2006-10-27 / Columnists

Eye On Physical Therapy

Commentary By Dr. Tim Rohrs, DPT

Last month I wrote about letting injured tissue heal properly.

I said that tendons, ligaments muscle would all heal given the opportunity to do so.

Some of you may be wondering, 'If I just need to let them heal why do I need to go for therapy or to see the MD?"

While it is true that tissues will heal on their own, therapy is very important for a few other reasons.

Many people who suffer an injury or are having pain, prescribe bed rest for themselves.

While this will certainly let the injured tissues heal, it allows other things to take place.

First and foremost it lets joint stiffness set in.

When someone has shoulder tendonitis or bursitis and starts to use the other arm for activities of daily living, that joint starts to get stiffer. Especially in the shoulder, a condition known as Adhesive Capsulitis (Frozen Shoulder) can result.

Early in rehab, one goal is to prevent further joint stiffness and maintaining mobility and flexibility.

In most cases it is one tendon, muscle or ligament that has an injury to it.

Isolating that injured part to allow healing while maintaining strength in the surrounding muscles requires the knowledge and skill of the physical therapist. Exercise to maintain the strength of the muscles in the area is just as important as letting the injured body part heal.

There have been numerous studies over the years that show that as few as 4 to 6 weeks of bed rest results in a 35% reduction in strength and muscle atrophy. Clearly, just letting the whole limb rest while an injury heals can be detrimental in the long run.

Finally, the last, but certainly not the least of our goals with rehabilitation is enhancing the healing process.

The best way of achieving that is through increasing blood flow. Nothing increases blood flow like good old fashioned exercise.

Using the bicycle, arm bicycle or treadmill help not only to improve peripheral blood flow but helps improve heart and lung function, improve blood sugar levels and weight control.

An area that is healing often has local swelling and inflammation. Some studies suggest that this inflammation has an overall negative ionic charge.

These studies propose that negatively charged ions in the blood are repelled by this local negative field and healing is compromised.

The increased pressure and blood flow from aerobic exercise flush the inflammation and force edema into the lymph system and healing speeds up.

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