Bone tissue can be partially or completely destroyed due to any injury. In this case, the person feels severe pain, and his motor activity decreases or becomes completely impossible. The possibility of disability should not be ruled out. A hip fracture is an injury that poses the greatest danger to a person, especially when it comes to older people. In order to speed up the recovery process, it is necessary to urgently contact qualified medical specialists. Competent organization of rehabilitation after a hip fracture is also important.
Introduction
The formation of this disease can be caused by exposure to direct and indirect force. For example, an injury can be either caused by a blow from outside or received by falling on a given organ. Hence, the types of fractures are distinguished - transverse, oblique, comminuted.
The duration and method of treatment with the recovery process directly depend on the nature of the injury. The approximate treatment time is 5 to 10 weeks.
For any type of fracture, the patient is prescribed complex therapy, which includes physical therapy, since health-improving gymnastics has a positive effect on the restoration and fusion of the limbs.
It improves blood supply and, as a result, bone tissue receives the necessary nutrients. Exercise therapy for the forearm allows you to restore damaged bones, restore mobility and tone to weakened muscle tissue.
Features of recovery after a hip fracture in old age
Rehabilitation after a hip fracture in old age is characterized by a longer period. In order to help a person of this age category recover from PB, you will need qualified assistance from a professional and participation from relatives and close people.
The main reason why broken bones heal more slowly is a lack of blood supply to the tissues and a slow metabolism. Complete regeneration of bone tissue may take 8-12 months.
At a fracture
When treating an illness, the patient is given a plaster cast from the shoulder to the base of the lower limb. However, throughout the treatment it is necessary to develop the fingers, and for this it is necessary to perform a number of exercises.
You can start exercise therapy after a forearm fracture on the second day after the splint is applied. Classes are held daily - rapid recovery will depend on this. The intensity of performing one exercise is, on average, 5 times.
The patient should perform the entire set of exercises without pain. The intensity of the exercise depends on the form of the injury. When performing gymnastics, you should follow all doctor’s recommendations. It is also important to consider that with some injuries it is impossible to perform recreational gymnastics. In this case, it is necessary to develop the muscles of the lower limb.
With regular training and complex therapy, complete recovery is possible within 1.5-3 months. It is important that a full recovery is impossible without exercise therapy after a forearm fracture. Unfortunately, there are no drugs that can regenerate bones and tissues.
The main objectives of physical therapy are:
- activate metabolic processes in soft tissues;
- increase muscle tone;
- improve blood circulation;
- restore fine motor skills of the lower limb;
- speed up the recovery process.
Exercise therapy for a forearm fracture involves a complex of treatment procedures. Experts have released a special video to illustrate the manipulations being carried out. Treatment gives maximum results when physical education is carried out in combination with basic rehabilitation methods.
Provision : a small degree of compression (no more than 1/3 of the height of the vertebral body), in the absence of compression of the contents of the spinal canal.
The method was developed by V.V. Gorinevskaya and E.F. Dreving is based on the fact that a compression wedge-shaped fracture of the body of the lumbar or thoracic spine is impacted, and this in itself, as a rule, favors rapid healing of the fracture and eliminates the possibility of secondary displacement. The damaged vertebra is not straightened. The spinal deformity is subsequently corrected due to compensatory curvature of adjacent areas of the spine.
The method of rehabilitation treatment includes four periods.
First period (duration 7-10 days). Restorative measures are aimed at raising the patient’s tone, improving the functioning of the cardiovascular system and respiratory organs, and preventing a decrease in the strength and endurance of the muscles of the trunk and limbs. PH classes include breathing (static and dynamic) and general developmental exercises for small and medium muscle groups and joints of the limbs.
Exercises of the first period
Raising your arms without lifting them out of bed.
- Dorsal and plantar flexion at the ankle joints.
- Bending the arms at the elbow joints.
- Alternately bending the legs at the knee and hip joints, sliding the foot along the plane of the bed.
Retracting the elbows from the “hands on chest” position.
- Rotation of the leg along the longitudinal axis (alternately and simultaneously).
- Rotation of the arms in the shoulder joints.
- Hands on the chest, abduction of the arm while turning the head.
- Clenching and unclenching fingers.
- Active movements in the wrist joints.
Provided that the patient can raise his straight leg to an angle of 450 without experiencing discomfort or pain in the damaged part of the spine, he can be transferred to the second recovery period of treatment.
Second period (duration until the end of the 1st month). Restorative measures are aimed at normalizing the activity of internal organs, improving blood circulation in the damaged area in order to stimulate regeneration processes, strengthening the muscles of the trunk, shoulder and pelvic girdle and preparing the patient’s body for further expansion of the motor regime.
