I woke up without a cast. How to recover from injury

The ankles are two protruding bones that are part of the ankle joint. The inner ankle is located on the inside of the ankle, and the outer ankle is on the outside. For a non-displaced ankle fracture, the traumatologist applies a plaster cast. After its removal, to restore the function of the lower limb, rehabilitation specialists at the Yusupov Hospital prescribe a course of physical therapy.

If on an x-ray the doctor finds displacement of fragments in an ankle fracture, he compares them (simultaneous reposition). After comparing the fragments, a cast is applied to the leg from the tips of the toes to the middle third of the thigh. The position of the foot depends on the type of fracture. The duration of immobilization is about 6 weeks.

If it is impossible to compare the fragments, surgical treatment is performed. The inner ankle is strengthened with a screw, and the outer ankle with a plate. If there is a rupture of the ligaments between the tibia and fibula, they are connected with a cancellous screw. After surgery, a plaster boot is placed on the injured limb for 6 weeks. Subsequently, rehabilitation specialists prescribe exercise therapy to the patient after an ankle fracture (the video is available on the Internet).

Stages of recovery after a fracture

In order not to aggravate the situation and cause even more harm to the body, it is necessary to treat a fracture at home in accordance with a clear sequential scheme. It provides the following main recovery stages:

1. The first stage begins immediately after the plaster is removed. At this time, the damaged area needs to be rubbed and massaged. Start exercises and massage almost immediately, but they should be light and not overload the still weak muscles. To stimulate recovery processes, local preparations in the form of a gel or cream can be applied to the area, but only as prescribed by a doctor.
2. The second stage begins when the muscles, ligaments and other structures become a little stronger. To increase tone and motor activity, begin exercise therapy, physiotherapy, and perform more complex and intense exercises.
3. The third stage is the final one. During this period, you can already increase your activity and go for long walks. The doctor can give a referral for treatment at a sanatorium or health center.

Equilibrium

Standing on the leg you are working on, try to maintain your balance for 30 seconds. Repeat 3 times. Start with your eyes open, and then try to repeat it with your eyes closed. When these actions are no longer difficult for you, try repeating them while standing with the developed leg on a hard pillow.

Exercises on a balancing platform

Stand on the balancing platform. Optimal position: feet shoulder-width apart.

Assistive devices and additional activities

Simple additional remedies that can be used at home will help increase the patient’s comfort during recovery after a broken leg:

• Orthopedic insoles. They help not to overload the injured limb, relieve stress from bones and joints.
• Belt. Special straps are attached to the bed, so the patient receives additional support when sitting down or standing up. Patients with a hip fracture especially need such a device.
• Crutches or cane. Depending on the severity of the injury, in the early recovery period the patient may require assistance while walking. Auxiliary supports will relieve excessive stress from the limbs and give the patient confidence during movements.

Rehabilitation measures provide for a uniform increase in the load on the body. Initially, the doctor prescribes simple breathing exercises to the patient, which help saturate the body with oxygen and develop the respiratory system. Afterwards, exercise is added, which is aimed at developing general body mobility. After about a month, physical exercises are expanded and divided into two groups:

• general – aimed at improving the health of the whole body;
• special ones - restore the damaged area.

Properly selected gymnastics and a course of physical therapy restore blood circulation, strengthen muscles, resume motor activity and prevent complications.

Ankle resistance

Sit on the floor facing the door. Using a loop, fasten one end of the expander to the toe of the leg you are working on, and the other end to the door. Move away from the door until you feel enough tension. Keeping your leg straight, pull your toe towards you, stretching the expander. Slowly return to the starting position. 2 sets of 15 times.

Recovery in a supine position

For fractures of the extremities, recovery must begin when the patient is in a supine position and cannot stand. Only an early start of rehabilitation allows you to achieve maximum results. Otherwise, the muscles become inactive and weaken, causing the bones to heal incorrectly.

The complex of therapeutic exercises for a bedridden patient includes:

• shoulder lifts;
• lifting on the forearms;
• hand rotations;
• flexion, extension, pulling the healthy leg to the chest;
• contraction and relaxation of the muscles of the legs and arms;
• raising, abducting, bringing the injured limb to the body.

At the initial stage, these exercises should be performed under the supervision of a specialist and with his help. Over time, the patient will be able to perform gymnastics independently.

How can a person get an ankle injury?

As a rule, ankle injury occurs after a strong blow to the leg in the ankle area. Sometimes the injury occurs as a result of a twisted foot. This can happen if you jump or land poorly.

Joint injuries occur especially often in older people, for whom walking on ice or even stairs can be dangerous.

Any destructive movement of the joint: bending or twisting can cause an ankle fracture.

