SCOLIOSIS

Our spine is naturally curved in order to distribute the weight of the body. A side-view X ray of a soldier standing rigidly at attention would show the cervical spine in his neck arched slightly forward. The twelve thoracic vertebrae curve gently to the rear. Then the lumbar spine, which bears most of our upper-body weight, arches forward as it nears the pelvis. 

About one in twenty-five adolescent girls and one in two hundred teenage boys develop scoliosis. Captured on an X-ray, their spines form, to varying degrees, a more pronounced S shape. When imaged from the back, a normal spine exhibits no curvature. A youngster is said to have scoliosis if her curvature is greater than ten degrees. 

The condition can occur as a complication of polio, muscular dystrophy and other central nervous system disorders, but four in five cases among teenage girls are idiopathic—that is, of unknown cause. Very often, though, a family member will also have had scoliosis. 

Symptoms Suggestive of Scoliosis May Include: 

• Conspicuous curving of the upper body 
• Uneven, rounded shoulders 
• Sunken chest 
• Leaning to one side 
• Back pain (rare) 

Scoliosis can develop quietly for months to years so it may only be picked up by the pediatrician during an examination of the teen’s back. Progression may occur quickly during the teen’s growth spurt. One in seven young people with scoliosis have such severe curvature that they require treatment. 

How Scoliosis Is Diagnosed 

• Physical examination and thorough medical history 
• X-rays 

How Scoliosis Is Treated 

• Bracing: Many such cases never progress to the point that treatment is necessary. Follow-up visits are scheduled approximately every six months for those diagnosed with curves between fifteen and twenty degrees. 

Curvature above twenty-five degrees may call for bracing. There are two main types of orthopedic back braces. The Milwaukee brace has a neck ring and can correct curves anywhere in the spine; the thoracolumbosacral orthosis (TLSO for short, thankfully) is for deformities involving the vertebrae of the thoracic spine and below. The device fits under the arm and wraps around the ribs, hips and lower back. 

Scoliosis patients can expect to wear the brace all but a few hours a day until their spinal bone growth is complete; usually that’s about ages seventeen to eighteen for girls, and eighteen to nineteen for boys. The braces are more cosmetically appealing than they used to be and can be hidden easily under clothing. Having to wear an orthopedic brace interferes only minimally with physical activity. Only contact sports and trampolining are off-limits for the time being. 

• Surgery: Posterior spinal fusion and instrumentation, the operation to surgically correct scoliosis, is typically recommended when the spine’s curvature is fifty degrees or more. The surgical procedure fuses the affected vertebrae using metal rods and screws to stabilize that part of the spine until it has fused together completely. On average, this takes about twelve months. Although teenagers who have the surgery still face some restrictions on physical activity, they can say good-bye to the brace. 

Helping Teens Help Themselves 

Only about 50 percent of young scoliosis patients wear their braces. Parents need to convey the importance of complying with the doctor’s instructions. At the same time, they should be sensitive to the tremendous impact the condition can inflict on a teenager’s body image, which at this age is inextricably entwined with self-identity and self-confidence. You might want to consider asking your pediatrician or orthopedist for a referral to a mental-health professional experienced in counseling children with chronic medical problems. A patient support group, like those run by the Scoliosis Association may also be helpful.

Source - 11/21/2015

Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics)

HIP DYSPLASIA DETECTION IN KIDS

Why does my pediatrician check my baby's hips at each check-up?

Hip dysplasia (developmental dysplasia of the hip) is a condition in which a child's upper thighbone is dislocated from the hip socket. It can be present at birth or develop during a child's first year of life. 

No one is sure why hip dysplasia occurs (or why the left hip dislocates more often than the right hip). One reason may have to do with the hormones a baby is exposed to before birth. While these hormones serve to relax muscles in the pregnant mother's body, in some cases they also may cause a baby's joints to become too relaxed and prone to dislocation. 

Factors that may increase the risk of hip dysplasia include 

• Sex - more frequent in girls 
• Family history - more likely when other family members have had hip dysplasia 
• Birth position - more common in infants born in the breech position 
• Birth order - firstborn children most at risk for hip dysplasia 

Detecting Hip Dysplasia 

Your pediatrician will check your newborn for hip dysplasia right after birth and at every well-child exam until your child is walking normally. 

