OrthopaedicPhysiotherapy.com

Welcome to OrthopaedicPhysiotherapy.com

 

There are two stages in the treatment of orthopaedic injuries or conditions;

  1. The restoration of anatomy (ie. also known as  “healing”) 
  2. The restoration of physiology (ie. also known as “restoring function”.)

Stage One: Restoring Anatomy (“Healing Stage”)

 

Healing is a biological process that the body initiates immediately after tissue injury.

Healing is achieved in two steps;

    1.  Aligning the injured tissues in the right position and close enough to one another so the body can build a “bridge” of repair tissue.
    2. Protecting the site of injury until the repair tissue heals enough to withstand load again.  Slings, casts, braces, splints are common examples of devices designed to protect repair tissue until it heals sufficiently.

Even though the healing process begins immediately it can take weeks to months for the repair tissue to mature sufficiently to withstand load again.

The length of time it will take an injury to heal depends on the following information that your physician or physiotherapist can provide you in their diagnosis.

    1. The injured tissue/tissues (ie. bone, cartilage, muscle, tendon, artery, nerve)
    2. The degree of blood flow in the  injured tissue(s) (ie. low to high)
    3. The type of injury/injuries (ie. fracture, sprain, strain)
    4. The severity of the injury/injuries (ie. mild, moderate, severe)
    5. The healing process can also be delayed in patients who smoke as well as patients with diabetes, rheumatoid arthritis, vascular or arterial diseases.

 

Step Two: Restoring Function (“Rehabilitation Stage”)

 

Restoring function is achieved through safe, appropriate, and progressive rehabilitative exercise.

The key to success is doing the RIGHT exercises at the RIGHT dose at the RIGHT time.

Unlike personal trainers, physiotherapists are recognized as experts by physicians and surgeons in designing safe and appropriate rehab exercise programs.

Rehabilitation exercises are selected to progressively improve joint mobility and muscular strength without disrupting the repair tissue.   The preservation of healing repair tissue is absolutely critical.

Only after the repair tissue has healed sufficiently is it safe to initiate exercise.

Because of the potential for permanent damage caused by inappropriate or premature exercises or activities, physiotherapists and surgeons are very strict in writing  rehab protocols that set out a clear schedule of what  a patient “can and cannot” do at each stage of tissue healing (ie. early rehab, middle rehab, late rehab)

 

Problem #1: Too Much, Too Soon

Unfortunately, if a patient initiates activity or exercises too early it can cause permanent damage to any non-surgical or surgical repair,  delay healing,  and lead to chronic pain and disability.  

 

Problem #2: Too Little, Too Late

In this situation, delayed rehab can result in permanent joint stiffness, severe muscle weakness,  chronic pain, and disability.   For this reason, physiotherapists and surgeons require patients to follow up with them in their clinics to ensure they’re meeting their rehab goals on time.

 

In order to achieve the best possible results – physiotherapists and surgeons typically individualize timelines and exercises based on the patient’s presentation.

How to return to activity as safely and as quickly as possible.

 

  1. See a physician or physiotherapist for an accurate diagnosis as soon as possible after your injury.  
  2. Ask your physiotherapist for a written rehabilitation protocol for your injury, surgical procedure or condition.   
  3. Your physiotherapist may make modifications to your protocol based on how well you are doing.
  4. Do not attempt new exercises or return to activities or sports without permission from your physiotherapist.   To avoid re-injury, ask your physiotherapist first before doing new exercises.
  5. To avoid permanent stiffness and tightness, follow up with your physiotherapist as they recommend.  
  6. To avoid re-injury and chronic pain, restore full muscle strength and function before returning to work or full sports.

 

Terry Kane, Registered Physiotherapist (Calgary, Alberta, Canada)