An ankle (ankle) fracture is common. Getting this injury is quite simple, but healing and recovery requires a lot of effort and time.

Working with gait

As part of rehabilitation after a leg injury, it is necessary to work on restoring gait. One of the most effective options is exercise on an exercise bike, to which the patient must be allowed by a doctor if there are no contraindications.

In addition to training on the simulator, it is also important to perform special exercises:

• grab a small object with your toes and hold it suspended;
• roll the ball with the foot of the injured limb;
• roll from toes to heels and back;
• walk backwards, sideways.

Classes should be continued until the patient’s motor functions are completely restored and swelling and pain go away.

How long does it last

To answer the question: “How long does rehabilitation last after an ankle fracture?” three criteria are always taken into account:

• the age of the injured patient and his lifestyle;
• the presence of chronic diseases that can (and will) slow down the process of tissue repair;
• the nature of the fracture, there are two of them, open and closed.

Now, in order. The older a person is, the more worn out the body is, and we emphasize that this includes his lifestyle - yes, this is relevant in our time, because now a huge number of people lead a sedentary lifestyle! Also, do not forget about one more thing - we are talking about the possible presence of bad habits that slow down the recovery process.

It’s worse when a patient, especially an elderly one, has diseases of the musculoskeletal system or diseases that can affect recovery processes - diabetes mellitus is a prime example! It has long been noted that diabetes significantly complicates treatment for other diseases and slows down the regeneration of damaged tissues.

Here is the nature of the fracture, if it is open (plus possible displacement, rupture of ligaments, blood vessels), then the recovery will become longer and more painful - about 6 months. In the best case, without complicating factors, a person will be able to get back on his feet after about 6 weeks. In children, the rehabilitation period is halved.

External means

After the cast is removed, the patient may experience pain and swelling for a long time. To get rid of these unpleasant manifestations of injury, the doctor may prescribe ointments and gels that relieve discomfort. Such drugs have important effects:

• analgesic – relieves pain, improves motor abilities;
• anti-inflammatory – improves tissue condition, relieves inflammation, redness, swelling;
• muscle relaxant – promotes muscle relaxation, relieves excessive tone, improves the effect of painkillers;
• regenerating – stimulates restoration processes, activates metabolism in damaged tissues.

External medications have much less negative effects than oral medications. Therefore, many doctors prefer ointments and gels with local action.

Rules for performing exercises

For each type of injury, special complexes have been developed that take into account the location and type of fracture, the presence of displacement and surgery, the patient’s condition, and his age.

Exercises for rehabilitation after a fracture of the tibia of the leg are performed in the following volume:

1. morning and evening exercises – 10-15 minutes every day;
2. exercise machines – 45 minutes 2 times a week;
3. daily walking in the prescribed volume (distance);
4. warm-up complexes – 3-4 times a day for 3-5 minutes;
5. swimming lesson – 45 minutes 2 times a week;
6. exercise therapy complex – 45 minutes 2 times a week.

Similar loads are also necessary during rehabilitation after a broken ankle; only special exercises can differ.

A prerequisite for exercise is to resume it several times during the day in order to constantly stimulate the muscles.

If it is not possible to perform some types of recommended exercises, you should increase the time and complexity of the possible ones. In this case, you should have a rubber band and a foot expander at home.

Exercising only in the gym will not create the necessary load; you need to study at home.

Attention ! Classes end half an hour before meals and 1.5 hours before bedtime.

Rehabilitation after a fracture of the little toe or other toe is faster. In this case, more movements are performed on fine motor skills - lifting small objects with fingers, rolling balls, walking on uneven surfaces barefoot.

A necessary condition for successful recovery is the full loading of all joints and muscle groups of the injured limb, and not just the diseased area.

Rehabilitation and exercises after a broken leg after osteosynthesis surgery begin after the sutures are removed. After using the Ilizarov apparatus or traction, classes begin 10-14 days after removal of the devices.

Important ! You cannot remain motionless for a long time, especially in an incorrect position. You should sit without crossing your legs; you will have to forget about your favorite cross-legged position.

Nutrition

The recovery stage must be accompanied by a proper diet. During this period, the body needs more vitamins and nutrients, which must be obtained not only from food, but also from additional vitamin supplements.

During the period of active recovery, you need to saturate your diet with:

• protein (found in poultry, fish, meat);
• calcium and silicon (can be obtained from cottage cheese, oatmeal, beets, cheese, parsley, sesame);
• vitamins B, C and D (found in maximum quantities in fish oil, liver, bananas, legumes, citrus fruits).

While recovering from a fracture, you need to give up alcohol, sweet carbonated drinks, coffee, chocolate, fatty and salty foods.

