Put your hands on your hips. Bring your knees in tight.

[venta]

A quick request for data points (or actual genuine knowledge, that would also work ;)

I've started getting physio for the duff knees (of which more later). I'm pretty sure that, when I was a kid and there was always someone in my class with a pot arm (usually for reasons of a falling-off-bike nature), no one was offered physio afterwards. A friend tells me that he did not get physio for a broken leg in the late 80s. A colleague who fractured both her arms a couple of years ago did.

So... is it that NHS treatment of injuries has moved on and decided that yes, physio is a bloomin' useful part of recovery? Or is it just that physio isn't offered to kids, on the grounds that they're bound to start running about as soon as physically possible?

Comments

[ylla.livejournal.com]

Or that it's really useful for e.g. a broken elbow and doesn't make a lot of different for e.g. a clean break in the middle of a long bone? I don't know the answer, though.

[venta.livejournal.com]

That is an interesting point I hadn't considered!

[bopeepsheep.livejournal.com]

My friend's brother had physio in the late 70s after a smashed up shoulder. We were 6 or 7 so he'd have been 9 at most; the lad who broke his thigh and hip at secondary school (~12) had months of physio because the broken bone ends damaged a lot of muscle. [And this is why "bundles" are a terrible terrible idea. I wasn't in it, thankfully, but I still remember watching him being carried off the field and feeling dreadful that we had ever done such a thing.]

I think as ylla says, it's mostly because childhood injuries are usually easily healed breaks in the middle of straight bones, and thus physio isn't a vast amount of help. But I got no physio after my knee was damaged in 1996; when I did the same thing to the same knee in 2000 I got offered physio. Not sure if that was a policy change or merely "if you do it twice, it needs physio".

[venta.livejournal.com]

I only relatively recently learned what a bundle was, from onebyone, I think. No one shouts "bundle" in County Durham.

Mind you, they do (or did when I was at school) shout "pile on", which apparently amounts to the same thing.

Wikipedia doesn't know about bundling, only about bundling (https://en.wikipedia.org/wiki/Bundling_%28tradition%29).

[shermarama]

Only a data point, but when my sister tore ligaments in her knee on a dry ski slope in about 1986, the NHS just put the whole lot in plaster and were going to leave it there for 6 weeks, despite there being no broken bones. A family friend who was a physio objected strongly to this, so they went private (as I recall), got the plaster removed, and she had a brace and physio treatment instead, which had her a long way to recovered after 6 weeks instead of stumping around in plaster all that time.

[shermarama]

Oh, and, I hear it's the pelvic thrusts that really drive you insane.

[venta.livejournal.com]

Actually, I'm doing ok with the pelvic tilts, it's the leg dead lifts that are doing my head in. But you may have a kudo anyway.

[ringbark.livejournal.com]

Dammit (Janet) - I missed out on another kudo. I was going to suggest a step to the right.

Anyhow, i have yet to be convinced that physio does anyone any good. It seems to be painful, protracted and ineffective. But it may simply be the people I know have all been grumps in a lot of pain.

[bopeepsheep.livejournal.com]

I can vouch for it having been useful for me, even though on at least one occasion I went in as a grump in a lot of pain and came out as a grump in a bit of pain. I've had several different courses of it, for different injuries, and in 2002 the fact that they got me from "barely able to walk without wincing" to "trail riding and hiking up a mountain top" in 4 months was seriously impressive. They stopped my pelvis from completely falling apart in 2003 - physio can be preventative or "problem management" as well as curing - but the post-surgery rehab in 2010 was less helpful (partly because the internal stitches had burst and we didn't realise for a while how badly that was affecting me). Physio on a damaged elbow was amazing - learned all sorts of tricks to get it moving without pain, which work on other bits of me. Am hoping the next course does similar for the healing bit of my shoulder, although there's bugger all they can do for the disintegrating part. For that, I'm just hoping for tips on not making it worse.

[venta.livejournal.com]

I am broadly pro physio; I've always seen what I've thought to be pretty positive results myself. Obviously this isn't a great measure, because I don't know how things would have gone for me without physio.

For the last few years I've been voluntarily seeing a physio monthly (and paying for it myself) for ongoing maintenance of non-fixable conditions. I feel I get my moneysworth :)

[ladythmpr.livejournal.com]

Disclaimer: I am in the USA.

I broke my ankle horribly in 1980 at age 18, and got no physio. (Looking back, since I could barely walk after the cast was removed after 14 weeks, I probably should have gotten some, but I was young and what did I know then?)

