A significant portion of household injuries are fractures of the upper and lower extremities. When falling with emphasis on the arm, a fracture of the radius often occurs, in which the patient has to be placed in a plaster cast. The hand remains in a fixed state for a month or more, and forced immobility leads to atrophic phenomena in muscle and connective tissue, disruption of vascular tone and nerve conduction. To restore hand function, a set of measures is carried out, including a special massage after a fracture of the radius.
Why is massage performed after a fracture of the radius?
After the cast is removed, the injured arm sometimes still hurts. It is necessary to restore joint mobility; in some cases there is residual swelling and cyanosis of the skin. Measures are needed to improve blood circulation in the limb, improve lymphatic drainage, and eliminate congestion. Massage helps with this.
Moderate physical impact during a massage restores blood flow, accelerates the restoration of nerve fiber conductivity, and eliminates spasm of blood vessels and muscles. The tissues receive the necessary nutrients, metabolic products are removed from the source of inflammation, swelling decreases, and muscle tension is relieved. This leads to a decrease in pain, increased joint mobility, improved nutrition and tissue regeneration.
When to start massage
The technique of performing massage for fractures of the bones of the upper limb varies widely depending on the location of the fracture, its type (open, closed, splintered, impacted, etc.), the severity of damage to the tissues surrounding the injured bone, and the duration of the injury as such. The start time for massage is also different: in mild cases it is allowed to be carried out within 2-3 days from the moment of immobilization of the limb, and in case of complex fractures it is recommended to wait for some time without massage.
Of course, it is better if the fracture is closed and localized in a typical location. Then massage is prescribed to the patient almost from the very beginning of treatment and it, just like medications, anesthetizes the site of injury, accelerates the processes of repair and regeneration of damaged tissue, promoting faster formation of callus, and also prevents atrophic processes in the muscles.
Massage technique
A restorative hand massage begins with kneading the muscles of the shoulder girdle. Next they move to the area of the elbow joint, massage the muscles and the joint itself well. Move to the forearm, carefully massage the area around the fracture site. They switch to the hand area and knead the joints, develop the muscles, and activate the mobility of the fingers.
During a massage after a fracture of the radius bone of the arm, the sequence of classical massage techniques is followed:
- stroking;
- trituration;
- kneading;
- vibration.
The movements are at first smooth, of low intensity, then their amplitude and strength increase. The direction of movement is along and across the line of the forearm and around the fracture site. Particular care is required when massaging the fracture site and nearby tissues. Moderate, careful circular movements with the pads of the thumbs are recommended here.
The following massage techniques are used on the forearm area:
- grasping strokes;
- circular stroking on the lateral surfaces;
- cross rubbing with the ribs of the palms;
- circular kneading movements with fingertips;
- rubbing by sliding along the lateral surfaces;
- two-handed forceps-like kneading of muscles.
Each massage session lasts approximately 10-20 seconds. Between techniques, several soft relaxing strokes are performed along the forearm. The massage at each area ends with fading stroking.
Duration of procedures
With a simple fracture without significant complications, the rehabilitation period of the limb will last approximately 1-1.5 months. And in the presence of contracture, the recovery period lasts up to six months.
The total duration of the massage session is 15 minutes, it is recommended to do it every day or every other day. The number of sessions depends on the complexity of the condition and is determined by the traumatologist
Features of the procedure for different types of fractures
Massage of the arm after a fracture of the radius should be carried out by a massage therapist, as it is necessary to follow a certain technique. Inept massage can cause harm to the affected limb.
Any massage should begin and end with stroking. The massage technique depends on the location and severity of the fracture, including whether there is displacement of bone fragments or not. Special efforts by a specialist will be required if, after removing the plaster, stiffness or immobility of the joint is observed.
The specialist applies the necessary massage technique, taking into account the complexity of the particular case. It’s one thing if you just need to develop muscles that have atrophied under plaster, another thing is to restore reduced conductivity of the nerve trunk and develop non-functioning fingers and joints.
Working on the hand requires great skill of a specialist, knowledge of anatomy and physiology. If there is joint contracture, then in addition to the usual measures to develop the joint and muscles, they improve the conductive function of the nerve fiber. The massage includes special stimulating pressure along the nerves and includes targeted physiotherapy.
Who does the massage
Usually, patients with a broken arm ask themselves the question: should they entrust the massage to a specialist or can they do it themselves? Of course, it is better for the treatment to be carried out by a professional who has experience in providing massage for a similar pathology. Only a specialist, based on a specific clinical situation - taking into account the location, type, duration of the fracture, the general condition of the patient and other factors, will select a set of massage techniques that is suitable for you, perform them in the correct order and with the required intensity. However, this does not mean at all that after removing the plaster cast, you cannot, in parallel with treatment from a specialist, self-massage the affected limb.
