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Exercises for the development of the elbow joint. Gymnastics for the treatment of pain in the elbow joints. Methods for the treatment of post-traumatic arthrosis

Some patients do not take gymnastics for the elbow joints seriously, considering this treatment method to be ineffective. But still exercise therapy for contracture is one of the the best options and is recommended by doctors as the main method for restoring normal range of motion.

Note. Especially effective are exercises for the elbow joint from Bubnovsky. They are designed in such a way as to obtain the most effective result with due perseverance of the patient: relieve pain and improve the tone of weakened muscles.

Preparation for exercise therapy and basic rules

Gymnastics for arthrosis of the elbow joints requires some preparation and implementation of a list of rules, which will significantly increase efficiency. So, the patient must:

Observe a break between meals and gymnastics for at least 2 hours.
Do a light warm-up before the main exercises (about 5 minutes). This is necessary to warm up the muscles and increase blood flow.

Note! You need to perform warm-up exercises sequentially from top to bottom, that is, start with the muscles cervical, then develop the shoulders, arms, etc. The warm-up must necessarily cover the entire body, and not just the arms.

Doing exercises to strengthen the elbow joint, in without fail should drink liquid in large numbers(minimum 1.4-1.6 liters per day).
It is also necessary to control breathing. Through exercise, muscle tissue and joints receive oxygen and nutrients. Therefore, breathing should be even and deep for maximum saturation of the blood with oxygen.
After you have completed a set of exercises for the elbow joint, you should take a shower (only cool), and then rub your hands with a terry towel. This stimulates additional blood flow and saturates the joint tissues with oxygen and nutrients.
You should eat or engage in the main activity only when the heartbeat has returned to normal and breathing has evened out.

Complex physiotherapy exercises: doing exercises

Therapeutic gymnastics for the elbow joints is simple, and its implementation will not take much time. So, take a starting position - sit sideways to a table or other flat horizontal surface so that its edge is in the armpit, and perform the following exercises to strengthen the elbow joint:

Starting with the vertical position of the forearm, try to bend and unbend the arm at the elbow. Keep a slow pace. Repeat 8-10 times. Gymnastics for joints with arthrosis of the elbow joint should be smooth, without jerks and excessive efforts. In case of acute pain, the exercise should be stopped.

Put your hand on the table, relax your muscles. Take a small ball or other round object (you can use a children's car) and roll it on the surface of the table. Movements should be done with the forearm until fatigue appears.

Swing your arms forward, up and to the sides. You can do both sitting in the same position and standing (10-15 repetitions). Move calmly, without fuss.

Bubnovsky recommends doing the following exercises for the elbow joint using an expander in the form of a rubber band. If the option described above is given to you quite easily, then to complicate it, you need to spread your arms to the sides with a projectile.

Hand movements imitating skiing. You can perform sitting or standing, it is advisable to take sticks in your hands. You can also use an expander. The pace should be calculated taking into account your own feelings.

Important! Thanks to the power elements of exercise therapy, the regeneration of joint tissues occurs much faster. In addition, after regular exercise, the entire neuromuscular system stabilizes its work.

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Peculiarities

The elbow contains many blood vessels and nerves. Due to such a complex anatomy, if the integrity of the joint is violated, surgery is almost always required to restore it.

There are the following types of fractures:

intra-articular;
periarticular;
with offset;
no offset;
closed;
open.

In an injury, one or more bones can be damaged at once. A fracture is often accompanied by a dislocation.

The causes of such injuries are strong mechanical effects on the arm, fall, impact.

Violation of the integrity of the bone is accompanied by sharp pain in the area of the affected joint. Often the pain radiates to the forearm, hand, fingers. Because of it and a violation of the structure of the joint, mobility is limited, but at the same time, “dangling” of the hand can be observed. In the area of damage, edema and hematoma form. With an open fracture with displacement, damage to blood vessels, muscles, and skin occurs, so the injury is accompanied by bleeding and bone fragments are visually visible.

A fracture of the elbow joint is often diagnosed in children, due to their increased activity and not fully strengthened bones. Symptoms of children's fractures are completely similar to adults.

After an injury to the hand, you should immediately seek medical help, this will help to diagnose a fracture in time and avoid complications.

First aid is the main points:

the first step is to ensure the peace and immobility of the injured hand;
then, in order to relieve acute pain and prevent severe edema, ice is applied (any cold-water, frozen foods) and painkillers are given in the form of tablets or injections;
a temporary splint is applied for hospitalization (any materials at hand can be used).

Treatment and rehabilitation

The choice of treatment method to restore the integrity of the joint depends on the severity of the fracture, its type and the presence of concomitant injuries and complications. For this, after the patient is admitted to the hospital, a series of diagnostic examinations is carried out to reveal the full picture. Then a plaster cast is applied.

