Physical therapy during fracture of the pelvis: what exercises should I do?

Exercise therapy for fractures of the pelvis is an important part of treatment. It is necessary not only to immobilize the damaged bone but also to establish respiration and maintain muscle tone. Without a gym, it may occur complications in the different organs, and the rehabilitation period after a trauma is much more difficult. Therefore, the therapeutic exercises are starting to do with the first days of therapy. Even if used for immobilization skeletal traction or plaster bandage, the patient performs movements of the hands, upper body and good leg. Used and special exercises, such as pelvic thrusts upwards, which gives the opportunity to enclose the ship and greatly facilitates patient care.

How is the treatment of fracture

The Pelvis support not only the spine, but to the whole human skeleton. With these bones of the limbs attached to the torso. In addition, within the pelvic ring are many internal organs. Therefore, the fractures of this part of the musculoskeletal system are considered in medicine severe injuries. Usually pelvic injuries occur in car accidents, assaults transport, getting under the falls. The injury is accompanied by severe pain and bleeding, shock.

A Fracture is diagnosed by x-rays. Also examine the rectum, and women prescribed a vaginal exam. The bone fragments can damage the internal organs. Immobilization is then carried out, her method depends on the type of fracture. If bone fragments are displaced, the impose skeletal traction. In bilateral fractures, the patient is placed in the position Volkovich: the patient lies on a hard bed with a divorced knees, placed under the feet special cushions.

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The Duration of treatment is from 1.5 to 6 months. Exercise therapy for fractures of the pelvis plays an important role in the process of therapy and rehabilitation. Gymnastic exercises help to avoid complications and recover faster.

When you can begin to exercises

Once the patient is removed from a state of shock, you can start to perform special exercises for fractures of the pelvis. Physical therapy usually start on the second day after placing the patient in a hospital. Gymnastics can speed up the process of accretion of bone. But exercises help prevent congestion in the respiratory tract, constipation, weakness and muscle wasting.

Periods of medical-sports complex

Physiotherapy at fracture of the pelvis is divided into several periods. At each stage of the therapy physical exercises are your tasks:

• 1 period. In the early stage of therapy exercises needed to maintain normal metabolism, prevent the decline of muscle tone and rapid healing of the damage. Allowed breathing exercises, movement of the upper limbs, feet and toes.
• 2 period. At this stage usually remove the immobilization. Gymnastics is directed on strengthening of muscles of a waist, the limbs and trunk. Gradually begin to exercise your joints and feet.
• 3 period. During this period of treatment the patient learns to walk. It is important to restore basic function and mobility of the joints of the lower limbs.

In More detail each a period of physical therapy after fracture of the pelvis will be discussed later.

The First period of physical therapy

This phase lasts from 10 to 14 days. Patients can do breathing exercises and active movement of the upper torso and hands. Feet must stay on the rollers. Special exercises for fractures of the pelvis include the lifting of the hips (for use of the vessel). First, this movement is performed under the supervision of an instructor, but with a 4–6 day of illness the patient can do it yourself.

By 5–7 day, the patient can bend the leg at the knee. The hip should lie on the cushion. If you are using skeletal traction, the patient can perform more active movement of the foot with a healthy side.

Physical therapy broken pelvis during this period can be combined with massage. This will help reduce swelling and prevent blood clots. Massage treatments you can start with 3–4 days, if there are no contraindications.

Before you begin to exercise, the room should be well ventilated. The head should be slightly raised position. 10–14 days, you can move on to the next stage of treatment.

The Second period of exercise therapy

How to do physical therapy after fracture of the pelvis in the second period? This phase of treatment lasts about 2-2.5 weeks. Allowed to perform more complex and intense exercises. Should be involved both lower extremities and hips don't rely on the roller. You can bend your knees to lift and hold each leg in an erect state.

Usually after 2.5 weeks after injury, patients are allowed to roll over. From this point of exercise, a pelvic fracture can be done not only on the back, but on his stomach.

If the patient tolerates the gym and not feel any pain during the exercises, then after 3–3.5 weeks he is allowed to get up and walk. After that we start classes the third period.

Third period physical therapy

At this stage, the goal of physical therapy during fracture of the pelvis is to strengthen the muscles of the lower extremities,recovery of walking and dealing with possible claudication. Exercises are performed mostly in a standing position. You need to train strength and endurance of the muscles of the foot, ankle, buttocks and thighs.