During the exam, your child's pediatrician will carefully flex and rotate your child's legs to see if the thighbones are properly positioned in the hip sockets. This does not require a great deal of force and will not hurt your baby. 

Your child's pediatrician also will look for other signs that may suggest a problem, including 

• Limited range of motion in either leg 
• One leg is shorter than the other 
• Thigh or buttock creases appear uneven or lopsided 

If you live in the state of Kansas as opposed to Missouri, you can visit a physical therapist like our own Hope Hillyard at Champion Performance and Physical Therapy for an assessment of possible hip dysplasia. If special tests are found positive, at that point it may be beneficial to schedule an appointment with your Pediatric physician for further imaging or testing. If your child's pediatrician suspects a problem with your child's hip, you may be referred to a pediatric orthopedic specialist who has experience treating hip dysplasia. 

Hip dysplasia is rare and in spite of careful screening during regular well-child exams, a number of children with hip dysplasia are not diagnosed until after they are 1 year old.

Source - 11/21/2015

Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)

PIGEON TOES IN YOUR TOT

Pigeon Toes (Intoeing)

Children who walk with their feet turned in are described as being “pigeon-toed” or having “intoeing.” This is a very common condition that may involve one or both feet, and it occurs for a variety of reasons. 

Intoeing During Infancy 

Infants are sometimes born with their feet turning in. This turning occurs from the front part of their foot, and is called metatarsus adductus. It most commonly is due to being positioned in a crowded space inside the uterus before the baby is born. 

You can suspect that metatarsus adductus may be present if: 

• The front portion of your infant’s foot at rest turns inward. 
• The outer side of the child’s foot is curved like a half- moon. This condition is usually mild and will resolve before your infant’s first birthday. Sometimes it is more severe, or is accompanied by other foot deformities that result in a problem called clubfoot. 

This condition requires a consultation with a pediatric orthopedist and treatment with early casting or splinting. 

Intoeing In Later Childhood 

When a child is intoeing during her second year, this is most likely due to inward twisting of the shinbone (tibia). This condition is called internal tibial torsion. When a child between ages three and ten has intoeing, it is probably due to an inward turning of the thighbone (femur), a condition called medial femoral torsion. Both of these conditions tend to run in families. 

Treatment 

Some experts feel no treatment is necessary for intoeing in an infant under six months of age. For severe metatarsus adductus in infancy, early casting may be useful. 

Studies show that most infants who have metatarsus adductus in early infancy will outgrow it with no treatment necessary. If your baby’s intoeing persists after six months, or if it is rigid and difficult to straighten out, your doctor may refer you to a pediatric orthopedist who may recommend a series of casts applied over a period of three to six weeks. The main goal is to correct the condition before your child starts walking. 

Intoeing in early childhood often corrects itself over time, and usually requires no treatment. But if your child has trouble walking, discuss the condition with your pediatrician who may refer you to an orthopedist. A night brace (special shoes with connecting bars) was used in the past for this problem, but it hasn’t proven to be an effective treatment. Because intoeing often corrects itself over time, it is very important to avoid nonprescribed “treatments” such as corrective shoes, twister cables, daytime bracing, exercises, shoe inserts, or back manipulations. These do not correct the problem and may be harmful because they interfere with normal play or walking. Furthermore, a child wearing these braces may face unnecessary emotional strain from her peers. 

Nevertheless, if a child’s intoeing remains by the age of nine or ten years old, surgery may be required to correct it.

Source - 11/21/2015

Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)

RECOGNIZING CONCUSSIONS IN STUDENT ATHLETES

A concussion is a mild traumatic brain injury caused by a direct blow to the head, face, or neck. In the United States, an estimated 300,000 sports-related concussions occur annually.

In high school gender-comparable sports, girls have a higher concussion rate than boys. Female athletes have also been shown to have a greater recovery time in postconcussion symptoms as compared to males.

