Exercise therapy (physical therapy) according to Gorinevskaya, Dreving: exercises, gymnastics, rehabilitation, adaptation, loads on the spine

A compression fracture is a “compression” of the vertebral body from top to bottom. Structures at the thoracic and lumbar levels are more susceptible to such injuries. The functional therapeutic method for compression fractures according to V.V. Gorinevskaya and E.F. Dreving, including spinal traction and exercise therapy, was developed back in the 30s of the last century and is successfully used to this day. This technique is indicated for a low degree of compression - no more than a third of the height of the vertebra.

The principle of therapeutic exercises

After a fracture, the patient must observe strict bed rest for 45-60 days. In addition, there are serious restrictions on physical activity. Let's take a closer look at the essence of the functional method and the basic principles of exercise therapy according to Dreving and Gorinevskaya:

• The patient is on a hard bed in an inclined position with the upper end raised (approximately 30-40 cm);
• The shoulders are fixed to the bed using soft straps passing through the armpits;
• Soft cushions are placed under the lower back and neck, which have physiological deflections;
• The entire rehabilitation period until the patient adapts to a vertical position is divided into 3 stages, for each of which its own elements of physical therapy and permitted loads on the spine have been developed;
• In the 1st period, axial physical load on the vertebrae is absolutely prohibited, in the 2nd period of the functional recovery method, the body prepares for the transition to axial loads, and in the 3rd period, the patient is allowed a full load on the spinal column along the axis, although it is carried out gradually, not the first time.

Peculiarities!

The functional technique does not involve wearing a corset or any splints. During physical therapy exercises, the patient forms his own muscle corset.

1 period

The main goals of the first period of the functional rehabilitation method (1-14 days from injury):

• General tonic effect;
• Stabilization of the function of the cardiovascular and bronchopulmonary systems;
• Activation of intestinal function;
• Preservation of muscle strength, prevention of atrophic changes;
• Stimulation of blood flow in the body in general and in the affected area in particular.

At this stage, the patient is strictly in a supine position, on his back. The training is repeated twice or three times a day for 10 minutes, and the number of approaches is not strictly regulated. It depends on the patient’s well-being and his body’s resistance to physical activity.

Examples of therapeutic gymnastics exercises according to Gorinevskaya-Dreving for this period:

1. Place one palm on the front wall of the abdomen, the other on the chest. Inhale using the diaphragm. At the same time, the hand lying on the stomach should clearly rise. As you exhale, it lowers.
2. Bend your feet towards and away from you.
3. Rotate the ankle joints in different directions.
4. Forcefully clench your fingers into fists and relax them.
5. Carry out rotational movements in the wrist joints.
6. Bend and straighten your arms at the elbows.
7. Spread your arms straight to the sides and raise them to the ceiling, clapping your hands.
8. Perform circular movements in the shoulder joints.
9. Alternately move your straight legs to the sides and return them to the middle, sliding along the surface of the bed.
10. Alternately pull your legs closer to the pelvis, without lifting your feet from the bed.
11. Bend your legs at the knees, raise your pelvis above the bed, resting your feet and shoulder blades on the bed.
12. If the thoracic region is damaged, you need to strain the muscles of the lower back, as if pressing the spine into the bed. If the lumbar vertebra is broken, then the pressure is exerted by the thoracic region.

Important!

Pain after a compression fracture can be quite intense, so painkillers are usually prescribed for the first time. However, if training provokes a significant increase in pain, then you should stop and consult a specialist.

2nd period

Tasks of the second period (15-30 days):

• Acceleration of healing processes;
• Prevention of the development of complications caused by prolonged stay in bed (thrombosis, congestive pneumonia);
• Normalization of the work of all internal organs;
• The beginning of the formation of a corset from muscles.

The duration of one lesson increases to 20 minutes. During this period, movements can be made not only on your back, but also by turning onto your stomach.

Note!

It is important to learn how to roll over correctly. This should be done with a straight back, grasping the headboard of the bed with the hand that is on top when turning. You should not linger in a position lying on your side.

