Scope of Action
Orthopedic Disorders
Treatment of an orthopedic disorder aims to correct the current problem, stabilize the outcome, and prevent future problems. Within this group of disorders we find those related to bones, joints, ligaments, tendons and muscles.
Regarding the bones, we can highlight a series of conditions in which we obtain results through physiotherapy.
On the one hand, fractures (continuity solutions that originate as a consequence of blows, forces or tractions whose intensities exceed the elasticity of the bone); In this case, the type of fracture treatment will determine the planning of physical rehabilitation, since for example a patient with comminuted fractures repaired with intramedullary nails will have very limited rehabilitation while those with simple fractures in two fragments repaired with bone nail and screws they will have very rapid rehabilitative progress.
On the other hand we find the so-called piezoelectric effect, which is the reason for the perfect structural and functional adaptation of the bone, that is, the adaptation of the bones to the mechanical stress required of them. The bones are subjected to physiological forces that create curvature forces in them, causing a change in their electrical charge. The decrease in negative charges in the bone area triggers the activation of osteoclasts, which results in the destruction of bone tissue. Through physiotherapy (passive exercises, massages and electrical stimulation) we increase blood flow in the soft tissue sheath and underlying bone, exerting a positive influence on the piezoelectric effect, promoting bone formation and preventing the formation and reappearance of fractures.
Regarding the joints, the piezoelectric effect also has a determining role, since it is responsible for stimulating the creation of the fibrils responsible for maintaining the articular cartilage. On the other hand, cartilage degeneration can occur as a consequence of the aging process, due to degenerative disorders (rupture of cruciate ligaments, for example) or due to immobilization, resulting in insufficient water uptake and consequently loss of elasticity and poor resistance to deformations. mechanical. In such cases, the main objective of physiotherapy is to ensure both adequate mobility and correct loading or use of the affected joint. The vicious circle formed by cartilage degeneration, pain, total or partial lack of use and reduced blood flow must be stopped through passive or partially active exercises and by restoring the supply of nutrients necessary for the cartilage. Pain control facilitates these efforts. Massage is useful for dissolving adhesions and electrical stimulation can provide effective, long-lasting relief or reduction in pain.
Ligaments and tendons are responsible for providing joint stability and absorbing the tension that occurs during muscle stretch-contraction. Both must be used regularly to maintain their capacity. Physiotherapeutic measures to combat the pathological processes that undermine this capacity are: massages (to mobilize adhesions and increase blood flow), passive exercises (flexion, extension and electrical stimulation) and aquatic therapy in the case of the ligaments and active extension of the affected tendon for the latter. In the case of tendons, the effect of temperature on their elasticity (elasticity increases by around 1% for every degree Celsius) explains the need to warm up and stretch before exercise.
Finally, muscle tissue degenerates during the healing process from trauma or immobilization as a result of neither contraction nor extension being present at the appropriate magnitude, resulting in muscle shortening and fibrosis. Massages increase local blood flow and mobilize pathological adhesions and since muscles conduct electrical impulses, the treatment of muscle disorders belongs to the field of electrical stimulation. By depolarizing muscle cells, electrical stimulation triggers muscle contraction and reproduces physiological muscle activity without placing loads on the extremities. Induced muscle contractions mobilize adhesions, stimulate local blood flow, improve tissue structure and prevent atrophy.