and has changed her level of physical activity to cope with her ankle injury. The enlarged circles and text indicate specific impairments that are contributing to her condition and health status. Abbreviations: ACL, anterior cruciate ligament; HRQOL, health-related quality of life.
Delahunt E, Remus A. Delahunt E, et al. J Athl Train. 2019 Jun;54(6):611-616. doi: 10.4085/1062-6050-44-18. Epub 2019 Jun 4. J Athl Train. 2019. PMID: 31161942 Free PMC article. Review.
Wikstrom EA, Hubbard-Turner T, McKeon PO. Wikstrom EA, et al. Sports Med. 2013 Jun;43(6):385-93. doi: 10.1007/s40279-013-0043-z. Sports Med. 2013. PMID: 23580392 Review.
Miklovic TM, Donovan L, Protzuk OA, Kang MS, Feger MA. Miklovic TM, et al. Phys Sportsmed. 2018 Feb;46(1):116-122. doi: 10.1080/00913847.2018.1409604. Epub 2017 Nov 29. Phys Sportsmed. 2018. PMID: 29171312 Review.
Guerra-Pinto F, Côrte-Real N, Mota Gomes T, Silva MD, Consciência JG, Monzo M, Oliva XM. Guerra-Pinto F, et al. J Foot Ankle Surg. 2018 Nov-Dec;57(6):1087-1091. doi: 10.1053/j.jfas.2018.03.038. Epub 2018 Aug 23. J Foot Ankle Surg. 2018. PMID: 30146335
Donovan L, Hertel J. Donovan L, et al. Phys Sportsmed. 2012 Nov;40(4):41-51. doi: 10.3810/psm.2012.11.1987. Phys Sportsmed. 2012. PMID: 23306414 Review.
Peri M, Gottlieb U, Finestone AS, Springer S. Peri M, et al. Brain Sci. 2021 Jun 15;11(6):788. doi: 10.3390/brainsci11060788. Brain Sci. 2021. PMID: 34203659 Free PMC article.
Tashiro T, Maeda N, Sasadai J, Kotoshiba S, Sakai S, Suzuki Y, Fujishita H, Urabe Y. Tashiro T, et al. Healthcare (Basel). 2021 Jun 10;9(6):707. doi: 10.3390/healthcare9060707. Healthcare (Basel). 2021. PMID: 34200684 Free PMC article.
McCann RS, Johnson K, Suttmiller AMB. McCann RS, et al. Int J Sports Phys Ther. 2021 Jun 2;16(3):741-748. doi: 10.26603/001c.22132. Int J Sports Phys Ther. 2021. PMID: 34123527 Free PMC article.
Lin CI, Houtenbos S, Lu YH, Mayer F, Wippert PM. Lin CI, et al. J Foot Ankle Res. 2021 May 28;14(1):41. doi: 10.1186/s13047-021-00480-w. J Foot Ankle Res. 2021. PMID: 34049565 Free PMC article. Review.
Zhang R, Zhang X, Chen Y, Song W. Zhang R, et al. BMC Musculoskelet Disord. 2021 May 18;22(1):453. doi: 10.1186/s12891-021-04345-y. BMC Musculoskelet Disord. 2021. PMID: 34006258 Free PMC article.

Mum-of-two and fitness instructor Tracey Kiss, 30, from Aylesbury, says the procedure has boosted her confidence in the bedroom
WOULD you be brave enough to try out anal bleaching?
The bizarre trend was sparked after celebrities including Kourtney Kardashian, Charlotte Crosby and Sophie Kasaei revealed they have lightened their behinds.
In fact, there's been a 23 per cent surge in the number of women seeking anal bleaching as they feel the pressure to "look like porn stars" in the bedroom, according to a top London clinic.
The procedure involves lightening the colour of the skin around the anus. It's done purely for cosmetic reasons to make the skin the same colour as the surrounding skin on the backside.
But, is it worth it? And does it hurt?
Two weeks ago we sent fitness instructor and mum-of-two Tracey Kiss, 30, from Aylesbury, along to HB Health Clinic in Knightsbridge, London, to have a 30 minute session.
She took boyfriend Freddie Shaw, 27, along with her and claims it's boosted her confidence in the bedroom...
TO be honest I'd not really given too much thought to that area of my body, I guess because it's not talked about a lot and people find it all a bit embarrassing.
But I can see why more and more women are having it done. We all like to be well groomed - I get regular bikini waxes and remove all my pubic hair.
Reading more about it, I did become a bit concerned deep down as to how mine looked.
I love sunbathing and wearing G-strings, and I've even had designer vagina surgery!
I'm into body building and I realised I'd not really been giving that part of my bum as much attention as everywhere else. So I thought, why not look into it?
I never realised just how many shades and colours skin in that area could be, and that I could even select as my "end result" colour.