Signs of a Concussion

Concussion symptoms usually appear within minutes of the injury; however, some symptoms may take several hours to occur. Any athlete who has lost consciousness during a sports-related impact should be examined for a concussion or a spine injury. A headache is the most common complaint of an athlete with a concussion. If you suspect your child has suffered a concussion, they may exhibit the following symptoms, which may worsen with stress or activity:

• Loss of consciousness
• Headache
• Feeling in a “fog”
• Difficulty remembering
• Behavioral changes (irritability, rapid changes in mood, exaggerated emotions, aggressiveness, depression, decreased tolerance to stress, etc)
• Nausea/vomiting
• Difficulty with balance
• Pupils that are enlarged or not equal in size
• Double or blurred vision
• Slurred speech
• Difficulty falling asleep
• Excessive drowsiness

What to do if you suspect a concussion in an athlete:

• Do not allow them to return to any sporting event. 
• The athlete should be allowed to rest until there is a resolution of symptoms. This allows the brain to recover. Rest involves allowing time to sleep or take frequent naps. Minimizing distractions, such as television, Internet, reading, or phone use is important.  
• It is unnecessary to wake the athlete up every hour. This disturbs sleep patterns, which can interfere with the healing process of the brain.
• The athlete should avoid pain relievers, like aspirin or other anti-inflammatory medications. These may increase the risk of bleeding in the brain.
• The athlete should not be left alone following the injury. Symptoms should be monitored closely. If they worsen, the athlete may need to be evaluated in the emergency room to determine if a more serious brain injury exists.  

PT FOR ATHLETES

If you’re an athlete, you know that long periods of training followed by performing at peak levels can take a toll on your body. Whether you’ve experienced an acute injury or have become hurt as a result of overuse, the professional physical therapists from Champion Performance and Physical Therapy in Prairie Village, Kansas can help you get back in the game with their effective sports physical therapy programs.

If you’re an athlete considering sports physical therapy, take a look at some of the ways in which you could benefit from treatment at Champion:

• Less Downtime: Sports physical therapy helps athletes regain muscle strength without damaging the injured area further. This will help you proactively work to repair injured tissue and get back to your training or active recovery period faster and with less downtime.
• Better Odds For A Full Recovery: Instead of letting an injury “ride its course,” physical therapy takes a proactive approach to healing and thus increases your odds of making a complete recovery. Under the care of a physical therapist, you’ll also know exactly when you can resume your normal activity levels again, whereas athletes who don’t seek physical therapy often try to do too much too soon and risk re-injuring themselves.
• You’ll Receive Tailored Treatment: Some athletes make the mistake of trying to rehabilitate their injured body part on their own, but this approach overlooks the fact that each body and injury is unique. The professionals at Therapy Works utilize a number of different treatment methods and have the skills, knowledge, and experience to tailor their sports physical therapy program to the unique needs of each patient.

Click on the contact information tab on our website menu for a full list of contact options. 

www.kcchampionperformance.com

WHAT EXACTLY IS A PHYSICAL THERAPIST?

As described by the American Physical Therapy Association

Physical therapists (PTs) are health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives.

PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles.

Physical therapists provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a physical therapist practices.

The Physical Therapy Profession

Physical therapy is a dynamic profession with an established theoretical and scientific base and widespread clinical applications in the restoration, maintenance, and promotion of optimal physical function. Physical therapists:

• Diagnose and manage movement dysfunction and enhance physical and functional abilities.
• Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health. 
• Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.

The terms "physical therapy" and "physiotherapy," and the terms "physical therapist" and "physiotherapist," are synonymous.

As essential participants in the health care delivery system, physical therapists assume leadership roles in rehabilitation; in prevention, health maintenance, and programs that promote health, wellness, and fitness; and in professional and community organizations. Physical therapists also play important roles both in developing standards for physical therapist practice and in developing health care policy to ensure availability, accessibility, and optimal delivery of health care services. Physical therapy is covered by federal, state, and private insurance plans. Physical therapists' services have a positive impact on health-related quality of life.

As clinicians, physical therapists engage in an examination process that includes:

• taking the patient/client history,
• conducting a systems review, and 
• performing tests and measures to identify potential and existing problems.

