1.Protection period.
Bed rest or bone traction phase (according to X-ray review by a professional doctor to decide when weight-bearing can begin)
Purpose: To reduce pain and swelling; to promote bone tissue healing and early isometric exercises to avoid muscle atrophy.
(1) Move the toes and ankle joint, and if pain permits, start ankle pump exercises (see Chapter 13, Section 5: Illustration 088).
Promote blood and lymphatic return through the squeezing action of calf muscle contraction and diastole. 5 min/set, 1 set/hour. This exercise is important for preventing swelling and deep vein thrombosis and promoting blood circulation in the affected limb, and should be practiced carefully.
(2) Isometric contraction exercises for quadriceps and N cord muscles (see Chapter 13, Section 4: Illustration 016, 017).
That is, the traction and relaxation of the anterior and posterior thigh muscles. The exercises must be performed in a way that ensures the position of traction, without moving the limb and without generating knee flexion and extension movements. Greater than 300 reps/day. Do as many as possible without increasing pain.
(3) Start straight leg raise plyometric exercises (see Chapter 13, Section 4: Illustration 018).
Straight leg raise after knee extension to heel 15M above bed, hold for 10 seconds and then slowly straighten. 10-20 reps/set, 1-2 sets/day.
(4) Posterior leg raise exercise (see Chapter 13, Section 4: Illustration 020).
Straighten the affected leg and lift it backward until the toe is 5 cm from the bed for 1 time, 30 times/group, 4-6 groups in a row, 30 seconds rest between groups, 2-3 exercises/day.
(5) Side leg raise exercise (see Chapter 13, Section 4: Illustration 019).
Both medial and lateral leg lifts should be practiced, 30 times/group, 4-6 consecutive sets, 30 seconds rest between sets, 2-3 exercises/day.
2. Early.
(After weight-bearing and mobility of hip joint can be started as decided by professional doctor according to X-ray review)
Purpose: Restore hip mobility exercises and start isotonic muscle strength exercises.
() Start active joint flexion and extension exercises (see Chapter 13, Section 5: Illustration 082).
With no or minimal pain and fracture stability, the range of motion cannot reach the angle in the illustration at the beginning of the exercise; the angle must be gradually increased. Slowly and forcefully, flex the knee and hip to the maximum, hold for 10 seconds and then slowly straighten. 10-20 reps/group, 1-2 groups/day. If bone healing is well recovered, aim to approach normal hip flexion angle in about 4 weeks.
(2) Hip mobility exercises in other directions (see Chapter 13, Section 5: Illustrations 083, 084, 085, 086, 087): if the bone healing is well recovered, aim to approach normal hip flexion angle in about 4 weeks.
(3) Start to walk on the ground with crutches.
If there is no pain, the affected leg can be partially weight-bearing (about 1/4 to 1/3 of body weight), pay attention to protection! Do not fall down!
3. Mid-term.
After determining whether weight-bearing can be started by X-ray examination
Purpose: To strengthen the joint mobility. Strengthen muscle strength and improve joint stability. Gradually try to improve gait with weight-bearing on the affected leg.
(1) Weight-bearing and balance exercises (see Chapter 13, Section 6: Illustrations 108, 109).
Must be performed only if the degree of fracture healing allows. Gradual transition of weight bearing from: 1/4 body weight to 1/3 body weight to 1/2 body weight to 2/3 body weight to 4/5 body weight to 100% body weight. 5 min/time, 2-3 times/day.
(2) Continue to strengthen joint mobility exercises.
(3) Start leg muscle exercises.
Prone position “leg hook exercises” (see Chapter 13, Section 4: Illustration 021).
10 times / group, 10-15 seconds hold / time, each interval of 5 seconds, 4-6 sets of continuous exercises, 30 seconds rest between groups. And gradually transition to “standing leg hook exercise”.
Resistance knee extension exercises (see Chapter 13, Section 4: Illustration 027).
10 times/group, 10-15 seconds hold/time, 5 seconds interval each time, 4-6 consecutive groups, 30 seconds rest between groups.
Heel lifting exercises (see Chapter 13, Section 4: Illustration 037).
2 minutes / time, rest 5 seconds, 3-5 times / group, 2-3 groups / day.
4. Late stage.
The following exercises can be started when the bone has recovered and healed well enough to be firm.
Purpose: To strengthen muscle strength and joint stability. Fully resume all activities of daily life.
(1) static squat exercises (see Chapter 13, Section 4: Illustration 022).
Gradually increase the angle of the squat (less than 90°) with increasing strength, 2 minutes/time, 5 seconds interval, 5-10 consecutive sets/group. 2-3 sets/day.
(2) Straddle exercises (see Chapter 13, Section 6: Illustration 111, 112).
Including anterior-posterior and lateral straddle exercises, 20 times/group, 45 seconds rest between groups, 4-6 consecutive sets of exercises, 2-4 exercises/day.
(3) single-leg squat exercises on the affected side (see Chapter 13, Section 6: Illustration 110).
Requires slow, hard, controlled (no swaying). 20-30 times/group, 30 seconds interval between sets, 2-4 times/day.