At this stage, the following exercises are recommended:

1. All tasks from the previous period.
2. Bend your thoracic spine, leaning on your shoulder blades and forearms.
3. Raise your straightened legs up, one at a time, perpendicular to the bed.
4. Imitate riding a bicycle, as if pressing the pedals.
5. Perform the classic “Scissors” exercise, crossing your legs raised above the bed in different planes.
6. Hold your legs suspended at an angle of 45 degrees for 5-7 seconds.
7. Turn over face down. Slightly arch your spine upward, resting on your forearms.
8. Then bend in the opposite direction, leaning first on your forearms and then on your hands.
9. Raise your head and upper chest above the bed, holding them for 5-7 seconds, without support.
10. Perform smooth swings back with straight legs, one at a time.
11. Simultaneously raise your right arm and left leg upward, and vice versa.
12. Simultaneously raise and hold the shoulder girdle, upper and lower limbs for 7 seconds.

Indications and contraindications

A set of exercises after a compression fracture of the spine is prescribed to achieve the following goals:

• Strengthening the soft tissues surrounding the spine. The condition of the spine depends on how strong the paravertebral muscles are. If they are strong, this helps remove most of the stress from the painful area.
• Restoring natural blood flow. Therapeutic exercises for a compression fracture of the spine help speed up metabolic processes and the delivery of nutrients to the damaged area.
• Restoration of motor activity of the spine. If damaged bone structures remain immobile for a long time, it will be very difficult to develop them later. Therefore, light exercises should be started immediately after the pronounced clinical picture has resolved.
• Reducing the risk of complications. Among them are swelling, subcutaneous hemorrhage, atrophic and necrotic changes, and a congestive inflammatory process in the lungs.

Exercise and massage for compression fractures of the spine in children and adults are carried out only after the patient’s well-being has normalized. Contraindications to physical activity must also be taken into account:

• persistent pain symptoms, which will only intensify during exercises and massage;
• increased general temperature;
• surges in blood pressure - exercise therapy contributes to a deterioration in the general condition;
• an increase in neurological symptoms, including a decrease in the sensitivity of the skin, motor activity, etc.;
• disruption of the functioning of internal organs, in particular, dynamic intestinal paresis.

Physical education after a compression fracture is prescribed by a doctor, based on the degree of pathological changes in the spine.

General provisions

If mild compression and a mild fracture are observed, conservative treatment is carried out with mandatory physical therapy. One way to normalize the condition:

• the patient needs to lie on a hard surface;
• raise your head slightly - you can place a sandbag or other hard object;
• place rollers of gauze and cotton wool under the vertebral curves;
• perform longitudinal traction of the spine through the armpits.

This traction helps to stretch the anterior longitudinal ligament and increase the space between the vertebrae, as well as reduce compression of the nerve branches.

Physical exercises after a fracture and surgery are divided into 4 stages:

1. first 7-10 days;
2. 10-30 days;
3. 31-60 days;
4. after discharge from the hospital.

Each stage is aimed at implementing certain tasks.

First stage

Rehabilitation allows you to achieve the following goals:

• improve the functioning of the cardiovascular system, respiratory system, and digestive system;
• prevent a decrease in the strength of the muscle structures surrounding the damaged spine;
• reduce the risk of stagnant processes.

During the recovery period, breathing exercises (static and dynamic types) and developmental exercises aimed at small and medium muscles and joints are performed.

Any movement should be performed smoothly and without jerking. You cannot do straight leg lifts, which causes pain due to tension in the back muscles. Raising the pelvis with support on the shoulder blades and feet is useful.

The duration of an individual lesson is up to 15 minutes. The starting position is exclusively lying on your back.

Second phase

Therapeutic exercise helps improve the functioning of internal organs, blood circulation in the injured area of ​​the spine, and tissue regeneration.
In addition, the muscle corset is strengthened. The duration of the exercise is 20-25 minutes with a systematic increase in the strength of the exercises. After 2-3 weeks, you can practice in a supine position on your stomach, placing a cotton-gauze roll under your stomach. This allows you to unload the injured vertebral bodies in the anterior section.

Static and dynamic exercises are prescribed for the upper limbs, dorsal and abdominal muscles. It is useful to perform extension movements (bending in the thoracic segments of the back). The bed is tilted.

Isometric exercises are performed for the back and abdominals. Alternating movements of the lower limbs of the active type with lifting from the support are shown.

Third stage

During physical therapy classes, the muscular corset of the back, pelvis, and limbs is strengthened, and the range of movements increases.
The duration of the gymnastic complex is increased, supplemented by movements with weights and resistance, isometric tension of the muscle corset, and exercises in the standing “dog” position. In this position, the load on the spine is removed, and cervical and lumbar lordosis increases. Active exercises on the lower limbs with separation from the support are carried out with two legs, and not alternately. Developmental and special exercises are carried out on a horizontal bed.

