When the vertebral bones in our spine are subjected to excessive pressure or injury, a compression fracture can occur, often leading to pain, limited mobility, and even a decrease in height. While this might sound daunting, the good news is that physical therapy offers a safe, effective way to alleviate pain. Whether you or a loved one has recently sustained a compression fracture, understanding the benefits of physical therapy is crucial. This blog post will guide you through the importance of physical therapy for compression fractures and offer practical advice on maximizing recovery.
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How Long After a Compression Fracture Should You Start Physical Therapy?
Generally, the decision of when to start physical therapy after a compression fracture depends on several factors, including:
- Severity of the Fracture: Not all compression fractures are equal in severity. A minor, stable fracture may allow a patient to start rehabilitation exercises sooner than a more severe, unstable fracture.
- Type of Treatment Being Used: Some compression fractures are managed conservatively with braces and rest, while others might require surgical intervention. The approach to rehabilitation may differ based on the treatment method.
- Pain Levels: Pain is an indicator of how the body is healing. If pain is extreme, aggressive physical therapy may be deferred. As pain decreases, mobility exercises can gradually be introduced.
- Doctor’s Recommendation: The treating physician, usually an orthopedic surgeon or a spine specialist, will provide guidance on the appropriate time to commence physical therapy. Their recommendation will be based on their assessment of the fracture’s healing progress and the patient’s overall health.
In many cases, some form of gentle movement or positioning exercises can begin relatively early to prevent complications. Still, more aggressive weight-bearing or strengthening exercises will typically be delayed until there’s confidence that the fracture is healing adequately. Always consult with a healthcare professional regarding the appropriate time to begin physical therapy for compression fractures.
What Is The Role Of Physical Therapy For Compression Fracture?
Physical therapy plays a pivotal role in the management and rehabilitation of compression fractures. The role of physical therapy in the treatment of these fractures can be multi-faceted:
- Pain Management
One of the primary goals in the initial stages of therapy is pain relief. Through modalities like heat or cold therapy, gentle mobilizations, and ultrasound, physical therapists can help reduce the pain associated with the injury.
- Improve Mobility
Following a compression fracture, it’s common to experience stiffness or reduced range of motion. Physical therapists introduce gentle exercises and stretches that gradually improve flexibility and restore normal movement.
- Education on Bone Health
For those with osteoporosis-related fractures, physical therapists often provide education on maintaining bone density, including weight-bearing exercises, nutrition, and lifestyle adjustments.
- Bracing
In some cases, a brace may be prescribed to provide external support to the fractured area. Physical therapists can guide patients on the correct use and weaning off of braces.
- Psychosocial Support
Coping with a compression fracture can be emotionally challenging. While primarily focused on physical rehabilitation, therapists also offer support and encouragement, emphasizing the importance of a positive mindset in the healing process.
Overall, physical therapy for compression fractures is a comprehensive approach that addresses the immediate symptoms. And also the underlying causes and long-term prevention strategies.
What Techniques Are Used In Physical Therapy For Compression Fracture?
Physical therapy employs a range of techniques to aid in the recovery from a compression fracture, each tailored to address specific challenges and promote healing. Here are some of the common techniques and modalities used:
Pain Management
- Heat and Cold Therapy: Using controlled temperature, therapists can target affected areas to either stimulate or soothe the tissues. Heat increases blood flow and can help relax muscles, making it useful for stiffness and muscle spasms. Cold, or cryotherapy, constricts blood vessels and reduces inflammation, helping to numb acute pain. Alternating between heat and cold can also be beneficial in certain cases.
- Electrical Stimulation (TENS): TENS devices deliver electrical impulses at variable intensities and frequencies to stimulate nerves, with the goal of disrupting pain signals traveling to the brain. This non-invasive method can be particularly effective for managing chronic pain conditions.
- Ultrasound: Beyond its diagnostic use, therapeutic ultrasound delivers sound waves deep into tissues, creating a micro-massage effect. This can reduce tissue swelling, improve blood flow, and aid in the healing process.
Manual Therapy
- Soft Tissue Mobilization: By manually manipulating soft tissues (like muscles and ligaments), therapists can reduce scar tissue, enhance blood circulation, and relieve muscle tension. Techniques might include kneading, pulling, or rhythmic stretching.
- Joint Mobilization: Gentle, controlled movements applied to joints can increase mobility, alleviate pain, and restore function. For spinal joints, this might involve slow oscillations or more sustained stretches, always taking care not to exacerbate the compression fracture.