Recovery diets

Proper nutrition should be organized while wearing a cast. It will help bones heal and improve muscle condition. If you have a fracture of the lower extremities, you need to consume protein up to 120 g per day.

To quickly heal bones, the body needs the following elements: calcium, zinc, magnesium. Sources:

• milk, fermented milk products;
• sesame;
• cabbage;
• legumes;
• cheese;
• seafood, fish;
• nuts;
• eggs;
• cereals, including buckwheat;
• fruits.

For better absorption of calcium, vitamin D is needed, which is found in large quantities in fatty fish.

Phosphorus, necessary for bone restoration, is contained in liver, grains, dairy products, beans, and nuts.

Vitamins help improve metabolism in tissues. In case of fractures, it is necessary to increase the consumption of products with vitamins D, C, A, group B or take pharmaceutical complexes.

The most suitable diet is No. 11 , with the necessary amount of protein to restore muscle and bone tissue, as well as calories to perform exercises for rehabilitation after a broken leg. Meals – 5 times a day, cooking – normal processing. It is necessary to avoid fried and smoked foods.

Liquid consumption – 1.5 liters .

Massage

Therapeutic massage after fractures involves the use of specific techniques:

• rubbing – active movements improve blood circulation and reduce pain;
• kneading – restore muscle tone, improve tendon mobility;
• stroking – light stroking movements relax muscles, improve microcirculation;
• effleurage - improves blood flow and increases muscle contractility.

The massage therapist selects a treatment course taking into account the characteristics of the injury and the exact location of the fracture. A course of therapeutic massage helps to avoid muscle atrophy and weakness, improve mobility, relieve swelling and pain.

How to walk on crutches

Crutches are used to improve coordination and reduce stress on the legs by increasing support and transferring body weight to the upper torso and arms.

Arm crutches

These crutches, which rest on the forearm, serve as a walking support for a person with injured or sore legs. The crutch is similar to a high cane, reaching to the elbow joint and topped with a special flexible cuff. They are made of aluminum and have a stand, a clamp and a handle. The height of the “Canadian” arm crutches must correspond to the person’s height. The height of all armrest “Canadian” crutches can be adjusted. Although crutches of this type provide insufficient lateral support, they are smaller in size and more functional when climbing stairs. They can be used simultaneously with orthopedic devices.

Reminder for learning to walk on elbow (Canadian) crutches

Using crutches requires fairly good balance and coordination, as well as muscle strength. Therefore, it is preferable to use crutches for “young” patients for a short period of time.

A. Training can begin only when the patient or person who has suffered an injury is already sitting with his legs down and gets out of bed on his healthy leg with the help of support (headboard, table, etc.)

B. Before standing on crutches, they need to be adjusted (the design of the crutch allows you to set the desired length). You need to know how to hold a crutch correctly:

1. the crutch rest (that is, the support for the hand) should be directed with the free end forward;
2. the cuff of the crutch should cover the forearm from behind, slightly below the elbow joint of the correspondingly bent arm;
3. The back of the person standing on crutches should be as straight as possible.

Q. How to walk on crutches correctly.

At all stages of training, safety net is required.

1. The patient stands on his healthy leg, holding on to a support with one hand, for example, a rectangular table, and the other on a crutch.

Then:

• puts the crutch forward at the length of the step;
• transfers the weight of his body onto the crutch;
• moves the healthy leg to the length of the step;
• repeating all this over and over again, he moves along the table;
• reaches the end of the table, turns around, swaps the crutch and support and moves back in the same way.

2. The patient stands on his healthy leg, with crutches in both hands.

Then he:

• brings one crutch forward a step length;
• brings another crutch forward a step length;
• transfers his weight to crutches;
• moves the healthy leg to the length of the step;
• repeats all this over and over again.

3. In the future, you can move on to walking when both crutches are brought forward at the same time.

When a person stands with two crutches, they should be spread slightly to the side - this gives the person greater stability.

Axillary crutches

Made from light wood or aluminum. Their design usually provides a platform for support under the armpit, a handle, a double bar that turns from below into one stand with a rubber tip with a diameter of 3-8 cm. Crutches can have clamps, screws or other devices with which their height is adjusted.

Axillary crutches

Serve as a support when walking for a person with injured or sore legs.

The height of the axillary crutches must correspond to the height of the person. The height of all axillary crutches can be adjusted.

To determine the correct height, there are two reference points: the axillary bar should be 4-5 cm below the armpit

• the forearm presses the crutch to the body
• the crossbar for supporting the hand is at the level of the wrist

The method for determining the correct selection of the height of the crossbar for hand support is as follows: in a standing position, with the arms extended along the body, the handle of the crutch should reach the level of the watch on the wrist. Note: Using crutches requires fairly good balance and coordination, as well as muscle strength. Therefore, it is preferable to use crutches for “young” patients for a short period of time.

