A full range of exercise therapy exercises for the wrist joint

Fractures, dislocations and sprains in the wrist area are quite common and significantly limit daily life. Regular performance of a full range of exercise therapy exercises for the rehabilitation of the wrist joint will help restore hand function faster. Gymnastics vary depending on the duration of the injury and its characteristics.

General methods of rehabilitation

Treatment and rehabilitation depend on the prevailing symptoms, characteristics of the injury, and the presence of complications. According to statistics, a fracture of the radius most often occurs in a typical area - in the area close to the wrist. This injury usually occurs when a fall hits the back of the hand.

A fracture necessarily requires immobilization, and in some cases, surgical treatment: in case of open damage, mixing of fragments, or development of an infectious process. At the same time, drug therapy with painkillers, anti-inflammatory drugs, antibiotics, chondroprotectors, and calcium supplements is prescribed. In case of tendon and muscle ruptures, surgical intervention and the application of a fixation splint are also necessary.

Exercise therapy and massage usually begin on the third day of injury with breathing, ideomotor and isometric techniques. Active activities are possible after 2 weeks.

Contraindications to exercise therapy for joint injury are:

• State of shock;
• Excessive blood loss;
• Risk of damage to a vessel or nerve trunk;
• Intense pain;
• Infectious complications;
• Severe diseases of internal organs.

Objectives and stages of exercise therapy after fractures of the forearm bones

The main points that are aimed at training the muscles of the forearm and hand after a fracture are to accelerate the healing process. This is achieved by the following mechanisms:

• Restoring blood circulation in the affected area;
• Reducing swelling after an arm fracture;
• Rapid formation of callus;
• Suppression of inflammation and pain;
• Restoring the mobility of muscles and joints of the arms after prolonged immobilization, preventing contractures.

Exercise therapy at different stages has its own characteristics and pursues different goals.

Stage I, immobilization

This is the initial stage of rehabilitation, which usually begins 3 days after the injury, during the period of time when a plaster cast or other immobilizing device is applied to the limb. Main tasks of the early period:

• Relieve swelling;
• Improve blood flow through the vessels of the forearm and hand;
• Activate metabolic processes in the musculoskeletal system of the upper limb;
• Stimulate regeneration processes.

Important!

When performing exercises at this stage, it is important to be careful not to provoke displacement of bone fragments and not to aggravate the situation.

Stage II, post-immobilization

The duration of wearing a circular plaster cast or other similar structures is determined individually and controlled by radiographic data. Usually you need to wear it for 2-3 months. After the cessation of immobilization, both the gymnastics itself and its main goals and objectives change:

• Restore the integrity of bones, ligaments and muscles;
• Restore muscle strength and performance;
• Improve mobility and flexibility of the wrist joint;
• Adapt the brush to your usual daily activities.

How to develop a limb in a cast

In the early recovery period, when the hand is still in a fixed position, exercises to develop the wrist joint after a fracture or other injury are gentle and affect only the fingers, elbow and shoulder joints. The duration of one workout should not exceed a quarter of an hour. Breathing exercises, ideomotor and isometric gymnastic elements are considered the most effective and safe.

Treatment with breathing techniques

Respiratory exercises can relieve pain and saturate damaged tissues with oxygen, which accelerates their regeneration. There are 2 different breathing techniques that need to be mastered during the treatment process:

1. Diaphragmatic breathing. Lie on your back, place one palm on your stomach, the other on your chest. As you inhale, only the palm on your stomach should move, the other one remains motionless. If it is difficult to place your hand in this way because of the splint, use another technique. In the same lying position, bend your legs towards your stomach, which should rise as you inhale, and retract as you exhale. After exhaling as much as possible, hold your breath for a few seconds.
2. Chest breathing. As in the first option, we place one hand on the chest, and the second on the abdominals. Only now, as you inhale, your hand should rise on your ribs. Another technique is performed lying on your stomach so that the load on the intercostal muscles is greater. As you inhale, the upper parts of the body should clearly rise, as if “pushing off” from the floor, and return back as you exhale.

Ideomotor exercises

This is a kind of mental training when gymnastic elements are worked out only mentally. The nerve impulses formed in this case stimulate the work of peripheral nerves and regulate vascular tone. You need to clearly imagine how the immobilized hand moves while performing specific tasks:

• Wrist flexion and extension;
• Rotation with brush;
• Clenching and unclenching fingers into a fist;
• Rotates the forearm in and out.