If a fracture of the elbow joint with a slight displacement is diagnosed, then a manipulation restoration of the correct structure of the joint is performed. But most often, such actions are performed surgically under local or general anesthesia. Operatively, bone fragments are repositioned, nerves, blood vessels, damaged ligaments and muscles are sutured. Bone fixation is carried out using screws, wires or other modern developments in the field of reconstructive surgery. If the articular head is damaged, an endoprosthesis is installed. After all recovery manipulations, an immobilization bandage is applied. The joint is in plaster for at least a month. Exercise therapy is prescribed even when the joint is in plaster to maintain muscle tone and blood circulation. To do this, perform exercises aimed at the work of the shoulder joint and hand.

After the plaster is removed for some periods of time, in order to begin to develop the mobility of the bone. At this time, do exercises for flexion and extension of the arm in the joint.

Rehabilitation is an important stage on the way to full restoration of joint mobility. Ignoring it can lead to ossification of the joint and the formation of contractures.

Rehabilitation includes physical therapy, physiotherapy, therapeutic massage. Joint development is a methodical daily exercise under the clear guidance of a doctor. Physiotherapy and massage are a set of measures that reduce swelling of soft tissues after prolonged immobilization, improve blood circulation and help increase muscle tone. Physiotherapy with calcium strengthens the bone.

Let's designate the main exercises with which the development of the elbow joint is performed.

And so, the first stage of exercise therapy is to perform supportive exercises aimed at:

stimulation of lymphatic drainage;
reduction of puffiness;
maintaining muscle tone.

They begin to perform the very next day after the plaster is applied. These are exercises for bending healthy joints of the injured upper limb. In addition, the hand is moved behind the head in the prone position.

A set of restorative exercises begins to be performed only with the permission of the doctor and at first under his guidance. Lfk in this case is individual. Exercise must be done with care. You need to start with a few repetitions, gradually increasing the load.

What exercises and how many times they need to be performed can be seen in the video.

Fracture of the condyle. Treatment

A condyle fracture is a complex intra-articular injury. Most often, children and adolescents are susceptible to it, in adulthood, it is much less common.

There are fractures:

internal condyle;
external condyle.

They are also divided into:

fractures without displacement and violation of the axis of the joint;
fractures of the condyle with displacement, without violation of the axis;
fractures of the condyle with rotation of the fragment around the axis.

This injury is evidenced by a change in the shape of the elbow joint: enlarged, deformed, the contours are smoothed. There is a violation of the isosceles triangle Guther. The joint is quite mobile in the lateral direction. Movement hurts.

If a condyle fracture occurs without disturbing the position relative to the axis, then the damaged joint is placed in plaster at an angle of 90 degrees for ten days.

When the integrity of the condyles is broken with displacement, then a one-stage reposition is made under anesthesia and a plaster is applied. How long the bandage will need to be worn depends on the age of the patient and the severity of the injury. IN childhood healing occurs within ten or twelve days, while adults need about three weeks. Then you need a complex of rehabilitation measures, it takes 3-4 weeks.

In case of severe injuries of the condyles or from chronic forms, surgical treatment is used.

Joint contracture after fracture. Methods of treatment

Contracture is a disorder of joint mobility that occurs after a fracture. Manifested as difficulty and incomplete flexion, turn of the arm. One of the reasons for the occurrence is the long-term wearing of a cast, as well as complications after an injury. The contracture of the joint leads to its deformation. Her companion is constant severe pain. Contracture is diagnosed with the help of an additional hardware examination. Contracture is treated mainly by conservative methods. Advanced complex cases require surgical intervention.

Elbow contracture is eliminated with the help of special gymnastics, massage, exercise therapy. With this complication, analgesics and hormonal drugs are prescribed. Carry out therapeutic blockade. Manual therapy is also shown.

Operative method, contracture is eliminated with the help of arthrolysis. This technique can be performed both open and closed.

After the operation and before it, it is necessary to perform therapeutic exercises, undergo physiotherapy. Inside the joint, injections of oxygen and hydrocartisone are administered. Such procedures prevent muscle atrophy and accelerate the development of the joint after surgery.

traumahelp.ru

Exercise therapy for damage to the capsular-ligamentous structures of the elbow joint

As a result of a number of injuries of the capsule and ligaments of the elbow joint, with insufficient immobilization, its instability occurs, which is accompanied by excessive deviation of the forearm.

and instability, a pain syndrome is noted, which provokes progressive hypotrophy of the periarticular muscles. In the chronic course of the process, not only periarticular, but also articular structures are involved. Post-traumatic deforming arthrosis develops, contracture is often formed. In some cases tendopathies and neuropathies are observed.

To restore the function or compensate for the functional failure of the elbow joint in case of damage to its capsular-ligamentous structures, it is necessary to carry out a complex set of rehabilitation measures that take into account the pathogenesis of the instability syndrome and secondary changes associated with it.