Fourth stage

Charging begins after the patient is allowed to get out of bed and walk and before discharge from the hospital.
The objectives of this stage are to strengthen the muscle corset and bones, restore the natural curves of the spine and motor activity. Place full axial load on the spine. It is acceptable to get up 45-60 days after the fracture without sitting down. This should be done by moving to the edge of the bed, lowering your leg, placing it on the floor, leaning on your hands, straightening and lowering your other leg.

As the general condition improves, the exercises are supplemented with exercises in a standing position: tilting the body back and forth, abducting and adducting the legs, half-squats, heel-to-toe rolls, etc.

Set of exercises

At the initial rehabilitation stage, you can do gymnastics for the spine in a supine position on your back with your arms along your torso:

• place a load weighing up to 1 kg on the abdominal region, exhale and inhale, holding each position for several seconds;
• clenching and unclenching fists, bending and unbending the upper limbs, spreading the arms to the sides;
• pulling the feet towards oneself and away from oneself, rotating movements of the feet, bending the legs alternately at the knees;
• diaphragmatic breathing.

Gymnastic exercises in the second period in a supine position with arms along the body:

• inhaling, spread your arms to the sides, exhaling, raise them, then lower them to the starting position;
• move your arms at shoulder level alternately, while turning your arm in the same direction;
• bend your legs at the knee joints alternately, stretch them up, then lower them to their original position;
• move your legs to the sides alternately, without lifting them from the support.

Exercises for the third period - in the initial position on the stomach with a bolster under the chest, legs bent at the knee joints:

• raise your head and shoulders, creating resistance to the hands of the instructor, who supports the patient’s head from behind;
• move the straightened leg back in the same position (the instructor helps);
• straight upper limbs are pulled back, raising the shoulder girdle, head and legs, holding at the maximum point as far as possible.

In a pose on all fours, walk in all directions. You also need to do slow swings of your legs back with your head turned in the opposite direction.

During the fourth period, exercises are performed in a standing position with support on the back of the bed:

• rolling from toes to heels;
• tilting the body back with throwing back the head;
• moving straight legs back;
• lifting the legs bent at the knee joints, performing circular movements;
• shallow squats with a straight back.

After discharge from the hospital, exercise therapy is supplemented with massage procedures and exercises in the pool. Only in a comprehensive way can you quickly restore the body after injury and reduce the risk of negative consequences.

Alternative methods of rehabilitation and restoration of normal functioning of the spine

Alternative methods include swimming and yoga, using a special diet and taking vitamins.

Nutrition during this period should include a sufficient amount of protein foods of plant and animal origin, as well as jelly-like foods, which are necessary to restore the normal functioning of cartilage. You should also consume low-fat dairy products. You need to eat fractionally, eating food 5-6 times a day in small portions. During the rehabilitation period, B vitamins are used, as well as calcium, vitamins C and D, and phosphorus.

Fractures and other spinal injuries are a serious problem that should not be joked about. Failure to see a doctor in a timely manner and negligent attitude towards oneself during the rehabilitation period can lead to a number of complications and related problems. such as treatment of osteochondrosis.

Exercise technique

The best time for exercise therapy is morning or evening. Exercises should be done smoothly, slowly, after warming up.

When performing exercise therapy, pay attention to your body’s reaction. If severe discomfort, pain in the heart, or back occurs, the training should be stopped or the load reduced.

You need to exercise daily, unless your doctor says otherwise. For therapeutic exercises to bring results, the load must be increased slowly: start with 3-4 repetitions, after a week do ten (no more).

At first, exercise therapy should be performed under the supervision of a doctor. He will show you how to practice correctly and correct any inaccuracies. He will tell you when to increase the number of repetitions and the load.

A set of exercises for spinal compression fractures

Classes must be individually designed by a doctor. Let's consider what gymnastics can be like for fractures of different parts of the spine.

Exercises for the cervical region

The complex should include light movements of the arms and legs. All of them are performed slowly, with periodic pauses. Prohibited in the early stages

In further rehabilitation, the complex is supplemented with static exercises: turning and tilting the head, bending the body. It is important that the patient masters proper thoracic and abdominal breathing, especially if he has to wear a plaster half-corset.

Gymnastics includes general strengthening exercises for the body, arms and legs, which are performed in a lying, standing and sitting position. Simple balance and coordination exercises are also done. Sharp turns of the head and body, jumps, and leaps are excluded.

