I am a rehabilitation therapist for the motor system (motor system refers to bones, joints, muscles, ligaments, etc.), mainly after surgery and sports injuries. It is difficult to understand the pain and impact on function of joint adhesions without experiencing them firsthand, and many patients are close to collapse under the double whammy of mental stress and physical pain during their long practice.
In order for fewer people to receive the correct rehabilitation exercises and treatment, to take fewer detours, and to avoid unnecessary pain as much as possible, we are now compiling our experience from our work to share with more people.
Joint adhesions and functional rehabilitation exercises after joint adhesion release are very difficult, long and painful. Although the sites of adhesions are different (shoulder, elbow, wrist, hip, knee, ankle, and other movable joints may have adhesions after injury or surgery), because the mechanisms of adhesions are the same, the principles guiding rehabilitation exercises are the same, and the methods of exercises are similar, so they are grouped together and described.
First, we will explain the mechanism of joint mobility restriction (i.e., joint adhesions that prevent movement) and rehabilitation exercises.
After a long period of limited joint mobility, not only will adhesions occur in the joint cavity, but the corresponding tissues around the joint (e.g., muscles, ligaments, joint capsule, etc.) will also contract (i.e., shorten in length and decrease in extensibility) after a long period of inadequate stretching, which will further aggravate the limited mobility of the joint. Therefore, it is important to treat joint adhesions scientifically at the early stage of treatment. The longer the delay, the more difficult the treatment will be, the more painful the treatment process will be, the longer the treatment will take, and the more difficult it will be to achieve the desired results.
It is because of the mechanism mentioned above that after the release surgery of joint adhesions, it is difficult to achieve a good angle of release pushing in surgery for a long period of time, and it is not that the function of joint movement is restored after the surgery. Rather, it is necessary to achieve good joint mobility through long-term functional exercises, stretching the corresponding tissues, and gradually lengthening all the relevant tissues around the joint, in order to ensure the effect of the release surgery. Otherwise, after the release surgery, not only will the joint mobility not be restored as desired, but it is more likely that the joint will re-adhere and cause more pain.
First, we will explain the situations that may occur during the rehabilitation exercises for joint adhesions, so that we can learn from them and know what kind of situation is not to worry about and is a normal reaction, and what kind of situation is abnormal and must be checked and treated in the hospital immediately.
The rehabilitation exercises for joint adhesions may often occur in the following situations.
First, pain cannot be avoided in the rehabilitation exercises of mobility. The absence of pain means that the limits of existing mobility are not exceeded and the corresponding contracture tissue is not stretched. Therefore, one should not be afraid of pain. Pain during rehabilitation is normal and should be adhered to.
But it must also be highly noted that although pain is normal, it is definitely not the case that the more pain you practice, the better the results! The faster the progress! Continuous damage and stimulation of tissues will not only fail to improve joint mobility, but also increase tissue inflammation, causing very serious complications such as “ossifying myositis”. And bite hard practice is no longer safe, it is likely to cause tissue rupture, such as fractures, muscle tendon rupture and other very bad consequences!
The normal level of pain is, in the process of continuous and treatment, the level of pain is “tolerable”, can not reach the level of “pain”, “heart-breaking”. After practice, it is normal for the pain to subside to its original level within 30 minutes of the end of the exercise. The reaction of the joints after the daily practice should disappear after 24 hours, that is, the pain when practicing, but rest until the next day to fully recover is right!
Second, throughout the process of rehabilitation exercises, the joints will continue to be relatively swollen. As long as there is no significant increase, or a sudden increase in swelling, the overall trend of the degree of swelling of the entire joint and tissue is slowly improving, is normal.
The swelling of the joint and surrounding tissues will gradually decrease until the mobility of the joint is basically back to normal, the exercise is no longer performed with great force, the pain and inflammation of the tissues have dropped to a very low level, and there is no continuous stimulation of the tissues by the exercise, and the swelling will gradually decrease and finally subside completely.
Third, during the rehabilitation treatment of passive joint movement, there may be a small fracture sound of the adhesion band being pulled, sometimes audible, sometimes just felt by the patient, and no obvious sound. The sound of a small adhesion break is like the sound of cotton thread being pulled, and the sound of a large adhesion break is like kraft paper being torn, which is normal as long as it is done scientifically by a professional or under the guidance of a professional and reasonable practice, so there is no need to worry too much.
However, if the pain is severe and cannot be relieved quickly, the joint swells up quickly, or even the shape of the joint changes, it may be a bad problem and must be checked and treated by a hospital as soon as possible. If it occurs during the hospital treatment. The therapist will also deal with it in time. No one will be willing to treat the patient badly, so there is no need to have too much burden of thought.
So here again, we emphasize the safety of joint adhesion rehabilitation! You should never grit your teeth and practice blindly for the sake of pursuing angles! You must find a regular hospital to receive professional scientific treatment and guidance! Problems should be dealt with in a timely manner and should never be delayed!
Fourth, in the joint adhesions after the mobility exercise, there will often be “repeated” phenomenon. That is, in a certain period of time, the angle of the joint will have regression, or progress is not much stagnation. This is the result of a combination of factors such as tissue inflammation and tissue extensibility changes during the rehabilitation process, and is a normal phenomenon that often occurs.
Of course, when this phenomenon occurs, it is necessary to go to the hospital in time for a review, so that the doctor can determine whether it is a normal “repetitive” phenomenon, which requires adjusting the amount and method of practice, and adhering to the practice for a period of time can improve, or there are other problems. Absolutely not to increase the amount of their own private hard practice!