Posture Training
- Ergonomic Training: This involves teaching patients how to optimize their work and home environments to maintain spinal health. From adjusting computer screens and seating positions to demonstrating safe lifting techniques, ergonomic principles can prevent undue stress on the spine.
- Postural Exercises: These exercises strengthen the muscles that hold the spine in its natural alignment, such as the back extensors, deep neck flexors, and shoulder blade stabilizers. These exercises often involve subtle movements and sustained postures to enhance the endurance of postural muscles.
Functional Training
- Activity Modification: Beyond basic movements, patients are taught to approach daily tasks differently to protect their spine. This might involve using a reacher tool to pick things up or learning how to roll over in bed without twisting the spine.
- Transfer Training: Especially important after severe injuries or surgeries, this involves teaching patients how to move safely between positions — for instance, transitioning from a bed to a chair or from sitting to standing without jeopardizing the healing fracture.
Gait Training
- Assistive Device Training: For patients who require walking aids temporarily or permanently, proper training is essential. Therapists ensure the device (e.g., cane, walker) is the right height and that the patient knows how to use it effectively and safely.
- Balance Exercises: These exercises help restore stability, which can be compromised after a fracture. Balance challenges might involve standing on one foot, walking heel-to-toe, or using tools like balance beams or wobble boards.
Breathing Exercises
Proper breathing not only ensures adequate oxygen supply but also engages core muscles, which support the spine. Techniques might include diaphragmatic breathing, where patients are taught to breathe deeply using their diaphragm rather than shallow chest breathing. This can also help in pain management and stress reduction.
Home Exercise Program (HEP)
A continuation of the therapy process at home is crucial for sustained recovery. Therapists design personalized exercise regimens that patients can safely perform outside of clinical settings. These exercises reinforce what’s done in therapy and maintain progress between sessions. Clear instructions, often accompanied by visuals or demonstration videos. This will ensure patients can perform them correctly and safely.
The application and emphasis of each technique will vary depending on the specific circumstances of the patient. That even includes the severity of the fracture, pain levels, and the overall health profile.
What Are Some Key Exercises For Compression Fractures?
When recovering from a compression fracture, it’s essential to approach exercises with caution and under the guidance of a trained physical therapist. Here are some key exercises often recommended for patients with compression fractures:
- Pelvic Tilts
Lie on your back with your knees bent and feet flat on the floor. Tighten your abdominal muscles, pushing your lower back into the floor. Slowly return to the starting position.
- Bridge Exercise
Lie on your back with your knees bent and feet flat on the floor. Lift your hips off the floor by squeezing your glutes and pushing through your heels. Slowly lower down.
- Knee-to-Chest Stretch
Lie on your back with your knees bent. Gently pull one knee toward your chest using both hands, feeling a stretch in your lower back. Switch legs.
- Cat-Cow Stretch
Begin on all fours in a neutral spine position. Arch your back upward (like a cat) and then sag it down (like a cow), moving through a comfortable range of motion.
- Wall Angels
Stand with your back against a wall. Keep your arms bent at 90 degrees, and slide them up and down the wall, trying to keep your elbows and wrists in contact with the wall.
- Seated Postural Exercise
Sit tall in a chair with feet flat on the ground. Gently tuck your chin and pull your shoulder blades back and down. Hold and then relax.
- Isometric Abdominal Bracing
Lie or sit comfortably. Tighten your abdominal muscles as if bracing for a punch. Ensure you’re not holding your breath. Hold for a few seconds and then relax.
Remember, always consult with a physical therapist or medical professional before beginning any exercise regimen, especially after an injury like a compression fracture. They can ensure the exercises are performed correctly and safely.
Conclusion
In managing and recovering from compression fractures, physical therapy stands as a cornerstone of effective treatment. From pain management techniques to tailored exercises, it offers a comprehensive approach to rehabilitating the spine, strengthening supporting muscles, and restoring functionality. As patients navigate their healing journey, it’s imperative to consult with healthcare professionals, ensuring that every step and stretch contributes to a safe and efficient recovery.
Remember, while exercises and techniques are invaluable tools, they’re most effective when tailored to an individual’s unique needs and circumstances. Physical Therapy helps patients recover from pain. If you’re experiencing Back, Shoulder, Knee, Neck, Elbow, Hip, or Arthritis pain, a physical therapist at PhysioMantra can help: Book an online physical therapy session.