After removing the cast, exercises are done in static tension (when the head is tilted, the person himself or someone else provides counteraction with their hands). Light resistance is allowed during circular movements of the head with a small amplitude.

Exercises that involve holding your head elevated above the couch while lying on your side, back, or stomach are useful. You can also use exercises to strengthen your neck muscles. Raising the arms and shoulder girdles, abducting the arms to a right angle with light weights, and so on are done.

Exercises for the thoracic region

3rd period

This period continues for 2 months after injury. This is the main stage of exercise therapy according to the Gorinevskaya method, in which a corset of muscles is formed. The patient is still in a lying position, but the spine is no longer extended and the tilt of the bed is removed. The exercise therapy complex includes the following exercises:

1. On the back: - Quick actions with both legs, which need to be bent at the knees, taken in different directions, doing a “bicycle” and “scissors”, lifting in a straight position; — Keep your lower limbs suspended, which will help strengthen your abdominal muscles;
2. On the stomach: - Without leaning on your arms, straighten your body and freeze for a while. Hands should be in front or to the sides; - Straighten your legs one by one; — Keep the lower limbs in a vertical position; - Use the “swallow” pose.

Let us repeat once again that this is the main stage of physical therapy according to Valentina Valentinovna, during which a corset of muscles is formed.

Top ↑

Evaluation of therapy outcome

There are standards, the fulfillment of which indicates the completion of the patient’s rehabilitation.

Checking the strength of the back muscles

Exercise: “swallow”, in the “lying on your stomach” position, move your arms back and at the same time lift from the plane of the bed and hold your head, shoulders and straight legs.

Normal: hold position for 2-3 minutes

Abdominal endurance test

Exercise: from a lying position, raise and hold straight legs at an angle of 45°

Normal: hold position for 2-3 minutes

Checking readiness to sit on a chair

Exercise: continuous walking for 1.5-2 hours

Normal: performing the exercise without pain or discomfort in the area of ​​injury

The test is carried out three months after the injury. A positive result allows the patient to sit on a chair with a bolster under the lower back.

The effectiveness of exercise therapy

The effectiveness of recovery is determined after completion of all three stages using special tests:

• The density of the muscle corset is assessed using the “Swallow” exercise. Lying on his stomach, the patient simultaneously raises the upper chest, arms apart and legs straightened. If he can remain in this position for at least 2 minutes, then the condition of the muscle corset is assessed as satisfactory.
• The strength of the abdominal muscles is also important. The patient turns over onto his back, lifts his straight legs up at an acute angle of 45 degrees. Normally, he should also hold them suspended for 2 minutes.

If both of these tests are successful, then the patient is allowed to stand up (45-60 days after injury).

• If after another month the patient is able to walk for 2 hours without a break without feeling worse, then he is allowed to sit down.
• 4 months after the injury, a control X-ray and examination by an orthopedic traumatologist are performed to assess the overall effectiveness of the treatment.

Symptoms of a compression fracture of the spine

Common symptoms of a compression fracture include: headache, nausea, vomiting, weakness in the limbs, choking, and spinal pain. The nature of the complaints depends on the level of damage to the spine and whether the spinal cord is damaged.

Injuries to the thoracic and lumbar spine are characterized by severe abdominal pain. Many patients suddenly experience short-term respiratory arrest after injury. It occurs reflexively in response to pain, bruise of the chest or spine.

After an injury to the vertebrae of the thoracic and lumbosacral regions, the victim experiences pain in the area of ​​injury, which intensifies during movement, turning over onto the stomach and lifting straight legs upward. Also, with a compression fracture of the vertebrae, pain occurs during rotational movements of the torso, for example, when a person reaches for a seat belt in a car, bends over to tie shoelaces, sits down on a chair, or lifts a child into outstretched arms.

If vertebral fragments protrude into the spinal canal and compress the spinal cord roots, the pain may radiate. When a vertebra is fractured in the cervical region, it spreads from the back of the head to the shoulder blades, spreading to the shoulder, forearm and fingers. When a vertebra is fractured in the thoracic region, girdle pain occurs, similar to intercostal neuralgia. It is shooting in nature, spreading along the intercostal space, sometimes radiating into the chest. When a lumbosacral vertebra is fractured, the pain radiates to the thigh, lower leg and foot.

Compression of the roots during a compression fracture can also be accompanied not only by their irritation, but also by death. Then the patient experiences a feeling of numbness in the area of ​​innervation of the dead nerve, muscle strength decreases until paresis or paralysis of the affected muscles.