To establish diagnoses, prognoses, and plans of care, physical therapists perform evaluations, synthesizing the examination data and determining whether the problems to be addressed are within the scope of physical therapist practice. Based on their judgments about diagnoses and prognoses and based on patient/client goals, physical therapists:

• provide interventions (the interactions and procedures used in managing and instructing patients/clients),
• conduct re-examinations,
• modify interventions as necessary to achieve anticipated goals and expected outcomes, and
• develop and implement discharge plans.

Physical therapy can be provided only by qualified physical therapists (PTs) or by physical therapist assistants (PTAs) working under the supervision of a physical therapist.

UNDERSTANDING BALANCE

Balance is a complex process involving the reception and integration of sensory input and the planning and execution of movement. It’s the ability to control the center of gravity over the base of support in any given sensory environment. Reflexes are automatic responses by the peripheral or central nervous system to help support postural orientation and maintain balance; they occur rapidly enough to not be under volitional control.

Balance is a result of the interaction of three separate systems in the body:

• The Visual System, which helps us see things in the environment and orient us to the hazards and opportunities presented.
• The Vestibular System (the inner ear), which provides the brain with information about the position and motion of the head in relation to gravity.
• The Proprioceptors/ Somatosensory Receptors which are located in joints, ligaments, muscles, and the skin to provide information about joint angle, muscle length, and muscle tension all of which is gives information about the position of the limb in space.

The brain needs input from all three systems to distinguish motion of the self from motion of the environment. Any mismatch in these inputs can produce nausea, vomiting and dizziness. Some common examples that we all experience are

• The sense of perceived motion when sitting in a car at a stop light and the car next to you creeps forward, causing you to slam on your brakes
• When on a boat, proprioceptors perceive a rocking boat under your feet, but your eyes see a steady horizon.

More long-term complications with balance can make an affected person feel persistently unsteady or dizzy. In fact, as many as four out of ten Americans will at some point experience an episode of dizziness significant enough to send them to a doctor. These issues can be caused by improper function of the systems mentioned above, health conditions, or as a side effect from some medications. In severe forms, a balance disorder can intensely impact day-to-day activities resulting in an inability to function and cause psychological distress.

BRACHIAL PLEXUS PALSY

A brachial plexus palsy happens when the nerves of the brachial plexus have been damaged during birth. The brachial plexus is a set of nerves that control the muscles of the arm. Palsy means not being able to move muscles in an area (paralysis).

Nerves are soft, tube-like structures inside the body. They contain many small fibers (filaments), like a telephone cable or a thick electrical cord. These small fibers carry signals from the brain to control the muscles. Nerves also carry signals from the skin to the brain. This is how we feel things on our skin.

The nerves of the brachial plexus go out from the spinal cord under the collarbone and into the armpit. From there, they branch out into individual nerves that control the muscles in the shoulder, elbow, wrist and hand.

When nerves in the brachial plexus get damaged, signals cannot travel like usual from the brain to the arm muscles. So some or all of your child’s arm muscles may no longer work. When this affects only the shoulder and elbow muscles, it is called an Erb’s palsy. When it affects all of the muscles of the arm, hand and wrist, this is known as a total plexus palsy.

Brachial Plexus Palsy in Children

Brachial plexus palsies usually happen because of a stretch injury to your child’s head, neck and shoulder. This can happen during birth, especially when the birth is difficult or complex. Sometimes a child’s shoulder will get stuck against the mother’s pelvis. This can result in a stretch injury as your child is being delivered.

The brachial plexus may be injured if a baby's shoulder gets stuck on the mother's pelvis during birth.

In older children, a brachial plexus palsy can occur because of an injury where the neck and shoulder get stretched.

Many children with a brachial plexus palsy recover on their own. But if the condition does not completely resolve within 1 month, it usually has lasting effects. That’s why we encourage you to have your child assessed 1 month after their birth or injury if they have not fully recovered. If treatment is needed, it’s important to begin early and to have ongoing therapy.

Physical and occupational therapy can reduce problems with stiffness or other bone problems that can happen as a result of the injury. Some children need to wear splints to help position their joints while the nerves are recovering. Some need surgery to repair their nerves.