Self-massage is performed by the patient using a healthy hand. It should be carried out from the fingertips to the shoulder - this will help reduce swelling, since this is the direction the lymph moves. You need to start and end the massage with stroking, and use rubbing in the middle of the session. We draw your attention to the fact that to achieve maximum effect, you should act on all surfaces of the limb - external, internal, lateral. The fingers are massaged in spiral movements, as if you were putting on a glove. It is important to perform self-massage every day; the optimal session duration is 15-30 minutes. To quickly restore the range of motion in the joints of the hand, impaired as a result of the fracture and the period of immobilization, after completing the massage session, you should perform several physical therapy exercises (these will be recommended by the doctor).
For better gliding during massage, it is advisable to use massage or simple baby oil, to which aromatic oils with anti-inflammatory, wound healing and other healing effects can be added. As an alternative to oils, special ointments are used to relieve tissue swelling, for example, Hepatrombin.
Also, at home, patients can use massagers made of metal, wood, jasper, tourmaline, jade and other materials.
Use of medications
To facilitate the massage, massage oil is applied to the skin. At the same time, the massage therapist’s hand glides better and does not injure the patient’s skin. Essential oils of coniferous trees (fir, pine, cedar, eucalyptus, turpentine) are added to the massage oil.
Oils have a local irritant effect, increase blood flow, improve microcirculation and metabolism in tissues, stimulate recovery, and also have antibacterial and anti-inflammatory effects. Oils of coniferous trees, especially fir, were used in folk medicine for closed injuries, fractures, and joint pain.
Among medications, ointments and gels from the group of non-steroidal anti-inflammatory drugs are widely used. These are diclofenac, ibuprofen, naproxen, ketoprofen and others. They have anti-inflammatory, analgesic and anti-edematous effects.
Other external agents have a more pronounced anti-edematous effect: troxevasin, indovazin, lyoton, venoruton, venolife and others. This group contains substances that strengthen the walls of blood vessels, reducing the permeability of veins and capillaries. Due to this, elimination of swelling, a cooling and analgesic effect are observed.
There is a group of products that contains bee venom, snake venom, red pepper tincture, collagen and biologically active components. They have a warming effect. They are used during a period when there is no longer significant tissue swelling, active inflammatory process or skin damage. Their action is aimed at improving nutrition and accelerating tissue recovery.
What besides massage?
In addition to massage, a complex of rehabilitation measures for fractures of the bones of the upper limb includes therapy with physical factors and physical therapy exercises.
The patient may be prescribed the following physical treatment methods:
- medicinal electrophoresis of painkillers, anti-inflammatory drugs and absorbable agents;
- magnetic therapy;
- ultrasound therapy;
- laser therapy;
- interference therapy;
- ultraviolet irradiation (a healthy arm is exposed in an area symmetrical to that of the fracture, when the affected arm is in a plaster cast; reflexively improves microcirculation in the damaged area);
- acupuncture;
- local pine or mineral baths;
- applications of therapeutic mud, paraffin or ozokerite.
These procedures are prescribed exclusively by a doctor. They are carried out not once, but in courses, which, as a rule, include from 8 to 10-12 influences.
Therapeutic exercise is prescribed to the patient almost simultaneously with massage. First, he is allowed small-volume movements in healthy, plaster-free joints, as well as isotonic tension of certain muscle groups (when the muscle contracts and relaxes at the will of the patient, but his joints are motionless).
Later, 2-3 weeks after applying the plaster cast, the doctor may allow the patient to increase the range of motion in the joints of the limb.
When the plaster has already been removed, the number of physical therapy exercises is increased, and their complexity also increases. If the hand is fractured, tying shoelaces, walking with your fingers on a table or wall, moving a matchbox along these surfaces, rolling tennis balls in your palms and other similar exercises will speed up the restoration of its functions.
Although exercise therapy exercises are useful, you should not overdo them either. The load on the limb should be increased gradually, without overloading the arm. The number of repetitions of each exercise should not exceed 10-15 times.
What not to do during massage
The massage is aimed at restoring limb mobility. Massage movements should be smooth and moderate, and should not cause pain or discomfort. Excessive movements can injure the ligaments in the joints.
It is necessary to monitor the patient's condition during the massage. Do not allow sudden massage movements or apply great force, especially at the fracture site. Sudden movements can cause muscle spasm and tension, which can lead to a re-fracture. This is especially dangerous in the case of a displaced fracture.
With a broken hand
The session begins with stroking from the shoulder and forearm. Then work the area above the wrist and near the cast, using weak and slow movements. The trapezius muscle is kneaded with circular movements, after which they proceed to rubbing the entire surface of the arm. Rubbing is followed by stroking with light pressure and shaking.