In severe compression fractures, the spinal cord itself can be damaged. Such an injury is accompanied by the development of the most severe neurological deficit: sensitivity in the limbs and trunk below the level of the fracture is impaired. In this case, the legs can be paralyzed, which is why the victim will not be able to move independently.

Some spinal fractures may be asymptomatic due to the absence of compression of the spinal cord or the presence of large reserve space in the spinal canal (as occurs with osteoporosis or vertebral hemangioma). Such injuries are usually discovered accidentally during an X-ray or MRI, or if the patient begins to feel stiffness or discomfort in the back.

Contraindications

Of course, treatment according to Gorinevskaya-Dreving is not indicated for all patients. There are a number of serious contraindications for functional rehabilitation:

• General serious condition of the patient;
• Unstable fractures;
• Comminuted fractures;
• Compression of more than 1/3 of the height of the vertebral body;
• Signs of compression of the nerve roots (paresis, paralysis, sensitivity disorders);
• Spinal cord damage (myelopathy);
• Fever;
• Unstable blood pressure;
• Severe pain at the fracture site, aggravated by exercise therapy;
• Development of paralytic intestinal obstruction.

The main goal of physical therapy after a spinal injury is to restore lost functions and return a person to a full life. In this case, the principle “if you drive more quietly, you will go further” works. There is no need to rush to increase the load, get to your feet or sit down. When treating diseases of the spine, you must strictly follow all medical recommendations, and then the recovery will be as complete as possible.

Main causes of compression fracture

Traumatic injuries to the bone tissue of the spinal column are dangerous by compromising the integrity of the spinal cord. The vertebrae protect its soft structure, surrounding it with a reliable ring. If they become deformed, this leads to pinched nerve trunks, compression, damage or even rupture of the spinal cord. Rehabilitation measures after a compression fracture are aimed at reducing the consequences of trauma to the thoracic spine.

Most often, damage to the integrity of the spine is caused by:

• heavy blow;
• shaking due to vertical landing on legs;
• falling on the buttocks;
• sudden lifting of heavy weight;
• cancer tumors, hemangiomas, intraosseous pathological processes.

Thanks to osteoporosis, which especially affects women after menopause, damage to the spine can occur even from sneezing or coughing. Closer to 80 years, almost half of the patients are diagnosed with KP.

Exercise therapy in the first period (first 7-10 days after injury)

Features of the period

If there are no contraindications, physical therapy begins a week after the injury. In the first period, light general exercises are prescribed to warm up the joints and muscles. Most of the complex is occupied by breathing practices and static load. The complex is performed in the only possible position, “lying on your back.”

Objectives of exercise therapy at this stage

Physical therapy in the first period of rehabilitation helps:

• increase the patient’s vitality;
• improve the functioning of the gastrointestinal tract, cardiovascular system and respiratory system,
• prevent muscle dystrophy.

Set of exercises

Starting position: on your back, arms along your body.

1. Diaphragmatic breathing. A load weighing 1-1.5 kg lies on the upper abdomen. Exhale – lift the weight, hold your breath for 5-10 seconds. Inhale – lower the weight to the lower abdomen. Exhale – rise, hold. Inhale - into the upper abdomen.
2. Clench and unclench your fist.
3. Pull your foot towards you, then away from you.
4. Bend and straighten your arm at the elbow.
5. Circular movements of the feet.
6. Bend and straighten your hands.
7. Circular movements with the hands.
8. Diaphragmatic breathing.
9. Extend your arms to the sides at shoulder level. Pull your shoulders back slightly. Circular movements of the arms with a feeling of slight tension in the back and shoulder blades.
10. Move one leg to the side without lifting it from the bed. Return to starting position. Repeat with the other leg.
11. Bend one leg at the knee without lifting your foot off the bed. Unbend. Repeat with the other leg.
12. Take turns bending your knees with your feet resting on the bed. Raise your pelvis, resting on your shoulder blades and feet.
13. Diaphragmatic breathing.

Next come static (isometric) exercises: slowly tense the muscles, hold the tension, relax. Some muscles will tense from a resting state, others will require the help of ligaments (see notes on points).

1. Static tension in the hand muscles (clench your fingers)
2. Static tension of the lower leg muscles (pull the feet towards you, fix the tension, then pull away from you and fix it again)
3. Static tension in the shoulder muscles.
4. Static tension in the thigh muscles.
5. Static tension in the muscles of the buttocks.
6. Static tension in the back muscles.
7. Diaphragmatic breathing.

