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Why Getting Back To Activity After Immobilization Is Essential

All over the world it is common practice to temporary immobilize structures after acute-traumatic injuries. Nevertheless, immobilization burdens our musculoskeletal system, leading to degeneration of our tissue structure and substantially reduced function. The longer the immobilization, the longer the following recovery process will last.

According to latest international guidelines the fundamental rehabilitation principle is taking up functional movement as early as possible. Different body structures, such as muscles, cartilage, capsules and even bones will be effected in a different way.

The first striking result of immobilization is the muscular atrophy. Especially upper and lower thigh muscles atrophy within short time. Trials show, that within 4 weeks of immobilization, the muscle profile is reduced by about 20 % – 40 %. The first 50 % of that reduction take place in the first 2 to 5 days and further 3-4 % per day during the following days. After 24 hours without motion, the metabolism inside the muscle slows down, which leads to reduced function and strength endurance. Depending on the immobilization position the mobility and flexibility of muscle tissue reduces as well.

Foundational work in order to build up muscle tissue is the improvement of local metabolism through local and basic endurance training. Next, the interplay between nerves and muscles, as well as the body perception needs to be trained in order to improve the coordination.

Muscle tissue recovery needs up to 4 times longer than the past period of immobility.

Through comparison of the healthy and the injured side, the strength deficit can be measured. Additional measurement of the strength ratio between agonist and antagonist of the impaired body part evaluates the level of muscular disbalance. Targeted strength training then stabilizes the impaired structures and re-establishes strength and loading capacity. Stretching and mobility exercises help to further improve the mobility of the structure to ensure full overall functionality.

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