Dear Mel,
I suspect this information is nothing new to the Physiotherapists reading
this page. Unfortunately it seems to have been kept secret from other
health care professionals. In the last three years I have encountered
patients who have had two weeks, or more, bed rest recommended by their
family doctor for low back pain and uncomplicated lateral ankle sprains
encased in plaster for seven weeks on the recommendation of orthopaedic
surgeons.
However it is good to see that this information is no longer classified.
> -----Original Message-----
> From: [log in to unmask] [SMTP:[log in to unmask]]
> Sent: 02 December 1999 23:11
> To: [log in to unmask]
> Subject: MOTION & HEALING
>
> This article on the value of controlled progressive movement and loading
> during rehabilitation may be of interest to readers.
>
> Mel C Siff
>
> ---------------------------------------------
>
> Buckwalter JA Effects of early motion on healing of musculoskeletal
> tissues. Hand Clin 1996 Feb; 12(1):13-24
>
> One of the most important advances in the promotion of musculoskeletal
> healing has come from understanding that treatment of injuries with
> prolonged
> rest may delay recovery and adversely affect normal tissues and that
> controlled early resumption of activity can promote restoration of
> function.
>
> Experimental studies of the past several decades confirm and help explain
> the
> deleterious effects of prolonged rest and the beneficial effects of
> activity
> on the musculoskeletal tissues. They have shown that maintenance of
> structure
> and composition of normal bone, tendon and ligament, articular cartilage
> and
> muscle, requires repetitive use and that changes in the patterns of tissue
>
> loading can strengthen or weaken normal tissues.
>
> Although all the musculoskeletal tissues can respond to repetitive
> loading,
> they vary in the magnitude
> and type of response to specific patterns of activity. Furthermore, their
> responsiveness may decline with increasing age. Skeletal muscle and bone
> demonstrate the most apparent response to changes in activity in
> individuals
> of any age. Cartilage and dense fibrous tissues also can respond to
> loading,
> but the responses are more difficult to measure. The effects of loading on
>
> healing tissues have been studied less extensively but the available
> evidence
> indicates that repair and remodeling tissues respond to loading and that,
> like immature normal tissues, repair tissues may be more sensitive to
> cyclic
> loading and motion than mature normal tissues.
>
> Early motion and loading of injured tissues is not without risks, however.
>
> Excessive or premature loading and motion of repair tissue can inhibit or
> stop healing. Unfortunately, the optimal methods for facilitating healing
> by
> early application of loading and motion have not been defined.
>
> Nonetheless, experimental studies and newer clinical investigations
> document
> the benefits of early controlled loading and motion in the treatment of
> musculoskeletal injuries, and show that optimal restoration of
> musculoskeletal function following injury or surgery requires early
> controlled activity.
>
> -----------------------
>
> Dr Mel C Siff
> Denver, USA
> [log in to unmask]
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