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KInetoterapia dupa contuzii

Article written by: DR. CATALIN GICAN, Medic primar ortopedie si traumatologie

Physiotherapy after contusions

Bruises are common as a result of direct trauma from falling, crushing, or hitting a blunt body. If the force of traumatic action is exerted obliquely, tangentially, the soft tissue injury will be more extensive but easier, but if it acts perpendicularly, the injury will be deeper, more serious and localized.

The contusion characterized by lesions of deep anatomical formations, without skin lesions, at most with the presence of abrasions, can be: mild (spontaneous, reversible) or severe (deep lesions). The superficial one includes: ecchymosis, hematoma, serum, and the deep one includes muscular contusion, muscular rupture, aponeurotic, tendon, capsulo-ligamentary.
Clinically, the following can be highlighted: pain, hematomas of the soft parts (bruising), hemarthrosis (blood in the articulation), pain, functional embarrassment with limitation of articulation movements, edema (swelling of the respective area). Muscle bruises are often underestimated, often overlooked. In mild muscle contusions, the patient has edema in the muscle and pain with a slight limitation of the movements of the articulations above and below the muscle injury.
Contusion treatment involves an acute phase, but also a recovery phase. The purpose of the acute phase is to prevent the formation of local hematoma, control the inflammatory process and reduce pain. Thus, the patient will follow the RICE method, also found in the treatment of sprains. If the contusion is located in the leg or forearm, the patient should consult an orthopedist to assess the risk of developing a compartment syndrome, the need to immobilize the affected limb or even hospitalize the patient.

The general recommendation is to avoid heat for the first 24-48 hours so as to avoid the spread of hematoma and local edema. Patients who have suffered concussions of the thighs are recommended to use crutches during mobilization because these contusions can be very painful, the load on the bruised limb can extend the injuries caused by the contusion.

The knee articulation should be flexed to the level of pain tolerance, in tandem with compression, thus facilitating drainage of edema from the region.

The contusion normally stabilizes in the first 24-48 hours, a secondary assessment dictating the treatment to be performed and the prognosis. Surgery is not necessary in case of contusions except in situations where compartment syndrome is confirmed.

In the second phase, also known as the recovery / regeneration phase, the main goal is to restore mobility and regain full range of motion. Early mobilization has been shown to significantly reduce recovery time and increase muscle breaking strength.

The patient is ready to progress to the next level of the recovery program when the full range of motion has been restored. Jackson and Feagin have shown that the patient is ready to advance to the next level when a 90-degree knee flexion is achieved. Isometric exercises are started to limit the pain. The load on the bruised limb will be done until the pain threshold. Also, early mobilization increases the vascularity of the injured area, thus decreasing the healing period.

Centrokinetic has an experienced medical team that can help you get over a contusion more easily.
The treatment of contusions also includes a third phase, known as the maturation or remodeling phase, characterized by a gradual recovery of the functional properties of the muscle, including the recovery of the resistance to muscle rupture, a property conferred by the connective component.
Exercises against resistance are encouraged until complete recovery of strength and range of motion is achieved. Remember that a too early or too aggressive recovery process can result in a muscle rupture.


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