How to massage a bedridden patient: features, techniques, contraindications

I admire pensioners who lead an active lifestyle: running, skiing, Nordic walking, trips to the country, swimming - all this gives the body a load appropriate for its age. By maintaining a cheerful spirit and joint mobility, older people are investing in their health, reducing the risk of developing various diseases. But sometimes neglect of simple rules leads to serious consequences and restriction of their activities for a long time.

Today we will talk about hip fracture, the risk of which is highest in people 60-65 years of age and older. The femoral neck is the narrowest part connecting the head and body of the bone in the hip joint. The hip joint, in turn, bears the main load when walking. Keeping all joints healthy is the key to a long and eventful life.

First aid for a hip fracture

There are several symptoms indicating the presence of this type of fracture:

• dysfunction of the leg - a person cannot stand or walk,
• pain in the groin area,
• the foot is unnaturally turned outward,
• shortening the leg by 3-4 cm,
• hematoma (bruise) in the area of ​​injury,
• pain when pressing or tapping the heel.

The presence of at least one symptom after the incident may indicate damage to the hip joint.

Contraindications

• Hypertension.
• Open fractures.
• Recently undergone surgery.
• Infectious and chronic diseases in the acute stage.
• The presence of malignant neoplasms.
• Taking certain types of medications.
• Some vascular diseases: atherosclerosis, thrombophlebitis, aneurysm, etc.
• Damage to the skin in the treated area: open wounds, fresh burns, bleeding cuts.

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Types of medical care after X-ray of the femoral neck

There are conservative and surgical methods of treating the femoral neck.

The conservative method of treating the femoral neck is most often used for people who have contraindications to surgery (previous stroke/heart attack). This method consists of immobilizing (ensuring immobility) the patient using skeletal traction and further restoring motor activity with the help of crutches.

Surgical treatment of the femoral neck is almost always carried out if there are no indications for a conservative method. It is divided into two large types: osteosynthesis (connection of fragments and parts using metal structures - knitting needles and screws) and hip replacement (replacement of the head of the hip bone and acetabulum with prostheses).

Duration of rehabilitation course and precautions

The rehabilitation course, regardless of the complexity of the injury, takes 1-1.5 months. If the patient at this time followed all the doctor’s recommendations, then the finger can be developed to the state before the injury.

During this period, precautions must be taken, these include:

• avoid sudden movements of the injured arm or leg;
• gradually increase the load on the broken limb;
• avoid overwork and overstrain of the affected area of ​​the hand or foot;
• repeat gymnastics no more than 4 times a day;
• Do the exercises regularly for several weeks.

During classes, you need to follow the recommendations of the exercise therapy instructor.

It is important to complete the rehabilitation course, even if the patient begins to feel better.

Important aspects of rehabilitation after a hip fracture

• Massage - preservation, restoration of motor activity, improvement of blood supply, prevention of bedsores.

• Breathing exercises - preventing pneumonia during prolonged recovery in one position

• A complete, sufficiently high-calorie diet with increased calcium content (vegetables, fruits, dairy products, beans, grains)

• A set of exercises selected individually for each patient in accordance with the stage of recovery

• Classes with a psychologist to prevent depression and improve well-being

• Hygiene - regular change of bed linen, assistance with the bedpan, assistance in brushing teeth and eating, monitoring the correct position of the leg in traction.

Recovery period

Rehabilitation of a broken leg begins immediately after removing the plaster cast and includes:

• Exercise therapy classes according to an individually developed plan. Exercises are performed, the load gradually increases, and the joints are developed.
• Diet therapy. Nutrition after a fracture must be correct: the patient needs more vitamins and microelements. You should consume dairy products, meat and fish (contain calcium and phosphorus). Include vitamins B, C, D (cereals, fruits and vegetables, fish oil) in your diet.
• Massage.

Massage after a hip fracture

The first and very important element of recovery after a hip fracture is massage. It is prescribed by the attending physician and carried out by a qualified specialist. The timing of the start of the massage is determined individually, but as soon as possible after the operation. This is due to strict bed rest, which leads to slow blood flow and a lack of oxygen in the bone tissue.