Note!

If during ideomotor exercises you feel involuntary trembling of individual muscle fibers, heat in your hand and increased heart rate, then you are doing the exercises correctly.

Muscle stimulation without movement

Isometric gymnastics after a fracture of the wrist joint is characterized by tension in the muscles of the hand and forearm, without active movements in the limb:

1. In a lying position, press on the support first with only your palm, and then with your entire forearm.
2. Now imagine that something heavy is placed on top of your hand, and try to lift it, overcoming the resistance.
3. Pretend that you want to squeeze a large, hard object with your palm.
4. Imitate rotating your forearm outward and inward through resistance.

Helpful advice!

When performing these tasks, make sure that the hand does not actually start to move, as this can cause complications.

Complex 1-1. Exercise therapy under a plaster cast for fractures.

Complex 1-2. Some exercises in plaster immobilizing bandages; exercises that prepare you for walking.

Complex 1-3. Exercise therapy for fractured ribs and bruises of the chest.

Complex 1-4. Exercises for all joints of the lower limb.

Complex 1-5. Exercises for the ankle and foot joints.

Complex 1-6. Exercises for the hip joint.

Before you start exercising, consult your doctor.

ONE OF THE BASIC PRINCIPLES OF PHYSICAL EDUCATION IS DO NO HARM

Complex 1-1. Therapeutic exercises under a plaster cast for fractures

If there is a fracture of the bones of a leg or arm, the doctor will apply a plaster cast. In this resting position of the limbs, conditions are created for the formation of bone callus and for the fusion of bone fragments. However, prolonged rest causes a number of undesirable changes. Under a plaster cast, the muscles gradually atrophy - muscle fibers change, and the strength of the bone itself decreases. At the same time, the nutrition of the joint is disrupted, the cartilage becomes less elastic, and mobility decreases.

Forced immobility of a person negatively affects the entire body and, in particular, such important systems as the respiratory, cardiovascular and digestive systems. Can these violations be prevented? Yes, with the help of therapeutic exercises - breathing exercises, intense movements of the healthy leg and arm, rhythmic contraction of the muscles under the plaster cast. Let's move on to the next point...

Therapeutic exercises for fractures under a plaster cast are performed, of course, only with the permission of the doctor. It promotes the resorption of edema resulting from injury, blood tumor - hematoma, which forms when blood vessels are damaged, as well as accelerating the process of callus formation. Uniform muscle contraction increases blood circulation in the injured limb, prevents the development of muscle atrophy and joint stiffness, and speeds up metabolism.

But such therapeutic exercises for fractures are not performed if the joints themselves are damaged - wrist, knee, hip, elbow, shoulder. Those who are allowed to exercise begin to do them after the pain at the fracture site has disappeared. As a rule, this occurs from the third to seventh day after applying a plaster cast.

With a broken leg. Initially, you can slowly bend and straighten your toes and try to flex and straighten your foot at the ankle joint. These and other movements are first performed with the healthy leg. The fingers are bent so that the ankle joint does not move. Similar movements are performed for 2-5 minutes. If there is a feeling of pain, then exercises are done in a smaller volume or stopped for several days. Following this, it is recommended to begin raising the straight leg. This exercise trains the very important quadriceps muscle. When it contracts, small compressive, piston movements are made in the knee joint, which improve its nutrition. If the plaster cast seems very heavy to the patient, you can lift your leg with outside help for the first 3-4 days, and then on your own. The leg is raised at a leisurely pace ten times. Two to three weeks after the fracture, the doctor may allow you to perform other exercises. One of them is tension in all leg muscles. Without making movements in the joints, the muscles of the foot, lower leg and thigh are tense. If a person masters this exercise with a healthy leg, it will be easier for him to reproduce the same with the sick leg. There is no need to worry if the cast feels tight, this feeling confirms good muscle tension. Subsequently, attempts are made to flex and extend the ankle and knee joints. During these exercises, the patient seems to be trying to break the plaster cast. But you should not be afraid that it will actually break; a bandage applied correctly will not be damaged. Thanks to this exercise, the legs and thighs contract and relax. After each exercise you need to rest for 3-5 minutes. It is recommended to do similar gymnastics regularly until the plaster is removed.

