This website is under development - The information contained on this site is for guidance only and is not intended for self diagnosis or self treatment. This will not replace professional medical advice or consultation. Always seek the professional advice of a qualified health care provider like your doctor or specialist before embarking on any treatment. If you have a problem please consult your doctor or specialist.
Basic instructions:
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1.
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Wear the sling for the specified period
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2.
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Exercise elbow, wrist and fingers as much you can
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3.
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Focus on
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A) Range of movement (using passive and active assisted exercise) followed by
B) Regaining functional strength
C) Regaining normal pattern and feed back
D) Finally return back to previous state.
Phases of exercises:
Phase 1 exercises - ROM within safe zones
Phase 2 exercises - ROM as able
Phase 3 exercises - Returning back towards normal
Types of Exercises
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1.
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Phase 1: Passive & Assisted (Active or Passive) ROM (Range of movements)
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Passive: No muscles in the joint are used. True passive exercises are difficult to do by yourself and you will need the help of the therapist.
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Assisted (active or passive) Opposite limb provides some support and power. Most exercises you do are usually passive assisted (movement purely with the help of non-
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2.
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Phase 2: Active ROM : Muscles that run across the joint are used and are actively contracting during movement.
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3.
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Phase 3: Strengthening -
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I rarely advocate true immobilisation. It has been recognised that immobilisation can actually promote stiffness and possibly poor healing Unless the risk of disrupting the repair is greater than doing gentle exercises, I do not recommend strict immobilisation. For this reason, I rarely use the body belt (which is know to have poor compliance anyway) and allow phase 1 exercises in the immediate post operative period. Reconstruction of complex fractures are perhaps the only exception when I recommend immobilisation for few weeks.
In my rehabilitation short form mnemonic of 1 - 2 - Go or 2 - 2 - Go, the letters represent the number of weeks phase 1 exercises need to done and the safe range within those week is described. When you reach Go stage, please move on to Phase 2 exercises. The safe range of movement is just an indication and it is not mandatory to reach that range during that time period. Sometimes, I may over-ride the ROM and give specific ranges as per circumstances.
Phase 1 exercises
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Pendular exercises -
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Gentle inner range circular movements
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Shoulder shrugs
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Scapular rotations on chest wall.
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Additional care - check with the therapist the following:
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Mastery in sling
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Personal hygiene -
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Lean to side + a bit forward whilst keeping the arm straight and thus it moves away from body.
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Showering
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Sleeping positions
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Day to day activities
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Dressing/Clothes
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