Physiotherapy uses natural factors such as currents, magnets, water, light and heat to treat diseases. How does the power of natural elements serve to restore human health?
Margarita Manasyan
Therapist with over 30 years of experience
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A fracture is a serious injury that is characterized by a violation of the integrity of the bone and adjacent tissues.
The main task in case of a fracture is to restore the anatomically correct location of the bone. For this purpose, plaster is applied to the fracture site and, if necessary, knitting needles are installed.
Next, the patient faces a long period of healing and rehabilitation. At this time, the patient experiences great discomfort and is constrained in his movements. Pain is a faithful companion to fractures.
Physiotherapy helps shorten the rehabilitation period after a fracture, relieves pain and swelling, and promotes rapid healing of tissues. Physiotherapeutic procedures can be used within 3-4 days after injury.
How does physical therapy help with fractures?
The main goal of physical therapy for fractures is the speedy restoration of the injured bone and its function without complications and pain.
Physiotherapy after a fracture helps:
- relieving pain during the “development” of atrophied muscles;
- activation of blood circulation in the extremities;
- elimination of contracture (limited joint mobility);
- tissue restoration (muscles, ligaments);
- acceleration of bone fusion;
- relieving swelling.
The use of physiotherapy in the presence of metal structures.
As is known, therapeutic physical factors are used with great success in all stages of tissue regeneration, including bone. They can reduce swelling, inflammation, pain, improve blood and lymph circulation, trophism, which ultimately leads to accelerated tissue regeneration and, consequently, a reduction in treatment time and a decrease in the number of complications. On the contrary, MK, although they create good conditions for strong fixation of bone fragments, are not biostimulators of reparative processes. They delay the processes of osteogenesis by approximately 1.5 times, which is associated with additional trauma to tissues, especially bone marrow, endosteum and periosteum, that is, tissues due to which callus formation occurs, therefore, in modern methods of treating fractures it is necessary to introduce irritants that stimulate bone processes and soft tissue regeneration. Such stimulants are therapeutic physical factors. It has been proven that the presence of modern metal structures (non-corrosive, non-magnetic) in the area of influence of physical factors, including electric and electromagnetic fields, at small dosages, does not lead to the development of such complications and, therefore, is not a contraindication to physiotherapy, if certain features are observed techniques, namely: - electrodes or emitters should be positioned in such a way that the electric or magnetic field lines running from one electrode to another pass along the metal structure; — the dosage of power, current, and magnetic field strength should be reduced by approximately 1.5-2 times compared to the generally accepted one. We begin physical therapy from the first days after surgery and continue until the end of treatment. From 1-2 days, in order to prevent early postoperative complications, we prescribe 3-5 procedures of UHF therapy in a low-thermal dosage (20-40 W) or magnetic therapy to the wound area, which have an anti-inflammatory, decongestant and analgesic effect. For the same purpose, you can conduct UV irradiation of the suture area (during dressings). If the operated area is covered with a plaster cast, irradiation is carried out on symmetrical areas of the healthy limb or using the reflex-segmental technique, i.e. on the corresponding segments of the spine. During compression-distraction osteosynthesis, it is necessary to position the emitters so that the electric or magnetic field does not pass through the metal rings of the device, i.e. so that the emitters are located inside the rings of the device. The metal spokes of the device must be isolated from wet gaskets with sterile pieces of thin rubber. 2-3 weeks after surgery and later, that is, at the stages of formation of osteoid and then bone callus, thermal procedures in the form of infrared radiation can be prescribed to improve tissue trophism. From the 4-5th week after the operation, we prescribe more vigorous thermal and hydrotherapeutic procedures - ozokerite or paraffin applications, therapeutic baths and PDM. Some orthopedic traumatologists avoid prescribing thermal procedures to the area where the mitral valve is located, mistakenly believing that coolants (ozokerite-paraffin mixtures, therapeutic mud, etc.) can cause overheating of the AV and, therefore, lead to bone burns or expansion (increase in size) of the structure with subsequent development of unstable fixation and, as a consequence, to fracture nonunion or loosening of the MV. Nothing like this happens during heat therapy, because... the temperature of the MC during the application of coolants cannot increase by more than a few tenths of a degree. However, this cannot be said in the case of inductothermy. During this procedure, the radiation energy, concentrating in the metal area, can actually lead to significant heating of the MC (by several degrees). This, in turn, can cause resorption of the bone tissue layer adjacent to the MC, and this will almost inevitably lead to unstable fixation, i.e. to loosening of the MV. Similar changes in bone tissue, i.e. its resorption occurs when the MC area is exposed to ultrasonic energy, however, these changes do not occur due to overheating of the metal, but due to cavitation phenomena at the interface of two media: bone - metal. Thus, when treating patients with injuries and diseases of the ODS, when the patient has metal structures in the area exposed to physical factors, all types of physical procedures (with some methodological features) can be used, with the exception of inductothermy and ultrasound. Zhirnov V.A. FGU "RNIITO im. PP Vreden Roszdrav", St. Petersburg
What physical therapy methods are used to treat fractures?