TMJ DISORDER - JAW PAIN

Temporomandibular joint disorder, or dysfunction, (TMD) is a common condition that limits the natural functions of the jaw, such as opening the mouth and chewing. It currently affects more than 10 million people in the United States. It is sometimes incorrectly referred to as simply “TMJ,” which represents the name of the joint itself. TMD affects more women than men and is most often diagnosed in individuals aged 20 to 40 years. Its causes range from poor posture, chronic jaw clenching, and poor teeth alignment, to fracture or conditions such as lockjaw, where the muscles around the jaw spasm and reduce the opening of the mouth. Physical therapists help people with TMD ease pain, regain normal jaw movement, and lessen daily stress on the jaw.

What Is Temporomandibular Joint Disorder?

Temporomandibular joint disorder (TMD) is a common condition that limits the natural function of the jaw, such as opening the mouth and chewing, and can cause pain. The temporomandibular joint (TMJ) is a hinge joint that connects your jaw to your skull in front of your ear. The TMJ guides jaw movement and allows you to open and close your mouth and move it from side to side to talk, yawn, or chew. TMD can be caused by:

• Bad posture habits. One of the reasons TMD is so common is because many of us spend a great deal of time sitting at a desk, where we often hold our heads too far forward as we work. But there are many other kinds of bad posture. Sitting in the car for a long commute, working at a checkout station, always carrying your child on the same hip—all can place the head in an awkward position and cause jaw problems. The "forward head position" puts a strain on the muscles, disk, and ligaments of the TMJ. The jaw is forced to "rest" in an opened position, and the chewing muscles become overused.
• Chronic jaw clenching ("bruxism"). Many people clench their jaws at night while they sleep, usually because of stress. Some clench their teeth throughout the day as well, especially when dealing with stressful situations. This puts a strain on the TMJ and its surrounding muscles.
• Problems with teeth alignment ("malocclusion"). If your teeth are positioned in an unusual way, greater stress is placed on the TMJ when performing everyday jaw motions, such as chewing.
• Fracture. In a traumatic accident involving the face or head, a fracture to the lower jaw may result and cause TMD. Even when the fracture is fully healed, TMJ stiffness and pain may remain.
• Surgery. Individuals may experience a loss of TMJ mobility and function following certain kinds of surgery to the face and jaw.
• Trismus ("lockjaw"). This condition—where the jaw muscles spasm and the jaw cannot be fully opened—can be both a cause and a symptom of TMD. Other causes of trismus include trauma to the jaw, tetanus, and radiation therapy to the face and neck.
• Displacement of the disc or soft-tissue cushion located between the ball and socket of the TMJ, which causes popping or clicking of the jaw and, frequently, pain.
• Arthritis in the TMJ.

How Does it Feel?

The symptoms of TMD can be temporary or last for years. Jaw pain is the most common symptom.

CAUTION: Jaw pain also can be a symptom of heart attack. Seek medical care immediately if jaw pain is accompanied by: 

• Chest pain
• Shortness of breath
• Dizziness
• Left arm pain
• Numbness in the left arm
• Nausea

TMD can cause the jaw to lock or get stuck in a certain position. You may experience headaches, feel pain when chewing certain foods, or have difficulty fully opening your mouth.

TMD symptoms include:

• Jaw pain
• Jaw fatigue
• Difficulty opening your mouth to eat or talk
• Ringing in your ears
• Dizziness
• Headache
• Popping sounds in your jaw
• Neck pain
• Locking jaw

How Is It Diagnosed?

To identify the cause of your symptoms, your physical therapist may:

• Review your medical history, and discuss any previous surgery, fractures, or other injuries to your head, neck, or jaw.
• Ask you to describe your pain, including headaches, and observe any pain patterns in the neck and TMJ.
• Conduct a physical examination of your jaw and neck, including the soft tissue and muscles in the area.

Your physical therapist will evaluate your posture and observe how your cervical spine—the upper portion of your spine, situated in your neck—moves. Your physical therapist will examine your TMJ to find out how well it functions and whether there are any abnormalities in your jaw motion.

If, after the examination, your physical therapist suspects that your pain is a result of the position ("alignment") of your teeth, the therapist will refer you to your dentist for further examination.

How Can a Physical Therapist Help?

