The ABCs of Rehabilitation: What, When, and How?
Contents
1. When rehabilitation is needed?
Rehabilitation is needed when we lose our ability to move freely due to an injury or surgery, our muscles become weak and our abilities or even our self-sufficiency is impaired.
Using personalized therapy, we help our patients mostly after dislocations, fractures, ligament tears and cartilage injuries after they underwent surgery or when they are healing without surgery. The exercises are performed during rehabilitation according to the most recent international and Hungarian protocols, with the utmost care and gentleness.
2. Sports rehabilitation
We treat two main categories of sports injuries: acute and stress injuries.
The former is caused by a one-time injury (dislocation, contusion, sprain, tear or fracture), while the latter is preceded by long-term continuous loading. A precise diagnosis and careful treatment are essential in both cases. We can provide effective help in the establishment of the diagnosis by our special movement tests and manual assessment, and if it is indicated, we recommend the involvement of a physician or diagnostic imaging tests (e.g. X-ray, MRI, sonography).
In our offices, we help in restoring the condition prior to the injury and we improve the endurance and stability of the body. Our goal is to allow athletes to return to the field and to ensure they are prepared to prevent new injuries as well.
Exploring the cause of injury is the most important part of sports rehabilitation. The injury might have resulted from a previous trauma that occurred several years in the past. In this case, both problems must be treated.
3. Post-surgical rehabilitation
We await patients who underwent surgery for the first time after suture removal, or in case of planned surgeries, we provide help already before the surgery in order to improve the patient’s physical condition. Recovery after surgery can be speeded up if the tissues and joints are appropriately strengthened before surgery, even in the form of only 2 or 3 sessions.
Physical therapy, complementary manual therapy and possibly physiotherapy and massage all play a very important role in post-surgical rehabilitation.
Manual therapy can be immensely helpful in reducing the complications arising from compensating movements due to the injury, and thus providing complete recovery and preventing the development of overexertion or weakness in other points of the body on the long term.
At the beginning of the rehabilitation process, we work together with the physician. It is the physician who knows the results of the surgery and thus can say which movement functions can be achieved and when, and we provide help in this process. As the patient’s condition improves, the physician can stop participating in the cooperation and simply books the patient for the next check-up. We still have a role to play until the movement functions are properly restored, and at this time, the patient can resume their everyday life or normal sport activities without any problems.
4. Timing is important!
To ensure fast and effective recovery, rehabilitation should be started as soon as possible after surgery. To understand this, we only have to look at what animals do when they are injured:
Take a dog, for example, with a painful leg which it cannot step on, and it tries to get around on three legs. However, as soon as it is able to, it will put its paw on the ground. It will not step onto it, but touch the ground and put some weight on it after a few days - limping though, but it will use the leg. Then it will step on that leg more often, and finally be able to run without limping.
And what do us, humans do after an ankle sprain? We fix and rest it, saying that “we are letting it heal”. The problem is that by fixing the injured part and excessive resting, we can hinder the healing process, which can later result in complications. Although the aim of fixation is to promote healing and prevent possible injuries, it is often rather harmful.
In case of acute injuries, the initial steps can be taken individually by the patient, so that the healing can begin as soon as possible. We collected these steps in one of our articles.
5. When can you start?
One of our responsibilities is to draw the line, meaning that the injured body part should not be loaded too early, while it should be put into use from the first moment. In case of a minor leg injury, we can take the example of the dog mentioned above, placing load on its leg, gradually increasing it instinctively, always to an extent that is just tolerable. How can we put this into practice?
I can demonstrate this best through the example of a sprained ankle. For the fastest recovery possible, after a short period of rest, try carefully putting some load on the painful leg. For example, on the first day simply put your sole on the ground while brushing your teeth. Then the next day, gently put some weight on it – following a gradual approach, making progress one step at a time.
We also guide or patients along these principles: we give them increasingly more difficult and complex tasks day by day. It is all right if it is slightly painful, because this is the only way to ensure the appropriate pace of recovery and reach our goals as soon as possible.