Bizarrely, Freddie seemed to know more about the procedure than me! Perhaps he'd done his research. It was great to be able to ask him what he thought and not have him freak out in horror or laugh at me.
Obviously I don’t look at that area of my behind very often, but from time to time he does "encounter" me from that view. While he had no complaints, I decided it would nice to have the dark-ish brown colour of the skin down there look more uniformly like the rest of me.
That’s the reason most models and celebrities say is behind them having the procedure.
I was surprised at how quick and simple it was.
When I got to the clinic I had to lie on my back with my knickers off - just like I was having a smear.
I was given special glasses to wear to protect my eyes from the laser and EMLA Cream was then applied to the surface area to allow the skin to numb for several minutes before treatment began.
The Double Wave Laser removes the melanin layer present in the sensitive area, meaning the source of the darker colouring is permanently treated, without leaving any scars or burning.
I didn't know how sensitive I would be for the very first zap, and I was worried I might jump with the surprise of it.
I'd imagined it would be painful but it was over with really quickly. I've had my underarms and rosacea on my face treated with laser before and I’d always felt a short, sharp sting during those procedures.
With this, I merely felt a couple of pings as laser shots were set off at my bottom. It was certainly easier than child birth or period cramps!
I chatted to Freddie about grocery shopping while Dr Madhok administered the laser, which helped me to relax as it took my mind off it.
Afterwards my bottom felt quite "hot" because of the laser and I was given healing cream which needed applying twice a day. We also couldn’t have sex for a week.
I couldn't wait to see what it looked like, and I was thrilled with the results.
I had Freddie take before and after images and I used a mirror between my legs to check on the recovery. The area is considerably lighter and looks just like my normal skin.
It’s gone from what I would say was latte brown to a strawberry milkshake colour. The whole experience was bizarrely liberating.
Now when I think about it, it's just like having the circles under your eyes improved!
It’s something that has really given me an extra boost down below and certainly smartened everything out there.
I've nicknamed the procedure my "cracking facelift" because it really felt like a face-lift for your anus.
When we had sex a week after the procedure I felt like a virgin again. It's allowed me to be more adventurous between the sheets. It's made me feel super confident.
Having anal bleaching doesn’t mean you want anal sex or are obsessed with it. It's about body confidence. Talking about it with my man was as liberating as having it done.
I think if the treatment makes you feel good about your body, then have it done.
I've never had any negative comments on the appearance of my anus, but I had the procedure for me. I love the results and am glad I did it.
What's all the fuzz about - and is it safe?
ANAL bleaching is the process of lightening the colour of the skin, not the hairs, in the bum region.
It was established for cosmetic reasons, to make the skin around the hole more uniform with the rest of your panty region.
After the rise of Brazilian waxes, women - and some men - began to notice that their anuses had a darker hue.
If you have noticed this on yourself, it is very common - and completely normal.
Thanks to the likes of Kim Kardashian, we're becoming more and more obsessed with our rear ends.
Scores of celebs have spoken out about their new-and-improved bums.
But be careful; if done in a dirty spa or by an untrained professional, anal bleaching can cause herpes, scarring and infection.
It could also lead to strictures, which make the opening smaller and bowel movements difficult, or tears in the anal canal.
"It’s not the most gratifying treatment," New York Dermatologist Doris Day MD told Cosmospolitan.
"The darker pigmentation will always come back so it’s not permanent.
"And there’s also a chance of total depigmentation (the skin going completely white) or in some cases, because of how one’s skin reacts to the bleach, a darkening of the area."
Freddie said: "I love the fact we can talk about these things. If you can accompany your girlfriend for anal bleaching I think you can definitely deal with any of life's other hurdles.
“It’s made us closer as a couple. Tracey is more confident in the bedroom and I love that. I'm glad she did it for herself and not me, because I love her how she is.”
Jane Wiles, clinic manager at HB Health of Knightsbridge, said the laser treatment is currently the most popular among patients, accounting for about 95 per cent of anal bleaching cases. In other cases women are seeking creams.
"The vaginal bleaching has always been quite popular but recently anal bleaching is becoming really popular as well," she said.
"A lot of women have issues where the pigmentation has gotten a lot darker and they are insecure about it.
"It is usually hormonal. So if you become pregnant, if you go through menopause, if your hormones change at all during your lifetime that is what will spark it to get darker."
Dr Minoo Madhok, who performed Tracey's bleaching, added: "Laser treatments tend to require two to three sessions, using a high-tech laser to remove a layer of melanin, which is responsible for darkness.
"Cream treatments work in the same manner as skin bleaching. Most people want it done for body confidence and it’s great to see people walk out feeling better about themselves."
One session at HB Health in Knightsbridge costs £500, while booking a block of three costs £1,300 - a saving of £200.
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