POST-FRACTURE PHYSIOTHERAPY CAN MAKE A DIFFERENCE


Post-Fracture Physiotherapy Can Make a Difference

The adult human body contains some 206 bones. These bones provide a supportive framework for the body, protect internal organs, store key minerals, and aid in the production of blood. These bones are also key to movement itself. When a bone is broken, or fractured, movement is hindered and sometimes stopped altogether. This is especially true when the fracture occurs in a bone we rely on for everyday activities such as walking or using our hands. While the first phase of healing a broken bone requires immobilization, the phases that follow require movement in order to strengthen the bone and related musculature. Physiotherapy is vital during this process to increase mobility and strength to the affected area. This article will discuss some common fractures and how post-fracture physiotherapy can help during the recovery process.

Commonly Seen Fractures

No matter where a fracture occurs, there will be a period of rest or immobilization to set the bone and allow it to heal properly. Each fracture is different, and your physician will decide what treatment option best suits you. During that time, movement will be restricted. Common side effects during immobilization include joint stiffness, loss of muscle mass, loss of strength and function, and overall weakness. Post-fracture physiotherapy addresses all those symptoms and is tailored to each individual and their specific injury.

Let’s take a look at some common fractures:

Boxer’s Fracture (5th Metacarpal):

– This is a fracture of the hand, often occurring when the fist is clenched and hits a hard surface with force.
– After receiving clearance from your physician, the goal of physiotherapy is to restore strength and function. Various exercises of the hand will be encouraged, and you will be quite stiff following any immobilization. Your physician and physical therapist will customize exercises according to your injury.

Wrist Fracture:

– The wrist contains 8 small bones that connect to the two forearm bones (radius and ulna). The most commonly seen wrist fracture involves one of these forearm bones and is called distal radial fracture.
– During the immobilization period it is important to perform range of motion exercises of the fingers, elbow, and shoulder to prevent stiffness and reduce swelling. It is common to experience a feeling of stiffness following immobilization, but your physician and physical therapist will customize exercises according to your injury.

Elbow Fractures:

– These can affect the radial bone (below the elbow), the humerus (above the elbow), or the pointy tip of the elbow (the olecranon, part of the ulna forearm bone). The immobilization period will likely include wearing a sling. Depending on your specific fracture your physician and/or physical therapist will likely introduce safe exercises to perform during and after immobilization. These are important in reducing swelling and stiffness.

Shinbone (Tibia) Fractures:

– This fracture occurs below the knee and above the ankle along the shaft of the shinbone.
– During the immobilization period a therapist will most likely help you learn to walk with crutches and avoid putting weight on the affected leg.
– Most likely your first exercises will focus on gaining flexibility and will be manually performed by a therapist.
– As you gain flexibility the exercises will focus on strengthening the extremity and could include pool or water therapy to reduce the stress of gravity or the use of a stationary bike.

Ankle Fracture:

– The ankle is comprised of three bones: the tibia, fibula, and the talus. Fractures of the ankle are common due to falls or twisting of the ankle.
– Many times the immobilization period is over a month’s time and can cause significant weakness or muscle wasting to the calf muscle. Physiotherapy has been shown to increase range of motion in ankle fractures and prevent any long-term disability.

Physiotherapy to the Rescue

Each patient is different, so not all fractures receive the same care plan or set of rehab exercises. In general, however, a physiotherapist will tackle 3 main issues seen from fractures:

Pain control

For anyone who has ever had a broken bone, it can be scary to start using it again especially when pain is involved. For this reason, physical therapists employ a range of practices to aid in pain relief before, during, and after physical therapy sessions.
○ Heat and cold therapies
○ Ultrasound
○ Electrotherapy
○ Massage
○ Acupuncture

Flexibility and Mobility

After any extended immobilization period, there is some expected stiffness and loss of muscle mass. This can make it difficult to go back to using the affected limb as before, and it can even cause other injuries when improper compensation of other parts of the body occurs. Physical therapists are in tune with proper functioning of body parts, including gait. They can provide invaluable advice and exercises specific to your injury, as well as appropriate adjustments during the healing/rehabilitative stage. Your first sessions with a physical therapist will most likely include:
○ Manual therapy
○ Stretching exercises

Strength and Function

Once you have gained some range of motion back, your physical therapist will work closely to help you gain strength and improve the function of your affected limb. Some common physiotherapy can include but is not limited to:
○ Resistance exercises
○ Weight bearing exercises
○ Rehab Pilates

Conclusion

‘Time is the medicine that heals all wounds.’ While that saying is partially true, you’ll need more than just time to help you recover what was lost. With the help of a skilled physiotherapist from Complete Care Physio, you can keep your body as strong as possible while your bones knit themselves back together. Once your bones are healed, focused therapy will enable you to build your strength and regain function. Physiotherapy should be an essential part of your healing process.

