Overcoming Stiffness After Fracture: Tips for Effective Rehabilitation

Fracture adhesion

Hello, doctor.
I fractured my humerus last June and have been in rehabilitation for over six months! Every time I stretch my stiff and tight joint, the angle improves a bit, but after two hours, it returns to its original state...
This constant cycle is really discouraging.
Will my arm really get better? Will I be able to move it normally again? Additionally, I’ve noticed that the angle I can achieve with passive movement is much better than with active movement.
How can I train to improve my active range of motion to match the passive one? What can I do at home to strengthen my muscles? Thank you for your hard work in responding, doctor.

Nai me, 20~29 year old female. Ask Date: 2020/01/20

Dr. Li Yanheng reply Rehabilitation

1.
Given your age, there is a high chance of restoring normal range of motion with active rehabilitation and appropriate treatment.
It is recommended to continue with active rehabilitation.
2.
Each patient's strength training focus is different; it is advisable to provide guidance after a professional assessment.

Reply Date: 2020/01/20

More Info

Overcoming stiffness after a fracture can be a challenging journey, especially when dealing with the aftermath of a significant injury like a humeral fracture. It’s understandable to feel frustrated when progress seems slow or when you experience a regression in your range of motion after rehabilitation sessions. However, with the right strategies and a consistent approach, you can improve your situation.

Firstly, it’s important to recognize that stiffness after a fracture is a common issue. The body’s natural response to injury includes inflammation and the formation of scar tissue, which can lead to stiffness in the affected joints. This is particularly true in the case of fractures, where immobilization is often necessary during the healing process. As you’ve experienced, even after rehabilitation, the stiffness can return if not consistently addressed.

Here are some tips to help you effectively manage stiffness and improve your rehabilitation outcomes:
1. Consistency is Key: Regularly performing your rehabilitation exercises is crucial. Aim for daily practice, even if it’s just for a short period. Consistency helps to maintain flexibility and strength in the muscles and joints.

2. Warm-Up Before Exercises: Before starting your rehabilitation exercises, warm up your muscles with gentle movements or heat application. This can help increase blood flow and make your joints more pliable, potentially improving your range of motion during exercises.

3. Incorporate Stretching: Include both dynamic and static stretching in your routine. Dynamic stretches can help prepare your muscles for activity, while static stretches can improve flexibility. Focus on the muscles surrounding the affected joint, and hold each stretch for at least 20-30 seconds.

4. Use a Combination of Passive and Active Range of Motion Exercises: Since you mentioned that passive movements yield better results than active ones, consider incorporating both types into your routine. Passive range of motion exercises can be performed with the help of a therapist or even a family member, while active exercises should be gradually increased as your strength improves.

5. Strength Training: To bridge the gap between passive and active range of motion, focus on strengthening the muscles around the joint. Start with isometric exercises, where you contract the muscles without moving the joint, and gradually progress to resistance exercises using bands or light weights. This will help build strength and improve your ability to perform active movements.

6. Utilize Assistive Devices: If you find it difficult to achieve the same range of motion actively as you do passively, consider using assistive devices like resistance bands or pulley systems. These can provide support while allowing you to work on your range of motion.

7. Stay Hydrated and Maintain Nutrition: Proper hydration and nutrition play a significant role in recovery. Ensure you’re consuming a balanced diet rich in vitamins and minerals, particularly calcium and vitamin D, which are essential for bone health.

8. Mindfulness and Relaxation Techniques: Stress can contribute to muscle tension and stiffness. Incorporating mindfulness practices, such as deep breathing or meditation, can help you manage stress and promote relaxation in your muscles.

9. Consult with a Physical Therapist: If you haven’t already, working with a physical therapist can provide you with a tailored rehabilitation program. They can assess your progress, adjust your exercises, and introduce new techniques to help you achieve your goals.

10. Be Patient and Set Realistic Goals: Recovery takes time, and it’s important to set realistic expectations for yourself. Celebrate small victories along the way, and remember that progress may not always be linear.

In conclusion, while the journey to recovery from a humeral fracture can be frustrating, it is possible to regain normal function with dedication and the right approach. By incorporating these strategies into your rehabilitation routine, you can work towards overcoming stiffness and improving your overall arm function. Remember to communicate openly with your healthcare team about your concerns and progress, as they can provide valuable support and guidance throughout your recovery process.

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