Your physical therapist can help you restore the natural movement of your jaw and decrease your pain. Based on your condition, your therapist will select treatments that will work best for you. Your treatments may include:

Posture Education. If you sit with your head in an increased forward position, you are placing greater strain on the muscles beneath your chin, causing the lower jaw to pull back and the mouth to be in an open position even when resting, increasing stress on the TMJ. You also might be overworking the jaw muscles to force the jaw closed so your mouth isn't open all the time. Your physical therapist will teach you to be aware of your posture so that you can improve the resting position of your jaw, head, neck, breastbone, and shoulder blades when you're sitting and walking.

Improving Jaw Movement. Physical therapists use skilled hands-on techniques (manual therapy) to gently increase movement and relieve pain in tissues and joints. Your physical therapist may use manual therapy to stretch the jaw in order to restore normal joint and muscle flexibility or break up scar tissues ("adhesions") that sometimes develop when there is constant injury.

Your physical therapist will teach you special "low-load" exercises that don't exert a lot of pressure on your TMJ, but can strengthen the muscles of the jaw and restore a more natural, pain-free motion.

Special Pain Treatments. If your pain is severe, your physical therapist may provide treatments, such as electrical stimulation or ultrasound to reduce it.

Referral to a Dentist. If your TMD is caused by teeth alignment problems, your physical therapist can refer you to a dentist who specializes in TMD, who can correct the alignment with special appliances, such as "bite guards" that create a natural resting position to relax the TMJ, relieve pain, and improve jaw function.

PT GUIDE TO WRIST FRACTURE

A wrist fracture is a break in one of the bones near the wrist. In the United States, 1 out of every 10 broken bones diagnosed is a wrist fracture. Injury can occur as a result of a trauma, such as falling while playing sports or simply tripping when walking down a sidewalk. Children are susceptible to wrist fractures because of the high-risk sports they commonly play. A child may sustain a wrist fracture falling off a bike, playing football or soccer, or falling off playground equipment. Wrist fractures are also common in women after menopause, and frequently occur in the elderly population due to falls. A physical therapist can help individuals who have sustained a wrist fracture regain normal wrist motion, strength, and function, and learn how to prevent future fractures.

What Is Wrist Fracture?

A fracture is a crack or a break in a bone. Wrist fractures due to falls happen most often when people stretch the arm straight out to catch themselves as they fall. The wrist is made up of 8 small bones called carpal bones, and 2 bones in the forearm called the radius and the ulna. A wrist fracture is diagnosed when any of those bones breaks or cracks. The most frequently fractured bone is the radius, the bone in the forearm that is closest to the thumb.

There are 3 types of bone fractures:

• Type 1 – a "nondisplaced" fracture, where the bone is broken but is still in a normal position.
• Type 2 – a fracture where a fragment of bone is shifted from its normal position.
• Type 3 – the most serious type of fracture, with multiple breaks of the bone or bones.

Type 1 and 2 fractures usually are treated without surgery. Type 3 fractures, however, usually require surgery.

How Does it Feel?

A fractured wrist is usually painful and movement is affected. If you have sustained a wrist fracture, you may experience:

• Pain in the area of the fracture, which could be anywhere in the wrist, depending on which bone was affected. The pain can radiate from the wrist into the fingers, and even into the forearm.
• Swelling in the wrist and possibly in the hand, usually on the top surface of the wrist and hand.
• Tenderness to touch in the wrist.
• Difficulty and pain when moving the wrist or fingers      

How Is It Diagnosed?

An x-ray is the best way to diagnose a wrist fracture. If you have sustained a fall and are experiencing any of the symptoms mentioned above, you need to visit an emergency room, an urgent-care center, or your physician to get a complete diagnostic x-ray.

If a physical therapist suspects that you have a wrist fracture, the therapist may arrange for an x-ray and refer you to an appropriate physician. Your physical therapist can check for damage to other joints and muscles, and make sure that the nerves and blood vessels in your wrist, forearm, and hand have not been affected by the broken bone. In most cases, people with fractures visit a physician with a specialty in managing bones and joints (an orthopedist). Depending on the type of fracture, the physician might prescribe a cast or a sling to immobilize the area for a period of time until the fracture is healed. The amount of healing time varies, depending on the individual and the type of fracture, and can be anywhere from 4 to 10 weeks. If the fracture is severe, surgery will be required. The recovery time may be longer following surgery, depending on the severity of the injury.