After removing the plaster cast, therapeutic hand massage techniques are added, including kneading the palm and each finger. Palm massage for a fracture also includes acupressure, pressure and rubbing.
Additionally, rehabilitation after a broken arm includes performing simple exercises: rolling a ball and tapping your fingers on the table.
Benefits of massage
Long-term clinical studies have shown that the massage therapist’s movements during a session activate a number of physiological and biochemical processes that have a beneficial effect on the patient’s health:
- blood supply improves due to the expansion of the vascular lumen and the opening of dormant reserve capillaries;
- nutrition of the forearm structures is normalized;
- lymph flow is activated, helping to cleanse the body of decay products, waste, and toxins;
- the composition of the blood changes: the level of red blood cells and protein, which resist infections, tumor cells, and pathogenic microorganisms, increases significantly;
- indicators of stress markers decrease, heart rate and anxiety levels decrease;
- the amount of endorphins - natural anesthetics - increases, the production of the hormone cortisol is suspended;
- muscle fibers stretch, become soft and elastic;
- the functions of the sweat and sebaceous glands improve;
- excess fluid accumulated in the interstitial space is removed;
- keratinized scales are removed from the surface of the skin.
Such changes in the body allow:
- eliminate fatigue and tension;
- relieve spasms;
- normalize muscle tone;
- calm the nervous system;
- relieve pain;
- remove swelling and inflammation;
- strengthen ligaments and tendons;
- increase the mobility of nearby joints;
- restore structures and tissues after injury or illness.
In addition, in the forearm area there are biologically active points, by massaging which you can get rid of problems with the large intestine, alleviate the symptoms of diabetes, stop an attack of bronchial asthma, and even control body temperature.
For an elbow fracture
A fracture in the elbow joint also has a long recovery period, because... More than 3 joints, tendons and muscle ligaments connect at the fracture site. Procedures can only be performed after the plaster is removed.
The correct massage technique requires mandatory work on the radial and wrist joints, as well as the fingers. Massaging begins with a healthy area with circular stroking and rubbing. Then they move on to kneading the ligaments located on both sides of the elbow joint. The back side is stroked with the palms, after which the entire area is covered with a light pinching. The session ends with simple flexion exercises.
A little anatomy
The forearm is the middle part of a person’s arm between the hand and the elbow joint. Its bone base consists of two tubular bones: the ulna and the radius. They are located almost parallel to each other, and only touch at the ends. The entire space between the structures is filled with a thin but very durable membrane.
The forearm has the shape of a truncated cone, on the surface of which two convexities formed by different muscle groups are clearly visible:
In the spaces between the fibers of the anterior group - the grooves - there are nerves that provide sensitivity to the forearm and blood vessels that nourish the tissues of this part of the arm. In some places, their proximity is so close that when injured, simultaneous damage to both structures often occurs. The skin of this area is practically devoid of fatty tissue. It is thin, flexible, and easy to fold.
Massage the muscles located along the spinal column
1. Straight-line stroking of the muscles with the pads of the index and middle fingers.
2. Other types of effects on the areas between the spinous processes. Lumbar massage
1. Straight stroking with the tubercle and the pad of the thumb.
2. Rubbing:
a) circular with the pad of the thumb;
b) circular with the pads of four fingers;
c) circular beak-shaped;
d) circular base of the palm.
Contraindications to massage
Before the session, tell the massage therapist about chronic diseases, infections or inflammatory processes. After all, even a light relaxing technique can cause many problems when:
- oncological diseases;
- dermatitis of any origin;
- fresh wounds, injuries, fractures, burns;
- purulent processes;
- bone tuberculosis;
- osteomyelitis;
- thrombosis.
Massage the surface with special care in the presence of moles, papillomas, nevi, warts, as well as places of fractures, sprains, ruptures of ligaments and tendons.
With a fracture of the humerus
A shoulder fracture is a complex one because it heals slowly and proper development of the arm is necessary during recovery. After a shoulder fracture, hand massage begins only after removing the plaster cast and always from a sitting position. The relaxed hand is placed in front of you on the table.
If the diaphysis is fractured, the session begins with massaging the collar area. Then rub and knead the cervical and thoracic spine with light pinching. Next, they move on to stroking from the beginning of the humerus to the site of injury. Any tapping, chopping or sawing techniques are prohibited in this area. With the help of massage, you can not only quickly restore joint mobility, but also relieve muscle tension and increase the range of motion.
For a fracture of the humeral neck, the following scheme is used:
- The therapeutic massage procedure begins with stroking and rubbing, the intensity of which increases gradually;
- a few minutes are spent on gentle stroking;
- move on to twisting techniques.
The treatment is completed with light vibration tapping and fading stroking.