For a fracture of the radius near the wrist joint or a fracture of the bones of the forearm, therapeutic exercises under a plaster cast consist of the following exercises. Hand on the table, palm facing down. Clenching and unclenching fingers. After a certain time, you can try to bend and straighten your hand at the wrist joint, and then turn your palm up and down.

When a shoulder is fractured, it is recommended to tense the muscles as they do when trying to bend or straighten an arm. And then they tense their muscles, as if intending to raise or lower their arm.

If the ankles , the patient lies down on a hard bed or floor. Movement of the toes. Then try to bend and straighten the foot at the ankle joint.

When a hip is fractured, the movements are the same as when an ankle and lower leg are fractured. Then they begin to lift the pelvis with support on the elbows and a healthy leg bent at the knees. Exercises are usually performed 10-15 times at a slow pace, repeated 3-4 times a day.

Complex 1-2. Some exercises in plaster immobilizing bandages; exercises to prepare for walking

Exercise 1. IP - lying on your back (high plaster hip cast). Tension and relaxation of the quadriceps femoris (“patella play”). The pace is slow (8-20 times).

Exercise 2. IP - the same, holding the edges of the bed with your hands. Foot pressure on the instructor's hand, board or box. The pace is slow (8-10 times).

Exercise 3. IP - lying on your back (high cast). With the help of an instructor, turn onto your stomach and back. The pace is slow (2-3 times).

Exercise 4. IP - the same, arms are bent at the elbow joints, the healthy leg is bent at the knee joint with support on the foot. Raising the sore leg. The pace is slow (2-5 times).

Exercise 5. IP - lying on your back on the edge of the bed (high plaster hip cast). Leaning on your hands and lowering your sore leg over the edge of the bed, sit down. The pace is slow (5-6 times).

Exercise 6. IP - standing (high plaster hip cast), holding the headboard with one hand or hands on the belt. Bend the torso forward, placing the sore leg back on the toe and bending the healthy one. The pace is slow (3-4 times).

Exercise 7. IP - standing on a gymnastic bench or on the 2nd rail of a gymnastic wall on a healthy leg, the patient is freely lowered: a) rocking the affected leg (12-16 movements); b) copying the figure eight with the sore leg (4-6 times).

Exercise 8. IP - walking with the help of crutches (without leaning on the sore leg, stepping lightly on the sore leg, loading the sore leg). Options: walking with one crutch and a stick, with one crutch, with one stick.

Complex 1-3. Therapeutic exercises for fractured ribs and bruises of the chest

It is used 3-5 days after a rib fracture or chest bruise. Exercise 1. I.p. - sitting. Calm breathing (6-7 breaths). Inhale through the nose, exhale through the lips into the tube. Exercise 2. Coughing, pronounce the sound “heh”, “kheh” (fix the area of ​​​​the rib fracture). Exercise 3. Alternately raising the shoulders - inhale, lowering - exhale. (4-6 times). Exercise 4. I.p. – arms along the body. 1) palms up - inhale, slightly expand the chest; 2) starting position (6–8 times). Exercise 5. I.p. – feet shoulder-width apart. 1) toes to the sides - inhale; 2) starting position – exhale. (10-12 times). Exercise 6. Alternately bending the arms at the elbow joints. Exercise 7. I.p. - hand on hand. Raise your arms to shoulder level – inhale. Starting position – exhale. (4-6 times). Exercise 8. I.p. - hand on hand. Taking to the side – inhale. Lower down - exhale. (4-6 times). Exercise 9. I.p. - hands on knees. 1) put the left one on the right one; 2) remove; 3,4) the same with the other hand. Exercise 10.I.p. – hands to shoulders. Circular rotations in the shoulder joints with a small amplitude. Exercise 11.I.p. - hands on knees. Inhale. Slightly forward - exhale. Exercise 12. Diaphragmatic breathing. Exercise 13. Pulling the knees to the stomach - exhale. Exercise 14. Walking in place. 30-60 minutes. Exercise 15. Alternately put your hands behind your head - inhale, lower them - exhale. Exercise 16. Squeeze and unclench into a fist. (10-12 times). Exercise 17. Circular rotations in the wrist joints. Exercise 18. Raise your arm forward – inhale. (On the healthy half of the body). We lower it relaxed - exhale. Exercise 19. Calm chest breathing. (30-60 minutes).