In the past 10-15 years, for major injuries (broken thumb, torn meniscus), and some minor ones (tendonitis, arthritis), I have been offered physio. It does work for me, but usually in 12 weeks, not the 6 weeks that is normally prescribed. It means that I have to go back and get another prescription if the first 6 weeks didn't get me totally back in working order, but that inconvenience is so worth it.

[venta.livejournal.com]

Thanks for your reply!

It does indeed sound like you ought to have been offered physiotherapy for your ankle, maybe an 18-yr-old would be with a similar injury today. I hope you managed to get it back into working order yourself!

Excepting the thumb, the more recent injuries do sound like the sorts of things I expect to hear of people being offered physio for. In the UK, physio seems to be the answer for any non-specific physical ailment you present to your doctor! Although I was diagnosed with arthritis without being offered physio, though in my case it's pretty minor and doesn't really affect my life.

[ar-gemlad.livejournal.com]

So, I broke my left radial ulna (top of fore-arm, basically elbow) when 6, and my right radial ulna when 20. Both same mechanism - falling onto outstretched arm, coupled with hyperflexion in elbows, leads to the shock being absorbed by the elbow rather than the collarbone, leading to a fracture.

Both injuries were given a 6-week prognosis of getting better.
Neither were plastered, but I was advised to not move the first injury, and was given physio for the second.

Both hurt a bloomin' lot, and the second was extremely painful when doing the exercises. However, I think I was using my right arm with less pain sooner than my left.

According to the physio for the second, it was a change in best practice for the treatment. And also, she had to grab her colleagues to squeal about how much my elbows bent backwards :) ("Oh, you're doing really well! This is nearly straight!" "Yes, but we're aiming for this for normal" "Ooooh, not seen one bend as far back as that before!")

[venta.livejournal.com]

Hmm. How well, exactly, does advising a six year old not to move go? (Though I guess a six year old with a hurty arm may be more inclined to take the advice!)

Surely if the hyperflexion is the (indirect) cause of the injuries, then the physio should have made you stop at 'straight' :) But always nice to be the cause of professional medical excitement!

Interesting to know that that was a change in best practice in, um, presumably the early 00s (ish)?

[ar-gemlad.livejournal.com]

I don't know when the change was - somewhere between *counts it out* 1987ish and 2001.

Yeah - I think having exercises to build up my tendon strength on elbows might have been a good plan! I think it was recommended that I worked on strength when better, but obviously I had better things to do ;) I have stopped showing off my bendy elbows at parties though, since an incident with a fellow bendy when drunk where we both managed to crick our necks at the same time by seeing who could contort the most...

I did have physio on my also hyperflexive legs, which did help a lot (no injury). I think they thought having straight arms wasn't so important as not falling flat on my face fairly regularly.

[drdoug.livejournal.com]

Have three anecdotes. That makes data!

As a teenager in the mid-80s, I fell over on to my hand and they thought I had a scaphoid fracture. They stuck my hand and arm in a pot for many weeks, but when they took it out again and X-rayed it, they decided I hadn't fractured it after all. But my hand and forearm were wasted away and feeble in a slightly terrifying way. I got minimal physio - they handed me a 2cm-diameter plastic tube and told me to grasp and ungrasp it to build up the strength. After it was recovered a bit, it occurred to me that I could give myself exercises to build it up simply by carrying my school bag in that hand. To this day it has stronger muscles, despite being my non-dominant hand.

My brother had a nasty soft-tissue leg injury playing football in the late 80s. I forget the details but it was of a similar magnitude to yours. It was one of those stupid things where, in the rush of play, he stood on the ball awkwardly and fell off with a twisty motion. He got more serious physio for that and - having tried ignoring the exercises and then doing them - he is now an evangelist for doing what the physio tells you. So long as it does work.

Much more recently - like a couple of years ago or so - he had a knee problem which needed surgery. The exercises his first physio gave him were desperately painful and he was making no progress a fortnight later when he turned up for a checkup. A different physio managed to say, in a professional manner, that the previous one had given him terrible advice, before giving him very different exercises, and those helped a lot.

[damerell.livejournal.com]

Tinies generally heal quicker, too, don't they?

[lnr]

When I sprained my ankle badly and chipped the bone I found the fracture clinic were pretty useless - they basically sent me away with my big velcro boot and told me I might be OK to cycle in about 6 weeks and to walk on it as I felt able. So I paid for some private physio. For me it was really worth it - and interestingly the physio herself thought it should be pretty much standard for all bad sprains.