It is Important to establish a proper gait and to prevent the uneven steps. Otherwise it may cause lameness. It is useful to do high steps in one place, holding onto the back of a chair or bed. Then supporting the patient's hands, you need to gradually teach him to walk without limping.

Exercise for the first time

All the exercises do, lying on your back and keeping your feet on the cushion. Physical therapy during fracture of the pelvis during this period should be performed for 20-25 minutes 4-5 times a day. The following types of exercises:

1. Bending and straightening the toes and hands (for 7–11 times).
2. Circular motion foot. First, the exercises do a good leg, then the patient. Next, make the movement of the two limbs at the same time.
3. Toes grab small items (balls, crayons).
4. Turn the Foot inward and outward, and bend and unbend.
5. Bending your legs at the knees.
6. Pulling each leg to the abdomen alternately.
7. Abstraction of each lower limb to the side and return to starting position. This exercise is contraindicated when injury of the symphysis.
8. Lifting each leg in a straight position up. This exercise is a pelvic fracture need to do, holding on to the edge of the bed.

When performing gymnastics after each exercise several times to make a deep inhalation and a full exhalation.

Exercises for your second period

During this period you can perform the exercises in the original position on the stomach. Under the trunk you should put a pillow. Can increase the burden on the lower limbs. At the same time we need to continue to do exercises to strengthen the shoulder girdle, arms and back. You can perform the following exercises:

1. Straight leg raise back one by one. Both limbs are lifted up, holding onto the headboard.
2. To Dissolve and reduce straight leg (contraindicated if the damage of the symphysis).
3. Lift your pelvis, leaning on her hands and socks.
4. Leg raises, bent knees.
5. The Deflection of the body back in position on the abdomen. This same exercise can be done on all fours.

In some types of fractures of the pelvis with the patient's care was transferred to the position on the abdomen. This applies to damage to the symphysis. Assign exercises must doctor, considering the patient's condition and speed healing of injuries. In good health, and fast accretion of the fracture in the second period the patient should learn to roll over on your stomach without using your hands. It will be a good muscle training.

To perform the exercises for hands and shoulder girdle, you need to lie on your back. You must do the following motion:

1. Lower the arms along the body. Then dissolve the upper limb in front of him and drive in front of chest. Then again lower along the body. Repeat the motion 4–5 times, alternating the breath (the hands) and out (when lowering).
2. Hands to dissolve in hand and do a circular motion, bending at the waist. Thus it is necessary to involve the muscles of the shoulders and forearms.
3. Leaning on the elbows and shoulders, to bend the chest.
4. Fold the upper limbs at the elbows and making them a circular motion back and forth.

Exercise for the third period

What exercises you need to do a pelvic fracture in the third period? This movement of feet and hands in standing position. At the stage of recovery it is important to establish the correct gait of the patient. Older patients at first do the exercises while holding on to the headboard. We can recommend the following exercises:

1. Hands on waist. The patient takes steps in place, lifting his feet high.
2. Walking on the toes and heels, with simultaneous movements of the arms (forward, backward, up and to the side).
3. Leg swings in all directions.
4. Exercises on the gym wall (climbing, push-UPS).

You Can do squats, but with caution. This exercise can only be performed if the patient can be about 2 hours on my feet without feeling discomfort and pain in the region of injury. If the patient suffered severe damage to the pelvic bones, it is impossible to squat another 6–8 months.

A Full rehabilitation happens after about 1.5–3 months after the fracture.

Features physical therapy for injuries of the acetabulum

In case of damage of the recess in the iliac fossa (acetabulum) for the third period of treatment lasts for a long time. Patients are allowed to walk on the affected leg later, and you have longer to use crutches.

If you use plaster immobilization, therapeutic exercise aimed at preservation of motion in the joint. Need a reasonable load on the axis of the limb when the patient is lying, and in the beginning of walking with crutches in a cast.

Walking in fractures of the pelvis

To create a proper gait, you need to avoid drawing legs and perevarivaya from one extremity to the other. A useful exercise in the third period is walking in the water.

Walking without crutches is allowed approximately 3 months after injury. For developing feet need daily walking. Their duration needto build up slowly. To restore proper gait will also help special exercise equipment - Steppers.

The Process of rehabilitation after fracture of the pelvis is different. Many patients are able to completely restore motor function. Damage symphysis most people are disabled. Often patients suffer periodic pain within 1–2 years after injury. As for professional athletes, they usually return to training and competition after suffering damage.