The overall load increases due to the selection of exercises, increasing the number of their repetitions and the duration of the session (up to 20 minutes). However, the features of this period are as follows: 2.5 weeks after the injury, the patient is allowed to turn on his stomach. In this position, in order to unload the anterior sections of the damaged vertebral bodies, a cotton-gauze roll is placed under the patient's chest, thereby achieving some hyperextension of the torso.
It is also recommended to perform extension exercises. All movements of this exercise are facilitated by the inclined position of the bed, since the weight of the lifted torso is partially transferred to the part of the body located on the bed and which serves as a support. Extension exercises should be combined with isometric positioning of the back and abdominal muscles, followed by relaxation.
Extension exercises
Lying on your back:
- Bend in the thoracic spine with support on the elbows.
- Bend in the thoracic spine with support on the elbows and feet.
Lying on your stomach:
- Raising the head and shoulders with support on the forearms.
- Raising the head and shoulders without relying on the arms.
- Slow bending in the thoracic spine, followed by maintaining this position for 5-7 seconds.
- Deflection supported by straight arms.
- Bend with arms lifted off the bed.
- Raising the head and shoulders with alternating movement of straight legs.
- Active leg movements are performed only alternately and with a separation from the bed.
Physical exercises are performed strictly while lying on your back and stomach. In these positions, massage procedures are performed to strengthen the back and abdominal muscles.
In therapeutic exercises, special physical exercises should alternate with general developmental, breathing and exercises aimed at relaxing muscles.
Exercises of the second period (lying on your back)
Arms to the sides, up, down and forward.
- Bending your arms with slight muscle tension.
- Movement of straightened arms with simultaneous rotation along the axis.
- Abduction of the arm while turning the head.
Arms to the sides - circular movements in the shoulder joints.
- Circular movements with bent arms.
- Alternately bending the legs at the knee and hip joints.
- Movement simulating cycling
- Raising a bent leg. Then straighten her and lower her onto the bed.
- Raising and abducting one leg from a bent position.
- Alternating straight leg raises.
- Alternating straight leg abduction.
The patient is not recommended to lie on his side! Provided that the patient can raise straight legs to an angle of 450 without discomfort, he can be transferred to the third period of rehabilitation treatment.
Third period (until 45-60 days after injury). Treatment is aimed at further strengthening the muscles of the trunk, pelvic girdle and limbs, improving coordination and mobility of the spine.
Features of the third period
Overall physical activity increases due to an increase in the duration and density of exercise, the inclusion of exercises with resistance and weights, and isometric muscle tension with greater exposure.
To transition to axial load on the spine, initial positions of standing on all fours and kneeling are introduced into classes.
In new starting positions (standing on all fours and kneeling), patients perform exercises for the trunk muscles: slight bends to the sides, backwards, coordination of movements, movements on the knees and on all fours forward and backward, to the side.
And active leg movements are performed not only alternately, but also simultaneously with lifting off the bed. Exercises are carried out on a horizontally lowered bed. When performing exercises in the initial position lying on the stomach, correction is carried out by position.
Bends forward are contraindicated for the patient !
Third period exercises
Starting position: standing on all fours.
- Arching of the back.
- Movement of the hand forward.
- Movement of the hand back, forward, up.
- Taking the leg back, raising the straight leg.
Starting position: kneeling
- arms to the sides - turn the body.
- bending the torso to the sides.
Starting position lying on your stomach.
- Rotation of straight arms in the shoulder joints with raised shoulders and head.
- Tilts the body to the right and left.
- With various hand movements, turn the body to the right and left.
- Raising both legs.
- Extension of both legs.
- Alternately raising straight legs, imitation of walking.
- Abduction and adduction of straight legs, crossing.
- Leg movement simulating cycling.
- Extension exercise (half bridge).
- Hyperextension in the thoracic region with support on the heels and arms bent at the elbow joints (full bridge).
- Bending in the thoracic region with support on one leg.
- The starting position is lying on your stomach - rotation of straight arms in the shoulder joints with raised shoulders and head.
- Bending of the torso while supporting the forearm and hands.
- Bending in the thoracic region when moving straight arms to the sides and back.
- Alternating straight leg abduction
- Raising straight legs.
- Swallow type exercise.
continues , aimed at strengthening the muscles of the torso and lower extremities.
If the result of functional tests is positive, the patient can be transferred to the fourth period of rehabilitation treatment.
The fourth period (from the moment the patient is transferred to a vertical position until he is discharged from the hospital). Restorative treatment is aimed at further strengthening the muscles of the trunk and limbs, increasing the mobility of the spine, restoring correct posture and walking skills.
of the treatment period is the transition to full axial load on the spine. The patient is usually allowed to get up 45-60 days after the injury .