Complex 1-4. Exercises for all joints of the lower limb

Complex 1. IP - lying on your back, the foot of the sore leg on a medicine ball. Rolling the ball towards the body and into the IP. The pace is slow (5-6 times). Complex 2. IP - lying on your back, holding the edges of the bed with your hands. "Bike". The pace is medium to fast (30-40 times). Complex 3. IP - standing facing the headboard with support from your hands: a) alternately raising your legs forward, bending them at the knee and hip joints. The tempo is slow (8-10 times); b) half squat. The tempo is slow (8-10 times); c) deep squat. The pace is slow (12-16 times). Complex 4. IP - standing, sore leg one step forward. Bend the affected leg at the knee and tilt the torso forward to a “lunge” position. The pace is slow (10-25 times). Complex 5. IP - standing facing the gymnastic wall. Wall climbing on toes with additional spring squats on the toe of the sore leg. The pace is slow (2-3 times). Complex 6. IP - hanging with your back to the gymnastic wall: a) alternate and simultaneous raising of the legs bent at the knee joints; b) alternate and simultaneous raising of straight legs. The pace is slow (6-8 times).

Complex 1-5. Exercises for the ankle and foot joints.

Exercise 1. IP - lying on your back or sitting with your legs slightly bent at the knee joints. Flexion and extension of the toes (actively passive). Flexion and extension of the foot of the healthy leg and the patient leg alternately and simultaneously. Circular movements in the ankle joints of the healthy leg and the diseased leg alternately and simultaneously. Rotation of the foot inward and outward. Extension of the foot with increasing range of motion using a band with a loop. The pace of exercise is slow, medium or varying (20-30 times). Exercise 2. IP - the same. The toes are placed one on top of the other. Flexion and extension of the foot with resistance provided by one leg while the other moves. Slow pace (15-20 times). Exercise 3. IP - sitting with legs slightly bent at the knee joints. Grasping small objects (balls, pencils, etc.) with your toes. Exercise 4. IP - sitting: a) the feet of both legs on a rocking chair. Active flexion and extension for the healthy and passive for the patient. The pace is slow and medium (60-80 times), b) the foot of the sore leg on a rocking chair. Active flexion and extension of the foot. The pace is slow and medium (60-80 times). Exercise 5. IP - standing, holding the bar of the gymnastic wall, or standing with your hands on your belt. Raising on the toes and lowering the entire foot Raising the toes and lowering the entire foot. The pace is slow (20-30 times). Exercise 6. IP - standing on the 2-3rd rail of the gymnastic wall, grip with your hands at chest level. Spring movements on the toes, try to lower the heel as low as possible. The pace is average (40-60 times).

Complex 1-6. Exercises for the hip joint. Exercise 1. IP - lying on your back, holding your hands on a cord tied to the headboard. Transition to a half-sitting and sitting position. The pace is slow (5-6 times). Exercise 2. IP - lying on your back or standing. Circular movements with a straight leg outward and inward. The pace is only slow (6-8 times). Exercise 3. IP - lying on your back, holding the edges of the bed with your hands: a) alternately raising straight legs; pace is slow (6-8 times); b) circular movements alternately with the right and left foot. The pace is slow (3-5 times). Exercise 4. IP - lying on your side, sore leg on top. Leg abduction. The pace is slow (4-8 times). Exercise 5. IP - standing sideways to the headboard, leaning on it with your hand: a) raising your leg forward and moving it back; b) abduction of the legs and arms to the side. The pace is only slow (8-10 times). Exercise 6. IP - standing, toes together. Lean forward, try to reach the floor with your fingertips or palms. The pace is medium to fast (12-16 times).

Post-immobilization period after displacement or fracture

Rehabilitation after a fracture of the radius does not end with its healing. Despite the restoration of normal bone structure, after a long forced position, the function of the limb suffers significantly. This is due to muscle atrophy, loss of the correct movement algorithm, and reduced excitability of nerve fibers.

Treatment complex after plaster removal

The first workouts should last no more than 15 minutes, then their duration and intensity can be gradually increased, using various sports equipment.

