The term “leg-breaking” is probably unique to China in the rehabilitation world.
In foreign countries, the rehabilitation system is better, and there are corresponding institutions to connect the rehabilitation after surgery. Therefore, the chances of post-operative adhesions are very low.
On the contrary, in China, due to the excessive concentration of medical resources in developed cities such as North, Shanghai and Guangzhou at this stage, many patients have come to big cities for surgery.
However, even the largest hospitals cannot meet the rehabilitation needs of patients nationwide. So most of the patients go home and feel their way to recovery after surgery.
Many of them delay the best time for training due to lack of knowledge or fear of pain during training, and thus adhesions occur. As a result, our group of therapists struggled with all kinds of adhesions every day, which was called “leg breaking”.
We also laugh at ourselves: we are probably the group of people who break the most adhesions in the world (an average of about 20 cases per person per month). Because there are basically very few abroad.
What do you break when you “break a leg”?
The so-called scar, not only the skin surface will grow after the trauma, but also inside the joint. The picture shows a specimen of scar removed from the joint during the adhesiolysis surgery. It is white and has a tough texture.
Small areas of scarring can be loosened by the therapist’s manipulation. However, large scars can be difficult and sometimes require release surgery.
What are the complications of “leg wrenching”?
1. Swelling, heat and pain.
Probability of occurrence: ★★★★★
Severity: ☆
Explanation: During “leg breaking”, the scar is torn open (usually a loud sound is heard), and at the same time, other tissues are likely to be damaged, and there is likely to be bleeding and oozing, resulting in swelling and fever.
Countermeasure: This is when pressure bandages and ice must be applied immediately. Ice packs should be applied for 20 minutes at a time. Usually 5-6 times a day. You can rest for 1-2 days before the swelling goes down again.
2.Quadriceps muscle strain
Occurrence probability: ★★★★
Severity: ☆☆
Explanation: Since there are scar adhesions in the joint, there is bound to be long-term joint mobility restriction as well. When the joint moves normally, the quadriceps muscle will stretch repeatedly, just like a very energetic leather band. When the joint is inactive for a long time, the quadriceps muscle also loses its vitality and becomes contracted. In addition, patients do not relax their muscles, so when they “break their legs”, they will not only pull the scar, but also likely to strain the muscle.
Countermeasures: ice, rest, appropriate stretching, suspension of quadriceps strength exercises.
3, knee extension device injury
Probability of occurrence: ★★★
Severity: ☆☆☆☆☆
Explanation: The knee extension device includes the quadriceps, quadriceps tendon, patella, and patellar tendon. In fact, quadriceps strains should be included in this category, but here we will focus on the patellar tendon. In rare cases, the patellar tendon can be damaged during violent leg breaking, mainly because the scar strength is greater than the patellar tendon strength, the patellar tendon is degenerated and its strength is reduced after a long period of disuse, and some patients are extremely uncooperative during training and twist their bodies strongly, which is the reason for the possible rupture of the patellar tendon.
Countermeasure: Suspend training immediately and brake. The next step varies from person to person.
4.Reconstruction of ligament injury
Probability of occurrence: ★
Severity: ☆☆☆☆
Explanation: Too many patients have asked me if the knee flexion training will damage the reconstructed ligaments, but for example: No! Nowadays, the mainstream surgery uses anatomical point reconstruction, and the reconstructed ligaments are basically isometric during knee flexion, which means that there is very little change in the tension of the ligaments during knee flexion. Therefore, passive knee flexion exercises will not damage the reconstructed ligaments. Of course the prerequisite is that the bone tract and point position are accurate and that the training is coordinated.
Figure: Wrong ACL point position leads to joint angle restriction
Countermeasure: Sometimes the bone tract or point position is so poor that a second surgery is likely to be required.
5.Mental breakdown
Occurrence probability: ★★★
Severity: ☆☆☆☆
Explanation: The process of breaking the leg is undoubtedly very painful, but also a test of the quality of will, some people grit their teeth and persevere, and some people choose to give up, that can only end up permanently lost a lot of functions.
Countermeasures: relax your mind, think about happy things, have goals in mind, and encourage each other with fork friends! Fully believe in your “leg breakers” so that you can cooperate with in place, with half the effort.