The Therapy Toolbox - Recovery at home – what can you do?

Following a life changing injury, the body needs time to rest and recover. However, once discharged from hospital, rest and recovery does not mean full bed rest, rather graded exercise and participation in a bespoke rehabilitation program. At Dorset Orthopaedic, our therapy team understand the importance of supporting our clients through their recovery and rehabilitation journey. We form a small part of what may be an extensive multidisciplinary team (MDT) incorporating many different professionals all working together to achieve the same goals – restoring each client to as near pre-accident levels as possible.

The client’s recovery is not the sole responsibility of their MDT, the most important member of the team is the client themselves and how well and how quickly they recover and achieve their goals is in the most part up to them. We will teach clients physical recovery techniques during their sessions in clinic; however it is important that they continue to do this independently at home, in between clinic sessions.

DOMS: It is natural for skeletal muscle to feel sore the day after exercise, a feeling referred to as DOMS – delayed onset muscle soreness, however when also recovering from injury this can be an unsettling experience. The soreness is caused by microscopic tears in the muscle fibres and is a necessary part of building strength. Following the micro injury, protein synthesis occurs – where new protein is produced to repair the muscle and subsequently promote muscle growth. DOMS should improve itself over a few days but below are a few example of things that can be done at home to speed up the process.

Stretching: Following significant limb injury, restrictions in movement are common but can often be reversed and corrected with a dedicated stretching program. Strengthening muscles within a restricted range misses a lot of potential and can ultimately lead to poor movement patterns and long-term pain. Tight, sore and restricted muscles can affect posture, joint range of movement and negatively alter movement patterns. This can all impact on walking technique and use of a prosthesis or orthosis. Holding a muscle in a stretched position helps to lengthen the muscle fibres, increases the blood supply to the area and reduces the likelihood of long-term biomechanical compensations occurring. Stretching programs are bespoke to each client based on their needs and exercises will be taught in clinic prior to being practised at home. Bear in mind that a stretch should not be painful – uncomfortable maybe, but not painful.

Massage: Massage is often advocated as an excellent way to promote muscle recovery after strenuous exercise/gait re-education sessions however massage for relaxation purposes is not the same as sports massage and the two should not be confused! Sports massage helps to lengthen the muscle fibres and flush away any toxins, promoting healing and rapid recovery. This can be done at home by the client themselves, a family member or a registered massage therapist if indicated. Adjuncts such as massage guns can be of benefit, but clients should be taught how to use these effectively to get the most benefit.

Foam rollers: Foam rollers also help to reduce DOMS by applying deeper pressure to the tissues, breaking down potential trigger points before they start to cause problems. The pressure from the foam roller helps to increase circulation in the area, bringing more oxygen to the tissues to aid recovery.

Hot/Cold therapy: There is ongoing debate regarding which is most effective – hot or cold baths following exercise? Some arguments state that hot baths increase blood supply through dilating the blood vessels which in turn helps to flush away toxins in the muscle and promote recovery.

Other papers argue that cold baths reduce blood flow through constricting the blood vessels which in turn reduces inflammation. Ultimately, there are many studies that argue the point for both. At Dorset Orthopaedic, we advise clients to use whichever one feels most effective for them post workout. It is, however, important to be aware that if there is any suspicion that post workout pain is due to injury, not DOMS, avoid heat therapy and speak to the treating team.

Sleep and diet: Good sleep hygiene and eating a diet high in protein, naturally occurring carbohydrates and beneficial fats are incredibly important to aid recovery and promote healing after injury. Sleep gives the body time to recover and restore energy levels whilst a good diet provides the essential nutrients needed to rebuild muscles and prepare the body for further activity the following day.

Whilst our therapy team can give basic advice, support with sleep hygiene and diet must be managed by registered professionals who specialise in these areas. Such individuals form an important part of any MDT and we advocate a strong interdisciplinary working method to support our clients to reach their full potential.

Rest: It is important to incorporate rest days into the rehabilitation plan to prevent overuse of muscles, particularly when learning to use a new prosthetic or orthotic device or if learning a new activity. Rest days should be planned in accordance with the client’s diary week to week. The medicolegal process often requires clients to travel to appointments across the country. This can be both time consuming and draining, physically and mentally, and rest days should be planned accordingly.

Well-being: Following traumatic injury, life often drastically changes and clients find themselves at home with a lot of time to fill. This can lead to over-thinking and cause increased anxiety and stress. There are many techniques that can be used to address these negative thought patterns that clients can practise at home alongside professional support if indicated.

Exercise has been proved to improve mood through the release of endorphins, decrease stress levels, reduce the perception of pain and maintain fitness. Whilst we recognise not every client wishes to or has the physical ability to go to a gym, any form of movement will help, even if it is simply standing up and sitting down. Our therapists will provide guidance on appropriate exercises to practise at home and will teach the correct movement patterns to avoid injury and prevent bad habits from forming.

Mindfulness and meditation techniques can be useful adjuncts to calm busy minds, reduce stress and anxiety and aid relaxation. Practise is required to find what works best for each individual and it is important to try a few different approaches. There are many apps now available that give guidance on techniques to use and programs to follow as well as professionals that can teach such practises if found to be useful.

During therapy sessions, the team at Dorset Orthopaedic will help clients address the many stresses of life following injury and are always on hand to talk. We recognise that life has changed drastically for most of the people who walk through our doors and we will always do our best to help.

For more information on any of the above, please do contact us, arrange an assessment or liaise with the team already involved in the clients care.