Ask a PT

156 Posts
 
Posted - 09/21/2006 :  15:56:26  Show Profile  Reply with Quote
Our user asked: "I am recoverying 10 1/2 weeks from a broken leg. surgery with a plate 14 screws and a couple bolts in the upper portion of the lower leg. doctor has said to start progressing into using a cane but hasn't started PT yet? I have tightenous in the knee and and inflamed muscle adjacent to the knee in the upper portion of the leg. While trying to walk(assisted) the injured leg has sharp pains(sometimes)in the muscle adjacent to the ankle through the lower leg. Looking for advice on getting the muscles stetched and useful. I have been using a exercise bike with no tension and changing elevation of the seat for about a month. Appreciate any information."

Ask a PT Response: "If you have progressed to walking with a cane it might be a good idea to ask your doctor if you could start PT. The symptoms that you are experiencing along with your immobility of your lower extremity for the past few months can definitely affect your ability to demonstrate proper mechanics with gait(walking). You describe "having tightness in the knee and inflamed muscle adjacent to the knee in the upper portion of theleg". This sounds like your quadriceps might be tight. Stretching this muscle along with massage can help decrease the tightness and inflammation. A hot pack to this area prior to the stretch can help increase the pliability of the tissue and make it easier to stretch as well. There are various ways to stretch the quads either in standing, sitting or on your stomach. The basic idea is you want to bend your knee back as far as possible. You will have to see what you can tolerate. You describe "While trying to walk(assisted) the injured leg has sharp pains(sometimes)in the muscle adjacent to the ankle through the lower leg". This is not unusual for patients to expereince. This is a matter of your body, bones and muscles getting use to putting weight through it again. With time this should hopefully improve. Meanwhile from my past experiences with patients that have had similiar surgeries as yours, I have my patients work on range of motion and lower level strengthening exercises for both the ankle and knee. You can see some examples of this on the video list. However, I would definitely recommend you see a PT prior to any self treatment as he/she will be able to better determine where your deficits are and help retrain your gait so you can walk normal or more normal again. The exercise bike is a great thing to be doing but when you see a PT he/she can give you more things to work on. Thanks for using CyberPT."

Our user asked: "Thank you so very much for your response. I contacted the doctor and am in the process of setting up an appointment with a PT. Is it recommended to place heat also along the leg in areas which aren't swelling to promote circulation?"

Ask a PT Response: "For areas that are swollen you would want to use an ice/cold pack. The rational behind this is that the cold acts as a vasoconstrictor (makes the arteries and blood vessels constrict- get smaller) so that less unwanted fluid can get to the area. Swelling is a natural process and is part of healing, but you want to minimize it. As far as heat I usally use it on patients who have pain or tightness in a certain area as the physiological effects of heat assists in helping a muscle relax, helps get the tissue more pliable and promotes circulation. So to answer your question, yes, it should be OK to place hot packs in areas which are not swollen to assist with promoting circulation. Good luck with therapy and thanks again for using CyberPT- "Your Online Physical Therapy Resource"."