6. Individual cases
Obviously no two injuries are the same, no two ankle sprains are the same. It is possible that in one case, recovery is achieved within two days, while up to one month might be needed for others. Therefore, regardless if the protocol says not to use your painful leg for two weeks, when it could become better within two days. We can see that complete recovery is very individual, thus physiotherapists are also responsible to define in these cases when and how much the injured leg should be loaded.
7. Preventing complications
A well-planned rehabilitation process can prevent possible complications and facilitates the faster recovery of functions. If, for example, you do not use a joint for a long time, irreversible adhesions or loss of function can develop. These processes are very difficult to reverse on your own, if at all.
8. Assessment is the first step
During the first therapy session, we assess the patient’s status, an integral part of which is the evaluation of past events, how and when the current injuries occurred or the type of any possible surgical intervention and its complications.
If something is unclear, medical records can be helpful, but a well-informed patient is able to tell these information to the physiotherapist appropriately. During the interview, we go through previous injuries and any associated pain or disease, then we continue with the examination. Finally, we summarize the assessment results and develop the treatment plan, which will be the basis of the rehabilitation process. Rehabilitation also includes exercises performed by the patient at home, increasing their activity regularly from time to time so that they can regain their trust in their own body.
9. How much time does recovery take?
It depends on the surgery and the severity of the injury. Generally we can say that rehabilitation after an anterior cruciate ligament replacement can take up to 6 to 12 months. So we have to be prepared that a serious intervention will require longer therapy.
An arthroscopic knee surgery already requires short-term rehabilitation – and in the absence of a larger incision, complete recovery can be expected within 2 to 3 weeks. Ankle sprains can already heal within a few days.
A medium-length rehabilitation procedure (2 to 3 months) can be expected in case of bone fractures if the healing is delayed. After the cast is removed – when the six-week period of bone healing is over – and the bone is properly healed, the further regeneration process will most likely be uneventful and will occur relatively soon. However, in some cases the patient may feel that the are is still numb, sensitive to weather conditions or feels tight even 6-12 months after the cast removal. In such cases, we often hear something like this: “My injured hand is different than the other.” The above mentioned symptoms occur due to scarring, which can be improved by manual therapy. It is worth knowing that during scar formation, the connective tissue adheres to its surroundings because of the changes in the quality and quantity of its hyaluronic acid content. Hyaluronic acid, a lubricant that can be found all over the connective tissue system, helps the tissues to slide and function more smoothly.
10. What happens if you do not undergo rehabilitation?
If you are brave enough and try moving while listening to the reactions of your body, you can avoid complications. Problems arise when you become completely helpless after surgery and use your condition as an excuse to lay in the bed and not use your body for two weeks. This results in the formation of scarring and irreversible conditions.
11. What happens with the surgical scar?
After surgery and suture removal, it is important to take good care of the surgical scar. This can be primarily achieved by physical activity, meaning that you should exercise every day. If you are not able to do this alone, it is recommended to ask help from a professional – it is useful to have a person motivating and helping you.
And another important thing: you do not need to worry about the surgical scar after C-section, it is enough to see a manual therapist 1,5-2 years after giving birth, who will be able to assess manually if there are any adhesions present in the area.
Remember, you have to give yourself enough time to heal. For example, after a C-section, it takes at least two years for the tissues to fully regenerate.
12. What we do not treat?
Sometimes patients come to us with “irreversible” conditions such as rheumatoid arthritis, multiple sclerosis, Parkinson’s disease, Bechterew’s disease etc. In these cases, we recommend to attend regular physical therapy sessions at the specialist outpatient clinic or physiotherapy office closest to your place of residence. Complications may occur that cannot be helped with active physical therapeutic exercise or lifestyle recommendations, and manual therapy is required to improve the patient’s ability to move, their condition and quality of life. In such cases, we are happy to help and complement your regular therapy with manual therapy treatment ever month or every other month.
13. Rehabilitation prices
Status assessment, is the first step to take in every case, which takes 60 minutes.
The status assessment session costs 17.000 HUF.
If a senior physical therapist performs it, it costs 22.000 HUF.
The status assessment includes consultation, testing and treatment.
The further treatment sessions are 50 minutes long and cost 17.000 HUF.
If a senior physical therapist performs them 20.000 HUF.
4.9 / 5
Assessment
Manual therapy
Physiotherapy
Therapeutic massage