Recommendations for implementation

Perform the exercises slowly with pauses for rest.

Repeat each movement 4-6 times.

During static exercises, the tension is held for 2-10 seconds.

The duration of the complex is 10-15 minutes.

The frequency of classes is daily, 2-3 times a day.

Lifting the pelvis only with support on the shoulder blades and feet.

It is strictly forbidden to raise straight legs, as this leads to overstrain of the long back muscles, pain and increased stress on the vertebrae.

Exercise therapy Gorinevskaya

Updated December 6, 2021 at 11:43 pm (edition)

In case of injuries and fractures of the spine, the use of special exercises included in the complex of physical therapy is indispensable to restore the functionality and performance of the human body.

One of those who proposed a complex of exercise therapy actions were V.V. Gorinevskaya and E.F. Dreving, who put forward their theory back in 1937. Let's look at gymnastics using this system in more detail.

: Valentina Valentinovna Gorinevskaya (1882-1953) - the founder of domestic traumatology, Doctor of Medical Sciences (1935), professor, Honored Scientist of the RSFSR (1943), colonel of the medical service. Author of more than 100 scientific papers.

The principle of therapeutic exercises

Exercise therapy Gorinevskaya includes the following features that help rehabilitation for spinal fractures:

• This technique can be used only with an intact spinal cord and low compression;
• In the early stages of gymnastics according to the Gorinevskaya method, a plaster corset is not used; the patient is prescribed to adopt a constant horizontal body position, while gradually stretching the spine;
• Creates a gradual corset from your own muscles;
• Constantly increasing loads as rehabilitation periods are used;
• The technique is based on strengthening the spinal muscles by straightening and bending parts of the body;
• For the first 2 months the patient takes a supine position, and only during the third month is he allowed to sit down;

The patient will be able to work within 6-8 months when using therapeutic exercises according to the Gorinevskaya method, but the body will fully recover only after a year, after the start of exercise therapy.

Physical therapy according to the Dreving method involves a certain position of the patient’s body. It is placed on an inclined surface so that the head is raised above the lower limbs by about 20 centimeters . Special non-rigid straps are placed under the arms, with which the patient is secured to the bed, preventing the person from slipping.

Small pillows are placed under the lumbar and cervical region so that the spine takes a natural position. But the fracture site should be left as it is, without any devices. If the thoracic vertebrae 1 to 3 are damaged, they are pulled out using a Glisson loop.

When the spinal fracture is closed, the method of exercise therapy by Dreving and Gorinevskaya can be used starting from the third day after the injury.

They also proposed sets of exercises corresponding to the various stages of the treatment. The entire course of Gorinevskaya exercise therapy contains 3 main stages of treatment and rehabilitation.

At each stage, gymnastics contributes to a tonic effect on the body, prevention of complications that can arise from a prolonged position in a horizontal position, strengthening the muscles of the back and lower back, which will strengthen the spine.

Physical rehabilitation

Rehabilitation for a spinal fracture is the next stage of the treatment process of paramount importance. After providing first aid, even if it involved minimally invasive cementoplasty, the patient must strictly observe a specific physical regimen for a certain period, attend physiotherapeutic sessions, undergo therapeutic exercises, etc. It cannot be otherwise if you have suffered such a serious injury.

Complicated injuries and those provoked by osteoporotic processes require a very careful selection of recovery methods. Therefore, it would be more advisable to take care in advance where to undergo rehabilitation after a spinal fracture; today there is no particular shortage of good specialized institutions.

Prescribing any restorative tactics to yourself is strictly prohibited! Rehabilitation of patients with a spinal fracture is being developed exclusively by the treating doctor together with a rehabilitation specialist. Our recommendations are given in general form and are for informational purposes only, so before using them, consult with a specialist about the possibility of using them for your specific medical problem.

We will talk about that important period when complete bone consolidation has already been achieved, since some patients at this stage stop working on their spine, but in vain. It is after 2-3 months that all emphasis should be directed toward developing and strengthening the musculoskeletal corset, which has become considerably weakened after prolonged immobilization and long-term unloading. In addition, thanks to the unique physical organization, the work of the gastrointestinal tract, cardiovascular system, respiratory system, reproductive, urinary system and many other important components of the body, which are entirely dependent on the health of the spine, will be stabilized.