Long road to rehabilitation begins with small steps

It doesn’t take long for an unused part of the human body to become almost unusable.

Only a few weeks after surgery for broken bones, someone who’s spent that time lying down recovering will find unused muscles and tendons are weak. It can become difficult for someone to use them for even simple things, such as bending and flexing.

That’s why immediate physiotherapy is so important, says Tanya Kessling, professional physiotherapist at Rehabilitation in Motion.

“It hurts if you stretch it, but if you don’t, it never comes back,” she says.

She never encourages patients to push through pain. Exercising to the point of pain is good, but it’s important not to go further, she tells a patient working out at her Willow Point clinic.

The man was involved in a car crash several months ago, which snapped a bone in his leg and shattered his ankle. He’s able to walk around now after several surgeries, but it’s difficult and painful. It’s the rebuilt ankle that’s giving him the most trouble – he can hardly flex his foot from the heel while in a sitting position, although it’s better than it was a few weeks ago.

“The big toe’s the next big push,” Kessling tells him, trying to help him flex and lift his toes without lifting his entire foot.

That’s the secret to successful physiotherapy – small goals, Kessling explains later.

“Having those goals is key,” she says. “If you just break it down for them, it doesn’t seem impossible.”

Surgeons set goals for their patients to help them recover lost muscle and tendon use. She helps make it happen.

“The biggest thing people need to see is results,” she says.

Kessling is blunt – it’s a long, difficult road to rehabilitation and seemingly insignificant goals might be discouraging to patients.

“Often the first six weeks is the hardest,” she says.

But once people start seeing improvements, they are encouraged to continue, especially when they understand how their own bodies can be their own worst enemies. Human bodies are excellent at repairing themselves, but they can grow back wrong. People who don’t go through proper physiotherapy can develop painful limps or other symptoms as they adjust their bodies and lives around their injuries, and never fully recover the function in their injured limbs. And they might not even know it.

“The longer your body stays in pain, the more it thinks it’s normal,” Kessling says.

And recovery isn’t easy. She says at least several times a week, she comforts patients who are so discouraged by their slow recoveries they are in tears. But she helps them see that slow and steady effort is the key to getting better, and they usually find the will to continue.

“I think their motivation is the biggest predictor of how someone’s going to do,” she says. “That really comes back to my role as a cheerleader. It’s not just important to get back to work, it’s important to get back to life, and what’s meaningful to you.”

And that’s what the man recovering from his car crash is doing. It’s going to take him at least a year to get his body back to the shape it was before his accident, but he’s determined to stick with the schedule.

And Kessling says that’s what matters most – his determination and his will to get better.

Physio facts:

n The first three months after an injury are the most important. This is when people make the most gains in recovering strength and mobility.

n A delay of even six months before beginning physiotherapy can lead to permanent loss of mobility.

n A physiotherapy regime first helps a patient regain range of motion, then builds strength and finally focuses on functional goals, fine-tuning and relearning motor skills, balance and co-ordination.

n Bones take six to eight weeks to heal. Ligaments and soft tissue can take up to 12 weeks to heal. Soft tissue continues to transform over a whole year after an injury depending on the stress put on it.

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