I. Why do I need functional exercise after a fracture?
”Reset, fixation and functional exercise” are the three major principles of fracture treatment. Whether the fracture can heal quickly, functional exercise can play an important role. Why is functional exercise so important? This is often not understood by many orthopedic patients and their families, and is often not taken seriously. We know that the ultimate goal of orthopedic trauma treatment is to make the injured part recover normal function as soon as possible.
The measures of medical care also revolve around this purpose, no matter it is rectification and fixation, or surgical treatment, it is only the initial treatment work. Only then can the patient reduce complications, heal smoothly and resume work and life as soon as possible. Some people use “three points of treatment, seven points of exercise” to describe functional exercise, which shows the importance of functional exercise for orthopedic patients.
Chinese orthopedic patients have the sixteen-word policy of “combination of movement and static, tendon and bone, internal and external treatment, and cooperation between doctors and patients”.
The role of functional exercise
1.Promote swelling, prevent joint adhesion and stiffness: from the perspective of traditional Chinese medicine, after a fracture, due to local bleeding, the venous and lymphatic flow is blocked, making the surrounding blood flow poor, resulting in swelling and pain at the fracture, which is the “pain if not pass”, early through the appropriate functional exercise, so that muscle contraction, play a local The function of massage, which is also known as “chirping effect” in medicine, makes the blood circulation smooth and achieves “no pain if it is not open”.
Functional exercise can promote venous and lymphatic reflux, promote the absorption of hematoma, reduce swelling, and reduce joint fluid exudation. This prevents joint stiffness caused by adhesions in the joint itself and soft tissues. After the fracture, most people feel that the joint around the fracture is not as active as before, some even swollen and deformed, which can be completely avoided if proper functional exercises are carried out again at the beginning, and the above two articles are self-evidently important for modern beauty-loving women.
2, promote fracture healing: repeated stretching and contraction activities of the injured limb muscles can strengthen the fracture longitudinal squeezing pressure, the fracture gap becomes smaller, the fracture part is more stable, the nutrition of the fracture part can be improved, and the enhanced bone capacity of the fracture end promotes the healing of the fracture.
3, promote blood circulation: functional exercise can promote blood circulation and prevent thrombosis. In long-term bedridden patients, the blood circulation will be slowed down due to the lack of stretching and contraction movement of the muscles, which makes it easy for “thrombosis” to occur. Small thrombus can dissolve by itself, if the thrombus is larger, it comes off from the blood vessel wall and enters the systemic circulation with the blood, which can cause infarction of heart, brain and lung important organs and may cause sudden death of the patient in serious cases.
4, reduce complications: through functional exercise, directly exercise the muscles around the fracture, reducing the degree of muscle atrophy, so that our thighs or arms are not so thin compared to the healthy side of the muscle, thus affecting the appearance of beauty, regular activity exercise, can prevent bone, joint, muscle and other complications, such as osteoporosis, delayed healing of the fracture, joint adhesions, joint capsule contracture, joint stiffness and muscle atrophy, and other complications.
In order for the patient to overcome the injury and recover the maximum range of body functions, the best therapeutic effect can be achieved only by insisting on scientific functional exercises under the guidance of medical personnel. Activities that are not conducive to fracture healing should be prevented as much as possible. This requires us to do the “combination of movement and static”. For example, the abduction activities of the adductor humeral epicondylar neck fracture and the inversion activities of the adductor humeral neck fracture should be avoided.
How to do functional exercise?
For example, after the stiffness of the elbow joint, many people try to move the joint by pulling the bar or lifting the bucket.
So how to carry out the correct functional exercise? Our view is to change passive to active, and the principle of treatment is to give priority to autonomous activities, supplemented by passive activities such as massage and massage, as long as the activities that do not increase the fracture dislocation are advocated, in short, activities that are contrary to the force of the injury at the time are allowed. Depending on the fracture site, we should carry out the correct autonomous functional exercises under the guidance of the doctor.
The close combination of fracture repositioning and functional exercise is one of the characteristics of TCM treatment of fractures. In other words, “tendons and bones together”. A series of functional exercise programs are formulated according to the differences of each fracture and each joint according to the differences of each person and disease. We try to make the patient’s limbs recover to the greatest extent possible.
The purpose of functional exercise during this period is to promote blood circulation in the affected limb, eliminate swelling and prevent muscle atrophy. Functional exercise should be based on the active stretching activity of the affected limb. In principle, the upper and lower joints of the fracture are temporarily inactive. The main form of exercise is the rhythmic contraction and relaxation of the muscles. The upper extremity can make a fist, hang the arm, lift the shoulder, make the whole upper extremity muscle contraction, and then relax. The lower limbs can make the ankle joint dorsiflexion, quadriceps contraction, so that the entire lower limb force, and then relax, one by one gradually. Do not do joint activity exercise in the early stage.
2.Middle term: 2 weeks after the fracture, the fracture has a fibrous connection and is becoming more stable, at this time, the upper and lower joint activities should be started to prevent muscle atrophy and joint stiffness. At this time, the local swelling and pain disappear and the fracture end is more stable due to fibrous healing. The fracture is not easily dislocated under the protection of splinting. In addition to continuing the muscle contraction exercise, do some active joint flexion and extension activities, from one to several joints gradually increase, the lower limb patients can support the bed to walk, the injured limb gradually weight-bearing.
3.Late stage: the fracture has reached the clinical healing standard, the external fixation has been removed, this is the key period of functional exercise. Patients can do some light work within their ability, so that each joint can be fully exercised, and patients with lower limbs can gradually walk with weight under the protection of crutches until the fracture heals firmly.
How to do “both internal and external treatment”?
Apply ointment externally and take self-preparation internally. The external application of ointment on the injured part can quickly activate the blood and silt, relieve the pain, connect the bone and renew the damage, so that the local situation of the injured limb can change rapidly. In addition, Chinese medicine treatment emphasizes “both internal and external treatment”, the early stage of blood activation and siltation, the middle stage of bone repair and damage, and the late stage of liver and kidney nourishment. The use of self-preparation of Chinese medicine is also one of the characteristics of orthopedic traumatology.
Bone Ning Wan, Swelling and Pain Relief Dan, Shu Tendon and Bone Tablet, Chasing Wind and Bone Capsules, Bone and Tendon Cream, Anti-inflammatory and Pain Relief Cream, Blood Activation and Swelling Cream, Orthopedic Washing Medicine, Orthopedic Formula No. 1 and No. 2, etc. are widely used in clinical practice, with remarkable efficacy and trust by patients.
V. The importance of “doctor-patient cooperation
The medical staff should introduce the principles, methods, precautions and importance of functional exercise to the patients in detail, so that the patients and their families can carry out functional exercise with confidence and initiative. Both doctors and patients should be “one heart, one mind and one strength”. In recent years, there is a trend of increasing number of elderly patients with bone and joint injuries.
Studies have concluded that the risk of fracture doubles for every 5 years of age in older adults over 50. Most fractures in the elderly are related to their osteoporosis and limb immobility. Among elderly fracture patients, there are more hip fractures (including femoral neck fractures and intertrochanteric fractures) and thoracolumbar vertebral fractures. These patients require prolonged bed rest for treatment and are prone to decubitus ulcers, cardiovascular disease and urinary tract infections if proper care and exercise are lacking. This requires close cooperation between patients and their families and medical staff for the early recovery of patients.