The most effective and modern physiotherapeutic means used now are:
- Electrotherapy . A procedure aimed at relieving pain, stimulating muscle tissue and nerve endings.
- Magnetotherapy . A low-frequency magnetic field helps get rid of swelling, pain, inflammation, and improves blood microcirculation. The procedure is especially effective for chronic pain in the spine, joints and muscles.
- Laser therapy . Has an analgesic, absorbable, anti-inflammatory effect. Under the influence of this procedure, regenerative processes are accelerated and the transmission of nerve impulses is activated.
- Electro- and phonophoresis . A non-invasive procedure, the purpose of which is to painlessly introduce anti-inflammatory and antibacterial drugs under the upper layers of the dermis. Stimulates the healing process of bone and muscle tissue.
It has been proven that physical therapy after fractures helps reduce the rehabilitation period by half and avoids complications.
Cosmetic procedures are contraindicated during pregnancy and lactation.
Exercise therapy after a fracture
When the hand is damaged, the radius bone is the most vulnerable, this is due to the structure of the skeleton, despite the fact that the hand at the wrist is very thin, it is constantly under stress.
The period of wearing a cast directly depends on the individual characteristics and the body’s ability to recover and rehabilitate.
Disconnection of the radius due to injury requires wearing a bandage for about one month, but normal functionality of the limbs occurs after one and a half to two months, and then only if the recommendations of a specialist are followed.
Regular exercise therapy, as well as a course of massage, play an important role in recovery. The restorative actions themselves should be started the next day after the plaster is removed.
Attention! This technique will prevent the formation of stagnant processes.
It is worth noting that rehabilitation after a displaced fracture of the radius takes longer than usual. At the same time, additional exercises need to be added to exercise therapy:
- raising your shoulders up and down;
- rotation of hands in a circle;
- clapping with outstretched arms forward and behind the back.
What you need to pay attention to when choosing a specialist and clinic
Pay attention to the experience and qualifications of the physiotherapist in working with a specific disease. Today's level of medicine and specialization does not allow even a top-class professional to be the best in all areas at once. Therefore, for example, when seeking help for back pain, make sure that the specialist is competent in the field of orthopedics and manual therapy. Working with neurological patients (for example, after a stroke) will require the assistance of a specialist with appropriate experience.
The second important factor is the diagnostic and treatment facilities of the medical clinic. Most physiotherapeutic procedures are impossible without special equipment. Make sure you don't have to travel to the other side of town for sessions by finding out what services the facility offers.
Our Clinic employs competent specialists who are not just professionals, but also preach the ideology of sensitivity and caring attitude towards patients. The staff includes both doctors with over 10 years of experience and competent nursing staff in physiotherapeutic procedures. They have an excellent treatment base: The clinic is equipped with modern medical equipment and provides all conditions for the comfort of patients.
Second stage of rehabilitation
During the second stage, the growth and strengthening of the callus is activated, muscle atrophy and stiffness in the shoulder joint are prevented by the following procedures:
- interference currents of different frequencies;
- ultraviolet (general suberythemal) irradiation with a minimum dose to expand capillaries and supply tissues with nutrition and oxygen due to the warming effect and local erythemal effect;
- electrophoresis with calcium ions to strengthen the structure of callus and cell differentiation. 2 electrodes are used: one each for the damaged and healthy limb. Course – 10-15 procedures lasting 15-20 minutes;
- massage above and below the injury to improve blood flow, reduce muscle spasms, and prevent muscle atrophy.
What diseases can physiotherapy treat?
Physiotherapists use their knowledge and skills to improve a range of conditions related to different body systems. Namely:
1. Neurological diseases (stroke, multiple sclerosis, Parkinson's disease);
2. Disturbances in the functioning of the musculoskeletal system (back pain, arthritis, arthrosis);
3. Pathologies in the functioning of the cardiovascular system (rehabilitation after a heart attack, hypertension, chronic heart failure);
4. Dermatological diseases (acne, seborrhea, eczema);
5. Problems with the digestive system (colitis, gastritis, ulcers);
6. Respiratory diseases (asthma, chronic obstructive pulmonary disease, cystic fibrosis).
Procedures can also be prescribed for other pathologies: from psychosomatic disorders to diseases of the reproductive system.