The massage is carried out in courses of 10-12 days with a break of one month.

The goals of massage are:

• improving blood circulation and providing oxygen to tissues,
• prevention of muscle atrophy,
• strengthening the muscular frame,
• bedsore prevention,
• restoration of motor activity of joints,
• relieving pain and swelling, improving lymph flow.
• prevention of pneumonia (in combination with breathing exercises).

Contraindications to massage are: varicose veins, acute inflammatory processes, purulent processes on the skin, tuberculosis, feverish conditions, undiagnosed pain.

Basic principles of massage

The massage begins with working out the muscles of the back and lumbar region. The specialist will have to adapt to the position of the patient in which he is recommended to be. Let's say the patient is lying on his side, healthy limbs on a hard surface. The leg to be restored and the healthy arm are on two solid supports parallel to the surface.

The massage continues with treatment of the healthy leg, thigh and lower leg. All techniques are allowed except deep vibration, since shaking can cause displacement of healing tissues and bones.

You should also pay attention to massage of the chest and abdomen. During bed rest, many processes slow down, including digestion and breathing. Massage helps protect against stagnation and relieve discomfort associated with prolonged stay in one position.

Do not massage lymph nodes. Movements are carried out along the lymphatic vessels. The duration of massaging one area should not exceed 3-10 minutes. Pain during massage is unacceptable.

Massage procedure

With skeletal traction, the massage begins with the healthy leg, which has a reflex effect on the sore leg. In the first days, the massage is as short and light as possible. The duration of treatment for a healthy leg starts from fifteen minutes and is subsequently reduced to two minutes, and for a patient, on the contrary, it starts from five minutes and reaches ten to twenty minutes.

Techniques for treating a sore leg are stroking and rubbing. The massage is carried out from the lower part of the limb to the upper. The leg should be straight and motionless.

Subsequently, the massage therapist’s movements become more persistent. The massage is carried out until the motor functions of the joints are completely restored.

When the period of immobilization is completed, patting, chopping and kneading techniques can be used. Particular attention should be paid to the knees, since the principle of motionless recovery significantly affects their basic functions.

If the specific nature of the injury requires the application of a plaster cast, then massage is possible through holes cut in the plaster. In this case, the part of the leg (foot and lower leg) not covered with gypsum solution must be crushed.

Separately, it is worth highlighting massage for the prevention of bedsores. First, the patient’s body is examined for purulent processes on the skin; if they are present, tissue stimulation is contraindicated. Then they carefully insert their hand under the patient’s body in places where bedsores usually form and perform stroking and rubbing.

Foot massage under a cast

It is important to begin massaging the injured limb as early as possible. A plaster cast is applied to the fracture site, so the procedure must be carried out under it as well. For this purpose, the doctor leaves special “windows” when bandaging. Through them the patient performs self-massage:

• Point kneading and finger pressure.
• Using massage sticks.
• Tapping on the cast - vibration vibrations are transmitted through the bandage to the limb.

This supports blood circulation and restores sensitivity.

All manipulations under a cast can be carried out no earlier than 2 weeks after the injury.

Self-massage for hip fracture

When recovery is close, with the permission of the doctor, you can begin self-massage of the limbs. After consulting with him, you can watch several videos with a clear example of the correct manipulations. It is advisable to follow all four basic techniques in the following sequence: stroking, rubbing, kneading, vibration.

Be careful when choosing a massage specialist. This should be a competent, attentive and tactful person to whom you can entrust your recovery.

Help and support from loved ones will also have a beneficial effect on the speed of rehabilitation.

During the period of immobilization, you can alternate watching comedies with reading educational books, listening to humorous radio with applied creativity, in order to continue to feel alive, active and needed in this world!

What is a fracture called?

A finger fracture is the partial or complete destruction of the bone shell resulting from pressure on the bone. In this case, the load turns out to be greater than the degree of density of the bone itself. Damage occurs due to injury or pathology of the musculoskeletal system.

According to the World Health Organization, finger fractures account for more than 5% of all bone fractures. Much attention is paid to the rehabilitation of broken fingers, especially the big fingers and toes.

