What Does Physiotherapy Mean?

What is physiotherapy?

Hands are one of the boby parts we use in our daily life. Being unable to use our hands for any reason substantially affects one’s daily life and business life. For treatment of hand injuries, physical therapy and rehabilitation are both complements for surgery. Unless the patients undergo physiotherapy and rehabilitation supports properly and in a timely manner, it will be very difficult for them to achieve the goals no matter how successful the operations are. The aim of rehabilitation is to augment the functions of the hand and life quality of the patient. The postoperative rehabilitation period varies according to the type of injury and the type of surgery performed. The objective here is to start with the treatment and return the patient to his or her job as soon as possible.

Primary issues that require physiotherapy and rehabilitation in hand surgery are:

Tendon injuries
Nerve injuries
Fractures and other soft tissue injuries of the hand
Replantation
Injuries of brachial plexus
Compressions of nerves (carpal tunnel etc)
Hand rehabilitation for certain professions such as sportmans, musicians…
Congenital hand injuries
Burn injuries of the hand

Tendon injuries: These injuries may result in insufficiencies of hand, especially fingers. Almost all tendon injuries need physiotherapy and rehabilitation after surgical repair. Early and proper treatment is essential to control adhesions and possible joint stiffness around the operation field.

Nerve injuries: Nerve injuries result in loss of sensation and motor abilities(power) in the hand. Nerves are important structures which need a long recovery period after surgery. Follow up with physiotherapy, using custom made splints on the need, and electrical stimulation to support weak or recovering muscles are all a must to reach to the intended target.

Fractures of hand: Such injuries interrupt the integrity of motion and appearance of the hand. These problems often require a long period of immobility in the postoperative period. One of the first aim of physical therapy is to control oedema. In addition to exercises, electrostimulation, and splinting should be used in order to get rid of joint stiffnesses and adhesions due to bony problems as well as long lasting immobility.

Injuries of brachial plexus: Five big nerves extending from the neck region of the spinal cord form a plexus which are responsible from all movements and sensation of whole upper extremity and upper part of the body. For these patient physical therapy should start immediately after the injury. This is very important for two reasons; First, if the patient needs surgery, all joints have to have maximum range of motions at time of surgery. Second, recovery period after surgery is very long. During this period, different kinds of modalities of physical therapy will be helpful. Brachial plexus injuries are seen mostly in two different age groups; newborn babies and young adults. The approach for each patient should be individualized. The collaberation of parents or care takers are very important in achieving successful result.

Nerve compressions: Nerves of the upper extremity might be compressed in various tricky areas along their route. Insufficiencies in both sensation and motor functions are main complaints. Problems due to nerve compressions can be due to incorrect positions and misuses. Although various physical rehabilitation methods and splints control the symptoms, some patients need surgical treatment after physiotherpy.

Hand problems releated with professions: Extensive and repeated use of hands in some professions such as sports and music might result in pain and sensitivity certain complaints in years. As inthe tennis elbow, feeling of pain and sensitivity observed in certain points where frequently used tendons cleave into the bone often get benefits from physical treatment and splints. Surgery might be required in resistant cases wherein complaints do not alleviate.

Congenital anomalies: Various different anomalies might be seen in the upper extremity of newborn. Physiotherapy and rehabilitation have significant importance in these cases pre- and postoperatively.