Exercise therapy for pelvic fractures is an important part of treatment. It is necessary not only to immobilize damaged bones, but also to improve breathing, as well as maintain muscle tone. Without gymnastics, complications from various organs can occur, and the rehabilitation period after an injury is much more difficult. Therefore, therapeutic exercises begin to be carried out from the first days of therapy. Even if skeletal traction or a plaster cast is used for immobilization, the patient performs movements with his arms, upper body, and he althy leg. Special exercises are also used, such as moving the pelvis up, which makes it possible to place the vessel and greatly facilitates patient care.
How a fracture is treated
The pelvis supports not only the spine, but the entire human skeleton. With the help of these bones, the limbs are attached to the body. In addition, many internal organs are located inside the pelvic ring. Therefore, fractures of this part of the musculoskeletal system are considered severe in medicine.injuries. Usually, pelvic injuries occur in car accidents, traffic collisions, falling under landslides. Injury is accompanied by severe pain and bleeding, a state of shock.
Fracture is diagnosed by x-ray. The rectum is also examined, and women are prescribed a gynecological examination. Fragments of bones can damage internal organs. Then immobilization is carried out, its method depends on the type of fracture. If the bone fragments are displaced, then skeletal traction is applied. With a bilateral fracture, the patient is placed in the Volkovich position: the patient lies on a hard bed with knees apart, special rollers are placed under the legs.
Duration of treatment takes from 1.5 to 6 months. Exercise therapy for pelvic fractures plays an important role in the process of therapy and rehabilitation. Gymnastic exercises help to avoid complications and recover faster.
When can I start therapeutic exercises
After the patient is taken out of the state of shock, you can begin to perform special exercises for fractures of the pelvic bones. Usually, exercise therapy is started on the second day after the patient is admitted to the hospital. Gymnastics cannot speed up the process of bone fusion. But exercise helps prevent congestion in the respiratory system, constipation, muscle weakness and atrophy.
Periods of the medical-physical complex
Therapeutic gymnastics for a pelvic fracture is divided into several periods. At each stage of therapy, physical exercises have their own tasks:
- 1 period. On theat an early stage of therapy, gymnastics is necessary to maintain normal metabolism, prevent a decrease in muscle tone and quickly heal damage. Breathing exercises, movements of the upper limbs, feet and toes are allowed.
- 2 period. At this stage, immobilization is usually already removed. Gymnastics is aimed at strengthening the muscles of the belt, limbs and torso. Gradually begin to train the joints and legs.
- 3 period. During this period of treatment, the patient learns to walk. It is important to restore the support function and mobility of the joints of the lower extremities.
In more detail, each period of exercise therapy after a pelvic fracture will be discussed below.
First exercise period
This stage lasts from 10 to 14 days. Patients can do breathing exercises and active movements of the upper body and arms. The legs must remain on the rollers. Special exercises for fractures of the pelvic bones include lifting the hips (for using the vessel). At first, this movement is performed under the supervision of an instructor, but from 4–6 days of illness, the patient can do it independently.
On the 5-7th day the patient can bend the leg at the knee. The thigh should lie on the roller. If skeletal traction is used, then the patient can make more active movements of the leg on the he althy side.
Exercise therapy for a pelvic fracture during this period can be combined with massage. This will help reduce swelling and prevent blood clots. Massage procedures can be started from 3-4 days, if notcontraindications.
Before starting the exercises, the room must be well ventilated. The head should be in a slightly elevated position. After 10-14 days, you can proceed to the next stage of treatment.
Second period of exercise therapy
How much to do exercise therapy after a pelvic fracture in the second period? This stage of treatment lasts about 2–2.5 weeks. More complex and intense exercises are allowed. In this case, both lower limbs must be involved, and the hips do not rest on the roller. You can bend your knees, lift and hold each leg straight.
Usually 2.5 weeks after injury, patients are allowed to roll over. From now on, exercises for a pelvic fracture can be done not only on the back, but also on the stomach.
If the patient tolerates gymnastics well and does not experience pain during exercise, then after 3–3.5 weeks he is allowed to get up and walk. After that, the third period begins.
Third period of exercise therapy
At this stage, the goal of exercise therapy for a pelvic fracture is to strengthen the muscles of the lower extremities, restore walking and overcome possible lameness. Exercises are performed mainly in a standing position. It is necessary to train the strength and endurance of the muscles of the foot, lower leg, buttocks, thighs.