It is these parts that provide a full range of human movements for self-service and work.

Such fractures are the most unpleasant; they can impair the functions of the limbs.

Other fingers and toes are less likely to break, but plaster is often applied to healthy fingers. The period of stay in the cast is a month, during which time the bones grow together.

The period of stay in a cast is at least 4 weeks, regardless of which finger is broken. After removing the plaster, you need to begin the recovery process - working out the finger after the fracture.

Symptoms

A toe fracture can be recognized by the following signs:

• pain;
• swelling and deformation of the damaged phalanx;
• hemorrhage under the skin or nail plate;
• local increase in temperature;
• forced position of the finger;
• motor dysfunction;
• tapping on the phalanx causes acute pain.

Some people are hesitant to seek medical help, considering a finger injury to be a minor injury. Meanwhile, the lack of treatment measures will lead to complications. This:

• formation of a false joint;
• osteomyelitis;
• cartilaginous growths;
• finger deformation;
• ankylosis of the metatarsophalangeal joint.

Attention
! Damage to the thumb occurs more often than others. The reason for this is the presence of two bony phalanges instead of three, as well as the fact that when walking it is subject to the greatest stress and protrudes forward.

Injury to other toes occurs with less pronounced clinical signs. For example, if your little finger is broken, it will not be immediately noticeable. Sometimes a person seeks help the next day, when the pain intensifies.

After a fracture of the big toe, swelling and blueness appear, which involve adjacent toes and spread to the entire foot.

General recommendations

After removing the splint or splint, for the first time you should not put much weight on the sore leg, as this can lead to a new injury to the fragile foot. However, complete inaction is also not recommended. In the early recovery period, you will have to move with the support of a stick.

Make sure you have comfortable shoes without heels in advance. It should be worn not only at home, but also on the street. High heels lead to excessive stress on the toes, which can lead to the formation of large calluses and curvature of the toes.

Special orthopedic insoles are useful: they will give the foot a physiological position and improve blood circulation.

Basic safety measures that should be observed when carrying heavy objects, skating and roller skating will help you avoid a fracture.

Salt baths

A moderate concentration of saline solution will help cure a foot injury. To prepare it, dissolve 1 tbsp in a liter of hot water. a spoonful of salt, it is better to take sea salt for these purposes. It has an anti-inflammatory effect and has a beneficial effect on bone tissue.

The optimal water temperature is 37-38 degrees . A warm bath will warm the sore spot well and speed up recovery. After it, a positive effect occurs - the muscles relax, the sensitivity of the nerve endings decreases.

Take the salt bath for 10-15 minutes , after which you do not need to wash your feet. Pat them dry with a dry cloth and let your feet rest. To enhance the effect, decoctions of medicinal plants and fir branches are added to the water.

During the procedure, the limb must be freely located in the basin so that the person has the opportunity to move it.

Attention

! Salt baths are not used for open wounds, diabetes, hypertension and a tendency to blood clots.

Methods

The procedure will only take 20 minutes to complete. There are certain methods of massage after fractures of the lower extremities:

1. Massage of a healthy leg: knead with stroking and strokes, rubbing and vibration, as well as shaking.
2. Massage of a broken limb: start by warming up the area, slightly above the injury itself, stroking, rubbing and kneading. In addition, the gluteal muscles, hip area, ischial tuberosity are massaged, and the pelvis is shaken.
3. Massage the damaged area: done carefully, stroking and rubbing the soft tissue. The muscles are warmed up in the longitudinal and transverse directions. If malnutrition is observed, then it is necessary to stimulate the muscles on the broken leg.
4. If the joints are difficult to move, they are stroked and rubbed during the massage. The capsular-ligamentous apparatus is massaged with fingertips. The fracture site must be stroked, rubbed, light vibration movements performed, stretched and shifted soft tissues that come into contact with the callus.
5. If regeneration in the fracture area occurs slowly, then the pads of the fingers are used to stroke these areas in a circular manner. Perform dotted shading and vibration, tapping and pressing.

All this will help injured bones recover in a short time. It is important to remember that you should act carefully so as not to injure your leg even more.