When getting out of bed, the patient should not sit down!
Fourth Period Exercises
While lying on his stomach, he moves to the edge of the bed, lowers the leg that lies on the edge and places it on the floor; leaning on his hands, straightens and lowers his other leg. As you adapt to the vertical position, your classes include physical exercises performed in an i.p. standing (initially with support on the headboard): bending the torso back, alternating abduction and adduction of the legs, half-squats with a straight back, heel-to-toe rolls, active movements in the ankle joint, etc. The classes include exercises that help restore motor skills and strengthen correct posture and restoration of walking pattern. Exercises in a therapeutic pool are advisable.
At the end of 3 months. after an injury, the patient should walk for 1.5-2 hours without experiencing discomfort or pain in the area of injury. If they are absent, he is allowed to sit on a chair. A cotton-gauze roll is placed under the lower back.
By the 10-12th month after the injury, it is necessary to constantly monitor the patient’s posture, paying attention to the fact that lordosis is maintained in the area of injury.
Earlier load on the anterior parts of the damaged vertebral bodies in the form of forward bending and rotational movements can lead to further deformation of the damaged area and the occurrence of neurological complications.
First stage of treatment
Therapeutic gymnastics is performed the next day after the injury, but in some cases, exercises begin after the pain has subsided. A set of exercises is done daily 8-10 times a day.
The patient must perform all types of exercises on the fingers and on the shoulder joint itself. However, doctors strictly prohibit performing those types of exercises that cause pain, as this can negatively affect the fusion of the limbs. As basic exercises you can use:
- flexion and extension of all limbs up to the palm;
- bend each finger separately.
Types of recovery after hip fracture after surgery
The recovery period after a hip fracture (HF) is very important. The patient’s further motor ability depends on it. The longest rehabilitation period is typical for people in the older age group. In some cases it can last 12 months. There are two types of rehabilitation, each of which is described below.
Early rehabilitation
Correctly organized and carried out rehabilitation after a hip fracture after surgery will allow you to avoid complications. It should be comprehensive and carried out starting from the very first days after the operation.
Early rehabilitation means that for several weeks immediately after surgery the patient:
- Provides loads on the lungs for ventilation. To do this, you need to take deep breaths and exhales two to three times a day, while lying on your back.
- Takes medications prescribed by the attending physician to relieve pain, prevent muscle spasms and accelerate the circulation of blood flow in the injured limb.
- Prevents bedsores by changing your position in bed, moderate tension of the body muscles and raising the sacrum. These movements should be performed exclusively in accordance with the doctor’s recommendations.
Late rehabilitation
This type of complex of rehabilitation measures takes place after the plaster is removed and the patient is allowed moderate loads on the injured limb. This period is characterized by the formation of a callus, which is not yet fully strengthened. This is explained by the fact that restorative measures are more aimed at maintaining subsequent regeneration and returning muscle functionality.
Second stage of treatment
It is started after the plaster is removed from the diseased limb. A set of gymnastic exercises is carried out about three times a day. It is mandatory to conduct classes twice in water at a temperature of 36-38 degrees. Also, all classes are accompanied by a special massage.
In addition, the attending doctor can prescribe physiotherapeutic procedures in the clinic. For a more successful recovery, procedures can also be performed at home. For example, you can do paraffin treatments using clay. They should be performed once every 3 days .
Doctors do not recommend that patients with fractures visit the bathhouse, since the water temperature should not exceed 38 degrees . Extremely high temperatures can cause swelling in the soft tissues. You should visit such establishments at least 4 months after complete recovery.
General exercises
In the second period, classes are conducted while sitting at a table. The gymnastic complex consists of five main types of exercises:
- you need to place your hand and shoulder joint on a hard surface;
- you need to perform the exercise with the help of additional equipment, it involves two hands;
- it is necessary to place the affected limb on a hard surface in a bent position, with the elbow bent at 30 degrees;
- place the limb on the table so that the hand hangs down;
- The lower limb should rest on the healthy forearm.
This gymnastic complex is performed for two months and, as recovery occurs, the load and intensity of the exercises increases.
Warm-up
The patient should not forget that any exercise begins with warm-up exercises. This is necessary in order to warm up the muscle tissue, normalize tone and prepare it for more complex exercises.
As a warm-up, you can rub all the phalanges of your fingers, and also use a special massage ball. They can be used to walk over the entire surface of the sore arm. In addition, at the pharmacy you can purchase a special ring for exercise therapy.
Attention
! Physical education is aimed at minimizing discomfort from shoulder and forearm injuries and ensuring accelerated remission.