It is important to establish the correct gait and prevent uneven steps. Otherwise, it may cause lameness in the future. It is useful to take high steps in one place, holding on to the back of a chair orbeds. Then, supporting the patient by the arms, you need to gradually teach him to walk without limping.
Exercises for the first period
All exercises are done lying on your back and keeping your feet on the roller. Exercise therapy for a pelvic fracture during this period should be performed for 20-25 minutes 4-5 times a day. The following exercises are shown:
- Bending and straightening the fingers of the foot and hands (7-11 times each).
- Circular foot movements. First, the exercises are performed with a he althy leg, then with a sick one. Then they make movements with two limbs at the same time.
- Toes grab small objects (balls, pencils).
- Feet rotate in and out and flex and extend.
- Bending the knees.
- Pulling up each leg to the stomach in turn.
- Retract each lower limb to the side and return to the starting position. This exercise is contraindicated in case of trauma to the pubic joint.
- Raise each leg straight up. This exercise for a pelvic fracture should be done while holding on to the edges of the bed.
When doing gymnastics, after each exercise, you need to take a deep breath and exhale completely several times.
Exercises for the second period
During this period, you can perform exercises in the starting position on the stomach. A pillow should be placed under the body. You can increase the load on the lower limbs. At the same time, you need to continue to do gymnastics to strengthen the shoulder girdle, arms and back. You can perform the following exemplary complexexercise:
- Straight legs lift back alternately. Both limbs are raised, holding on to the headboard.
- Spread and bring straight legs (contraindicated in case of damage to the pubic joint).
- Raise the pelvis, leaning on the hands and socks.
- Rise with knees bent.
- Bending the body in the lower back, in the position on the stomach. The same exercise can be done on all fours.
In some types of pelvic fractures, the patient is carefully transferred to the prone position. This applies to damage to the symphysis. The attending physician should prescribe gymnastics, taking into account the patient's condition and the speed of healing of the injury. With good he alth and rapid healing of the fracture in the second period, the patient should learn to roll over on his stomach without using his hands. This will be a good muscle workout.
To perform gymnastics for the arms and shoulder girdle, you need to lie on your back. You need to do the following movements:
- Lower arms along the torso. Then spread the upper limbs in front of you and bring them together in front of the chest. Then lower again along the body. Repeat movements 4-5 times, alternating inhalation (when bringing the hands together) and exhalation (when lowering).
- Spread your arms to the sides and make circular movements, bending in the lower back. In this case, you need to use the muscles of the shoulders and forearms.
- Leaning on your elbows and shoulders, arch your chest.
- Bend the upper limbs at the elbows and make circular movements back and forth.
Exercisefor the third period
What exercises should be done for a pelvic fracture in the third period? These are movements of the legs and arms in a standing position. At the stage of recovery, it is important to establish the correct gait of the patient. Elderly patients at first perform gymnastics, holding on to the back of the bed. The following exercises can be recommended:
- Hands on the belt. The patient takes steps in place, raising his legs high.
- Walking on toes and heels, with simultaneous movements of the hands (forward, backward, up and sideways).
- Swinging legs in all directions.
- Exercise on the gymnastic wall (climbing, push-ups).
You can also do squats, but with caution. This exercise can be performed only if the patient can be on his feet for about 2 hours without feeling discomfort and pain in the area of injury. If the patient has suffered severe damage to the pelvic bones, then you can not squat for another 6-8 months.
Full recovery occurs approximately 1.5-3 months after the fracture.
Features of exercise therapy for acetabular injuries
In case of damage to the recess in the iliac region (acetabulum), the third period of treatment takes place for a long time. Patients are allowed to step on the affected leg later and have to use crutches for longer.
If plaster immobilization is used, then physical therapy is aimed at maintaining movement in the joint. A moderate load is needed along the axis of the limb when the patient is lying down, and during the period of the beginning of walking with crutches in a cast.
Walking for pelvic fractures
To form the correct gait, you need to avoid dragging your legs and moving from one limb to another. A useful exercise in the third period is walking in water.
Walking without crutches is allowed approximately 3 months after the injury. To develop the legs, you need to take daily walks. Their duration should be increased gradually. Special exercise equipment - steppers will also help restore the correct gait.
The process of rehabilitation after a pelvic fracture is different. Many patients manage to fully restore motor function. With damage to the pubic joint, most people remain disabled. It is not uncommon for patients to suffer from recurrent pain syndrome for 1–2 years after the injury. As for professional athletes, they usually do not return to training and competition after suffering an injury.