1. We clench our fingers into a fist and then relax.
2. In turn, we connect the pad of the thumb with all the others.
3. We connect the brushes into a lock and stretch them in different directions, then, on the contrary, we press them against each other.
4. Let's imitate playing the piano.
5. We bend and extend the arm at the wrist joint.
6. Perform circular movements with the brush.
7. We clap our hands in front of the chest and behind the back.
8. Place your palm edge-on on the table surface. We alternately place it on the table with the palm side and then the back side.
9. We roll a ball placed under the palm surface on the table.
10. We tie the laces.

Water gymnastics

An effective way of rehabilitation for a fracture of the wrist joint is physical therapy in the pool, since less gravity makes it easier to perform many movements:

1. We clench our hand immersed in water into a fist and rotate it in a circle.
2. We spread our fingers like a fan and connect them together.
3. We alternately perform dorsal and palmar flexion of the hand.
4. We make wave-like movements with our fingers.
5. Now we imitate wave-like movements with clasped hands.
6. Emerging from the water, we clap our hands.

There are several useful wrist fracture exercises that you can do in your own bath:

1. Throwing and rolling balls on the surface of the water.
2. Sponge squeezing.
3. Moving small objects along the bottom of the bathtub.

Occupational therapy at home

Occupational therapy allows the patient to restore fine motor skills after a fracture of the radius or injury to tendons and muscles, as well as regain the ability to perform professional and everyday activities:

• We sculpt figures from plasticine or clay;
• We draw with pencils or a brush;
• We play the piano;
• We make applications;
• We embroider or knit;
• We sew soft toys;
• We go through small mechanisms.

There can be many options, the main thing is that such an activity is enjoyable.

Attention!

Any restorative treatment can be carried out only against the background of moderate, tolerable pain. If the pain becomes acute and severe, then the activity should be stopped and the doctor informed.

Treatment of osteoarthritis of the hands

Treatment of the disease begins after it is confirmed. The diagnosis of “osteoarthrosis of the hands” is made on the basis of characteristic clinical manifestations. In case of diagnostic doubts or an atypical course of the disease, an X-ray examination of the patient can be performed. During the diagnosis, it is possible to identify certain changes in the joint - osteophytes and narrowing of the joint space.

Treatment of arthrosis is multifaceted and depends largely on the severity of the disease. As a rule, therapy is aimed at maintaining physical fitness for as long as possible and combating the pain that accompanies the disease. Today, there are three therapeutic tactics: therapeutic exercises (exercises), physiotherapy and prescription of medications.

Recovery period

This is the final rehabilitation stage, where the focus is on increasing the range of motion in the joint, building muscle mass and restoring muscle strength, and mastering fine movements. During this period, the following loads on the limb are possible:

• Exercises with a skipping rope and a gymnastic stick;
• Hand training using a regular or gyroscopic expander;
• Weighted exercises, the use of dumbbells weighing 2-4 kg is allowed;
• Limb stretching;
• Honing everyday skills - tying shoelaces, opening locks and hinges, stirring food, etc.

Diagnosis of arthritis of the wrist joint

The main manifestation is joint pain and swelling. There is often slight redness in the joint area, and sometimes morning stiffness. The clinical picture can be quite varied, depending on the cause of the arthritis. X-ray examination may show no changes. The tests showed an increase in ESR and C-reactive protein (this is typical for all arthritis). In arthritis caused by a certain disease, other indicators may change (increased blood uric acid in gout, increased rheumatoid factor in rheumatoid arthritis, etc.).

Massage after injury

Massage improves blood and lymph circulation in the area of ​​damage, while activating metabolism, stimulating nerve endings and accelerating tissue regeneration. The procedure is usually prescribed in the first days of treatment before exercise therapy to prepare the muscles for stress.

Massage and self-massage includes the following techniques:

1. Stroking. Performed with light movements, without pressure, from the periphery to the center.
2. Trituration. This is a more active effect, in which the upper layers of the skin are shifted in different directions.
3. Kneading. They mainly knead the muscles of the palm, as well as the area around the elbow and shoulder joints.
4. Vibration. The masseur imitates vibration movements with fingers collected in a pinch.
5. Squeezing. Intense pressure on the palmar surface of the hand. Done with caution.

Therapeutic exercises are important not only for rehabilitation after injury, but also for the wrist joint affected by arthrosis. Rehabilitation treatment, if necessary, should combine surgical correction, immobilization, medication support, exercise therapy, massage and physiotherapy. Only with an integrated approach will it be possible to achieve the desired result.