A. Training can begin only when the patient or someone who has suffered an injury can already sit with his legs down and get out of bed on his healthy leg with the help of support (headboard, table, etc.)

B. Before standing on crutches, they need to be adjusted (the design of the crutch allows you to set the desired length). You need to know how to hold a crutch correctly: The top of the crutch should not rest against the armpit. The gap should be two fingers. The back of the person standing on crutches should be as straight as possible. The crutch arm should be positioned so that there is an angle of approximately ten degrees at the elbow joint.

B. How to walk on crutches correctly:

1. At all stages of training, safety net is required;

2. The patient stands on his healthy leg, holding on to a support with one hand, for example, a rectangular table, and the other on a crutch.

Then:

• puts the crutch forward at the length of the step;
• transfers the weight of his body onto the crutch;
• moves the healthy leg to the length of the step;
• repeating all this over and over again, he moves along the table;
• reaches the end of the table, turns around, swaps the crutch and support and moves back in the same way.

3. The patient stands on his healthy leg, with crutches in both hands.

Then he:

• brings one crutch forward a step length;
• brings another crutch forward a step length;
• transfers his weight to crutches;
• moves the healthy leg to the length of the step;
• repeats all this over and over again.

4.In the future, you can move on to walking when both crutches are brought forward at the same time.

When a person stands with two crutches, they should be spread slightly to the side - this gives the person greater stability.

When using different types of crutches, remember that:

• body weight should be transferred to the arms and not to the armpits to avoid damage to the axillary area;
• maintain a wide base of support even while resting;
• keep the crutches approximately 10 cm from the edge and in front of the leg;
• when using crutches with emphasis on the armpits, the support posts should be close to the chest to ensure better balance;
• keep your head straight and maintain an even body position while walking.

The best position for the patient is: head raised high, back straight, healthy knee slightly bent. You can lean your back against a wall for support. The tips of the crutches are placed at a distance of approximately 15 cm from the socks and slightly anteriorly. If the patient has wide hips, it is better to move the tips to the side at a greater distance. The distance between the armpit and the top of the crutches should be about 2-3 fingers. Elbows are bent at an angle of 25-30. With a push you can check whether the body easily comes off the floor. Your arms should be almost straight. Adaptability to crutches is tested during a walk.

In order to get up from a chair, crutches folded together are placed on the injured side and grasped from the inside. Then they throw them over the chair with the other hand and straighten the healthy leg.

To sit down, repeat the same movements, starting with placing two crutches on the injured side. Then the patient straightens his back and sits down. At the same time, he must be sure that the chair or chair does not rock.

When walking with crutches, place both crutches simultaneously 30 cm in front and 15-20 cm towards the toes. They carry the weight of the body forward, leaning on the handles. You can swing on crutches. Land on the heel so that the crutches are behind the patient.

The shuttle type gait is the simplest and safest for those who begin to use crutches. You need to start by bringing the crutches forward, transferring the weight of your body forward, leaning on your hands, and sliding in the same direction with your healthy leg.

When going up or down stairs, you can use the following method. The patient takes both crutches under one hand and holds them from the inside with his thumb. The other hand grabs the railing (the hand is slightly in front of the body).

When lifting, the crutches are left at the level where they stand. Then distribute body weight evenly on the hand holding the crutch and on the railing. Raise the healthy leg onto the step, leaving the sore leg behind, straighten the healthy leg and move the crutches forward.

When descending the steps, crutches are placed on the lower step and the affected leg is extended. Then they lean evenly on the hand holding the crutches and on the railing. Move the healthy leg forward onto the lower step. It is recommended to use this method when going up or down narrow stairs.

Go to the Crutches section

Rehabilitation for a shoulder fracture

Keeping the hand in a certain state for a long time has a negative impact on the muscles and mobility in the joint. As soon as normal fusion of the fragments has occurred, it is necessary to begin developing the shoulder joint after the fracture. All this can be accompanied by severe pain that requires painkillers. The development is carried out strictly under the supervision of the attending physician, who periodically prescribes X-ray examinations. During the examination, certain physical exercises are recommended. Rehabilitation activities require the following popular types of exercises:

• periodically raising the shoulder girdle 5-7 times;
• spreading and retracting the shoulder blades 5-7 times;
• flexion and extension of the forearm with the healthy arm, not reaching 90 degrees relative to the body, 5-7 times;
• with a small amplitude, flexion and extension of the shoulder 5-7 times.

A month after immobilization of the fragments, exercise therapy for a fracture of the shoulder joint can become more complicated. Now all movements should be accompanied by raising the arm to a horizontal level.