How Can a Physical Therapist Help?

Your physical therapist will work with you following a wrist fracture to help you regain normal wrist motion, strength, and function, and will provide education and training to help you prevent future fractures.

While Your Wrist Is In a Cast or a Sling

While your bone heals, your arm will be in a cast or a sling to keep it still and promote healing. During that time, it is important to ensure that the arm does not get too stiff, weak, or swollen. Depending on the amount of activity that is allowed for your type of fracture, your physical therapist will prescribe gentle exercises to keep your shoulder, elbow, and fingers moving while you are in the cast or sling.

Most people with wrist fractures will slowly return to exercising the other arm and the legs, so that the rest of the body doesn't get out of shape while the fracture is healing. Your physical therapist can help you adapt your exercise program, so that you can maintain your overall strength and fitness without interfering with the healing of your wrist.

When the Cast or Sling Is Removed

After your cast or sling is removed, your wrist will most likely be stiff, and your arm will feel weak. Your physical therapist will examine your wrist, and select treatments to improve its function and restore strength to your arm.

Your rehabilitation will include treatments to:

Reduce Pain. Your physical therapist might use either warm or cold therapeutic treatments, or electrical stimulation, to help control pain or swelling in your wrist, hand, or arm.

Relieve Stiffness. Your physical therapist may use skilled hands-on techniques (manual therapy) to enable your joints and muscles to move more freely with less pain.

Increase Your Strength and Ability to Move. Physical therapists prescribe several types of exercises during recovery from a wrist fracture. Early on, your physical therapist can help you begin to gently move your elbow, using "passive range-of-motion" exercises. As your arm gets stronger, you can exercise it yourself without weights ("active range-of-motion" exercises). Once the bone is well-healed, you can begin to perform resistance exercises, using weights or elastic bands. In addition to prescribing range-of-motion and strengthening exercises, your physical therapist can help you retrain your muscles to react quickly when you need to protect yourself from a fall.

Get Back to Your Daily Activities. Your physical therapist will help you remain independent by teaching you how to perform your daily activities (eg, dressing, working on a computer, and cooking), even while wearing a cast or a sling. Once you can move your arm freely without pain, your physical therapist may begin adding activities that you were doing before your injury, such as using your arm for dressing, grooming, and housekeeping. Your physical therapist will design your individualized program based on an examination of your wrist, goals, level of physical activity, and general health.

Prepare for More Demanding Activities. Depending on the requirements of your job or the type of sports you play, you might need additional physical therapy tailored to meet specific demands. Your physical therapist will develop a specialized program to address your unique needs and goals.

Prevent Long-Term Disability. Everything your physical therapist prescribes for you will help prevent long-term disability by:

• Returning the arm to a strong level of fitness.
• Restoring full movement and strength in a safe manner, while healing occurs.
• Assessing the fracture to make sure that you can return safely to previous home and work activities.
• Guiding you to a safe return to sports and other physical activities. A return too early after a fracture may increase the risk of another fracture.
• Recommending protective equipment, such as wrist guards, for use during sports.

Can this Injury or Condition be Prevented?

In addition to helping individuals prevent long-term disability following a wrist fracture, physical therapists can help different at-risk populations prevent fractures.

• For the aging population, avoiding falls and other trauma is the best way to prevent fractures. Physical therapists are experts at determining your risk of falling, and can teach you how to perform balance exercises and take precautions to avoid falls. They also can perform work and home safety evaluations to make sure that your daily environment is safe.
• For postmenopausal women with osteoporosis leading to a higher risk of wrist fracture, a physical therapist can teach weight-bearing exercises to help build stronger bones. Your physical therapist also may refer you to a nutritionist for vitamin D supplements or other dietary changes to help make your bones stronger. Education in proper posture and body mechanics and joint protection techniques can be helpful in preventing strain on the wrist and arms.
• For children, wearing proper protective gear, such as wrist guards, can reduce the risk of a wrist fracture when playing certain sports. Making sure that playground equipment your child uses is safe and built on a soft surface can also reduce the risk of wrist fractures due to falls.