The Road to Recovery After a Motor Vehicle Accident

In 2017 alone, there were nearly 155,000 motor vehicle accidents reported in Canada. With estimates stating the average one-way commute for Canadians being around 28 minutes, it’s likely that at some point in your life you or someone you know has been or will be involved in a motor vehicle accident. Even the most cautious drivers may encounter an accident since many factors are out of our control on the road. The after effects of any collision, even so-called minor ones, can be painful and long-lasting. After a few weeks in the shop, your vehicle may be as good as new, but the truth is, the body takes longer to heal. What can be done to recover more quickly and efficiently? For many, the key has been physiotherapy. This article will discuss some common motor vehicle-related injuries and the different types of physiotherapy that can help in the recovery process.

Common Motor Vehicle Injuries

A collision doesn’t need to occur at a high velocity to cause damage. Due to an adrenaline rush after a collision, many have overlooked “minor” issues, only to have intense pain in the days and months that follow. The body is made up of various structures such as bone, muscle, ligaments, tendons, nerves, etc. Any of these structures can be disrupted in a motor vehicle crash. Here is a list of common injuries seen with collisions:

Whiplash

This injury is seen most often in cases when someone is rear ended. When whiplash occurs, the soft tissues of the neck become stretched and extended in a forward and backward motion, sometimes even sideways. The result is usually pain and tenderness to the neck and shoulders, with stiffness and associated headaches.

Fractures

Most commonly seen in high velocity accidents, fractures can occur in the spine, the legs, the arms, the feet, the hands, etc. Basically, if there’s a bone, it can be broken. The first line of treatment for fractures involves setting the bone and immobilizing it so that it can heal properly. During the immobilization period strength and mobility to the affected area decreases, resulting in decreased muscle mass and stiffness.

Back pain

Made up of 33 bones, the spine is complex, with discs, muscles, ligaments, and nerves all connected and vital in nature. Motor vehicle accidents can cause a range of injuries to the back, including but not limited to vertebral fractures, sprains, strains, and disc herniations, all of which lead to pain. In addition to pain, some experience difficulty performing everyday tasks such as bending over or changing positions. Back pain therefore can lead to other problems related to a decrease in mobility and the fear of re-injuring oneself.

How can Physiotherapy help?

Just as each collision is different in nature and severity, so too are the injuries sustained by the individual. This is why it is vital to seek medical care with a physician following any motor vehicle crash. From there, depending on your injury, your physician can refer you to physiotherapy. What exactly is physiotherapy? It is a degree-based profession in healthcare that assists individuals with injuries, pain, or disabilities through the use of manual therapy, movement, targeted exercise, and professional advice individualized to each person. It is an important adjunct to healing and restoring movement and function to the body. Here is a brief overview of some common therapies/treatments a physiotherapist can provide:

Manual Therapy

This involves manually stretching, manipulating, and mobilizing the spinal structures and their associated joints. This is performed by a trained physiotherapist with the goal of pain relief and improved mobility and function.

Acute Injury Care

For an acute injury, or one that has occurred suddenly, inflammation will be present. Using ice in the first 48 hours can assist to decrease swelling and pain. Rest is vital for healing, and that includes resting from any activity that may exacerbate the affected area. Depending on your injury, your physiotherapist can provide specific advice to decrease swelling and pain in those first few days after an injury.

Transcutaneous Electrical Nerve Stimulation (TENS)

This is a common treatment used for acute and chronic pain that involves the use of electric energy transmitted to the nerves. This can be performed in-office or even at home. The device works through electrodes or patches placed on the skin to deliver the electric waveforms to the desired area to provide pain relief, improve circulation, and decrease muscle spasms.

Acupuncture

With its roots in Traditional Chinese Medicine (TCM), acupuncture is used to treat a variety of health conditions and is a great alternative for managing pain. Acupuncture uses sterile needles inserted along specific points in the body to stimulate those areas and produce a healing effect. With the use of acupuncture some have been able to avoid taking pain medications.

Dry Needling

With its roots in Western medicine, dry needling uses sterile needles as well, but unlike acupuncture, dry needling is used specifically on trigger points in myofascial structures. The goal is to stimulate stressed muscles to relax, to increase circulation, and encourage proper nerve function.

Rehab Exercises and Lifestyle Modifications

An unforeseen effect of having endured a motor vehicle accident, is a reduction in physical activity. Some individuals are in pain and thus are afraid to do anything that would exacerbate their injury. Although rest is initially advised, after a certain time period it’s important to engage your body in healthful exercise such as pilates, or stretches specific to your injury. A physiotherapist can also help you to adjust the way you perform daily tasks to avoid any further injury.

Conclusion

It’s clear that physiotherapy plays an integral part in the recovery process when it comes to gaining strength, function, mobility, and decreasing pain after a motor vehicle accident. Our team at Complete Care Physiotherapy is ready to help you get on that road to recovery. We have several locations, each with skilled and experienced staff members that can give you the confidence to move forward beyond your injury.