PARTIAL MUSCLE RUPTURE
5 people were under observation.
Of these, 2 patients were diagnosed with a partial rupture of the 4th femoris muscle and 3 – a partial rupture of the 2nd femoris muscle. The symptoms of the injury were dominated by severe pain, swelling and tenderness in the area of muscle rupture, and impaired function of the lower limb. Large hematomas were diagnosed in the rupture zone, popliteal fossa, and later in the calf muscle. The patients were treated in the day hospital of the clinic. In addition to the fixation bandage, heparin ointment and analgesics were prescribed.
Magnetic therapy was prescribed for the thigh and lower leg. The main inductors were placed in the form of a solenoid on the limb, “N” with the surface to the skin. Magnetic field parameters: pulsed, pulsating, pulse frequency 10-16 Hz, magnetic induction 6 mT, exposure 30 minutes daily. The course of treatment is 15 procedures. The symptoms of the disease partially regressed and partially resolved. Treatment result: clinical recovery.
Fracture of rib and ribs
Fracture of the rib and ribs is the most common and common injury in our daily life. A person has 12 pairs of ribs and any of them can be damaged!
Fractures of the ribs occur as a result of some kind of mechanical damage - a blow, a fall on any protruding object, a road injury, a sharp compression of the chest. Depending on how many ribs are broken, the severity of the patient’s condition is determined.
What does a patient feel when a rib and ribs are fractured?
-Acute pain in the projection of the fracture, which intensifies when turning the body and taking a deep breath.
-Assumes a forced body position.
-At the moment of the act of breathing, the damaged half of the chest lags behind.
-Swelling and hematoma of soft tissues are possible in the area of the fracture site.
-When pressing on the site of injury, a crunching or crepitation may be felt as friction of bone fragments occurs.
If the patient experiences the above symptoms, it is necessary to contact a traumatologist, having first called an ambulance, or apply independently, preferably with an accompanying person.
The doctor will assess the patient’s condition, directly determine by palpation the severity and location of the fracture, prescribe an X-ray examination, and in the most serious cases, or for the most reliable examination, prescribe a computed tomography scan. Subsequently, based on examination and examination of the patient, treatment will be prescribed. As a rule, it is either conservative - which can be on an outpatient basis under the supervision of a traumatologist, or inpatient - in a hospital under the supervision of a thoracic surgeon or traumatologist.
In case of an uncomplicated fracture of a rib or ribs, the traumatologist will correctly select the method of conservative treatment.
Prescribe modern and most effective NSAIDs in the form of intramuscular or oral administration. Prescribe NSAID ointment. The patient will also be advised to eliminate physical and intense dynamic stress and create rest.
To enhance therapy, it is possible to prescribe physiotherapy (UHF, Magnetic therapy, electrophoresis, etc.) It is also recommended to use calcium supplements with Vit. D3, breathing exercises. It is also necessary to follow the doctor’s recommendations during sleep, if you have trouble sleeping in a flat lying position, or if you need to take a semi-sitting position with elastic pillows under your back using a reclining chair or bed. If you follow your doctor's recommendations, you will be able to restore motor and physical activity in the shortest possible time.
On average, the healing time for an uncomplicated rib fracture is 3-4 weeks.
Restoration of full working capacity occurs in 4-6 weeks. after injury. It is also necessary to take into account the age of the patient; younger people recover faster.
In case of complicated rib fractures accompanied by pneumothorax (when the lung is ruptured by a rib fragment and the accumulation of free air between the sheets of the pleura), hemothorax (accumulation of blood in the pleural cavity, which leads to compression of the lung), subcutaneous emphysema (entry of air from the lung into the subcutaneous tissue), organ injuries abdominal cavity (mainly lower ribs), heart injury (if damaged by the ends of the ribs) - immediate hospitalization is required.
How is the first appointment and diagnosis carried out?
At the first appointment, the doctor conducts a consultation, collects anamnesis, determines the presence of indications and contraindications for a particular procedure. This is followed by an examination, during which the specialist measures the patient’s blood pressure and pulse rate, listens to the heart and respiratory organs. The next stage of diagnosis depends on the patient’s complaints: the nature of the problems comes to the fore.
It is also possible to have a referral for physiotherapeutic procedures issued by a specialist. In this case, there is no need for any additional specific diagnostics: as a rule, the doctor immediately describes the optimal treatment regimen, which indicates the type and number of physiotherapeutic procedures.