PHYSIOTHERAPY FOR POST-SURGICAL REHABILITATION

Physiotherapy for Post-Surgical Rehabilitation

Do you have a surgery planned for the near future? Or have you already been under the knife? Either way, an essential part of your recovery is physiotherapy. In this article, we’ll discuss why physiotherapy is necessary post-op and what you should expect.

Why Needed?

There are many types of surgeries that require physiotherapy afterward. Though many may think that only those who have undergone orthopaedic surgery need physiotherapy, it has been shown that patients who have undergone other major procedures such as cardiac operations, transplants, abdominal surgery, neurological surgery, etc, have benefited from physiotherapy as well. Due to the lengthy recovery time required from some of these surgeries, physiotherapy goes a long way in assisting you to get you up, moving and living again. Physiotherapy is sometimes overlooked by patients as unnecessary. In fact, it should go hand in hand as part of the healing process after many surgeries. Listed below are some benefits of physiotherapy for post-surgical rehabilitation: Increases mobility and function for muscles and joints Improves posture and balance Corrects imbalanced compensations of the body Decreases the risk of blood clots post-surgery by promoting good circulation Trains patients how to adjust post-operatively for activities of daily living Provides specialized stretches and exercises to build strength Assists with pain control via manual therapy, electrotherapy, etc.

What Can I Expect?

Most likely you can expect a visit from a physical therapist during your stay in the hospital post surgery. Depending on your surgery, they will most likely assist you with getting out of bed, walking, sitting and standing properly, etc. After your initial recovery phase in the hospital, you can expect a physical therapist to do a more thorough evaluation and give you a set of exercises to perform under their care, and throughout the day, as part of your rehabilitation regimen. Listed below are some major surgeries that require physiotherapy:

Cardiac Surgery

Usually, a physiotherapist will encourage chest exercises involving deep breathing and range of motion exercises. They will provide advice on what to do if you need to cough or sneeze, as this can be very painful. The goals of physiotherapy, in this case, are to prevent any post-operative complications, improve lung function, and encourage physical activity.

Abdominal Surgery

Laparoscopic and open abdominal surgeries will require in-hospital physiotherapy for breathing exercises to reduce lung complications and to assist in the basic activities of daily life such as sitting up, standing up, walking, etc. Depending on your surgery, your physiotherapist will provide a list of dos and don’ts post-op, and gradual exercises to strengthen your core and promote mobility.

Orthopaedic Surgeries

Knee Surgeries

There are a variety of conditions that would necessitate a knee or its surrounding structures to require surgery. Some common knee surgeries are: torn meniscus repair, ACL reconstruction, full or partial knee replacement, etc. Generally speaking, for each surgery the exercises will vary, and they will increase in intensity as each week passes, gradually building up mobility and strength. There will be certain limitations placed on the knee joint by the surgeon to prevent disrupting any repairs made. This necessary action will cause some stiffness to develop, but physiotherapy is aimed at mobilizing soft tissue structures and gradually and safely progressing with a range of exercises to improve function. Physiotherapy will address muscle conditioning, proprioception, as well as ways to manage pain and swelling.

Shoulder surgeries

Common surgeries include rotator cuff repair and a variety of arthroscopic surgeries to repair damaged tendons or cartilage. Early mobilization will be encouraged to prevent stiffness and speed up recovery time. The use of a sling will mostly likely be utilized, as well as ways to decrease inflammation and swelling. Your physiotherapist will provide specialized plans, encouraging range of motion exercises that gradually increase in range and will also focus on related structures to the shoulder such as the elbow and hand of the affected side.

Back surgeries

Common back surgeries include fracture repair, discectomy, laminectomy, spinal fusion, etc. Most likely, physical therapy will have begun prior to surgery, and will continue afterward as well. The goals are to promote early mobilization such as walking, transferring from the bed to a chair, or climbing stairs. Patients usually become quite stiff and need manual therapy to loosen stiff joints. Exercises will promote the strengthening of core muscles and stretching of related musculature such as hamstrings. Typically, the exercises will advance from an acute phase to a regular maintenance phase. Physiotherapy will provide advice on what to avoid, and how to adjust the way you once performed daily activities in order to prevent a re-injury. Pain control methods are also an important factor in physiotherapy, such as electrotherapy, cold treatments, acupuncture, and massage.

Bone Fractures

These could include any part of the body such as hands, feet, ankles, arms, legs, etc. Depending on the nature of the fracture, some will require the use of plates or screws, and periods of immobilization while the fracture sets. Casts, slings, and crutches are commonly used as well. During the immobilization period, a physiotherapist will provide appropriate range-of-motion exercises and methods to decrease swelling. Following the immobilization period, a physiotherapist will focus on strengthening and improving mobility that was lost during periods of inactivity and disuse.

Conclusion

While the surgeries listed are by no means exhaustive, it does give an idea of the importance of physiotherapy in the rehabilitation process. From breathing to walking, physiotherapy encompasses the well being of the entire person, not just the area that was operated on. If you are ever scheduled for surgery, or have to have one unexpectedly, the professionals at Complete Care Physiotherapy are here to help.