With partial damage to the capsular-ligamentous structures of the elbow joint (medial section), the treatment is conservative. In acute injury, immobilization is necessary to create conditions that are optimal for the formation of a full-fledged connective tissue scar (immobilization period). In the future, the amplitude of passive movements should be restored in such a way as not to overstretch this scar (early post-immobilization period). At the same time, it is necessary to train the periarticular muscles, which act as active stabilizers of the elbow joint. In this regard, hydrokinesitherapy is used to a limited extent in this group of patients, since it promotes muscle relaxation and can cause an excessively rapid increase in the range of motion.

In the future, after the restoration of the amplitude of movements, an enhanced training of the strength of the periarticular muscles is carried out. At the same time, excessive loads on the emerging scar should not be allowed - forced radial deviation of the forearm. And only after the restoration of amplitude, strength and endurance for long-term work, the task of restoring coordination of movements with additional burdening and resistance (sports movements) is set. Apart from functional characteristics with increasing loads, it is always necessary to focus on the phases of the formation of a connective tissue scar. Intensive power loads can be started no earlier than 2.5 months. after such an injury.

To speed up the process of restoring the strength of the periarticular muscles, additional means of rehabilitation are used:
1) training with biofeedback in strength;
2) isokinetic training;
3) dynamic electrical stimulation of muscles with weights;
4) manual massage of the muscles of the shoulder and forearm according to the tonic technique (without direct impact on the elbow joint).

With more pronounced post-traumatic instability of the elbow joint, the treatment is surgical.

The rehabilitation program after surgical treatment of elbow joint instability consists of four periods:
I period — early postoperative (immobilization of the elbow joint).
II period - late postoperative (restoration of mobility).
III period - pre-training period (restoration of stability).
IV period - training.

The tasks of the first period are the prevention of hypotrophy of the muscles of the operated limb, the improvement of peripheral blood flow and the maintenance of general professional and sports performance.

For this purpose, isometric muscle contractions are used, which can be rhythmic and prolonged. Rhythmic tensions are performed in rhythm 30-50 times per minute. Muscle tensions held for 3 s or more are regarded as long-term. The optimal duration of isometric tension is 5-7 s. Prolonged isometric tension is necessary to increase muscle strength.

From the 2nd day after the operation, rhythmic isometric tension of the flexor muscles of the hand, fingers and shoulder begins by trying to perform movements in the corresponding joints. During one lesson, it is considered optimal to perform 10-12 stresses. During the day, patients should repeat classes up to 20 times.

From the 3-4th day after the operation, isometric tensions become prolonged. Particular attention is paid to the synergistic muscles of the medial ligament, as well as the triceps muscle of the shoulder.

For selective isometric training of muscles at this stage, the use of biofeedback according to EMG is most effective.

After normalization of the general condition (5-7th days after the operation), to maintain sports performance, general developmental exercises are used, active movements with resistance and weights for a healthy limb, walking at an average pace, easy running, jumping in place, squats, lunges exercises on simulators treadmill, etc.). The load is gradually increased by increasing the duration of the lesson and reducing rest breaks.

In addition to LH, during immobilization, a course of rhythmic electrical stimulation of the triceps muscle and hand extensors is performed.

With severe swelling of the periarticular soft tissues, UHF therapy is prescribed in an oligothermal dosage or magnetotherapy.

In the II period, along with the restoration of mobility in the elbow joint, classes are continued to maintain sports performance.

After the termination of immobilization, a special orthosis is put on the arm - a tire consisting of a sleeve of the shoulder and forearm, which are connected by two hinges with locks, which ensure the setting of the limits of the permissible range of motion.

In the first 3-4 days, relaxation exercises are used: active voluntary and post-isometric relaxation. Exercises for stretching the paraarticular tissues are performed strictly in the plane of motion in the shoulder and elbow joint, excluding lateral deviation of the forearm (actively facilitated movements and self-help exercises). Each procedure ends with the placement of the operated limb in the position of flexion and extension of the elbow joint (postural exercise). Delayed mobilization uses "sliding" laying with a roller trolley and on an inclined polished panel.

After the restoration of the full range of motion in the joint, period III begins, the main task of which is to increase the strength and endurance of the muscles surrounding the elbow joint. Exercises with resistance, weighting with a load of up to 6 kg, an expander, etc. are used. Exercises that cause stress in the medial department of the capsular-ligamentous apparatus are excluded. As a rule, movements are performed in a special splint with hinges, which prevents deviation of the forearm.

Additional funds are also used to speed up the process of restoring the strength of the periarticular muscles. These are BFB strength training, isokinetic training, dynamic electrical muscle stimulation with weights, manual massage of the muscles of the shoulder and forearm (without the elbow joint) using a tonic technique.

Together with special exercises, general tonic, auxiliary and imitation sports exercises are performed (running, walking, game elements, exercises with weights for the legs and torso, imitation of a snatch and push with a gymnastic stick for weightlifters, gripping techniques, sweeps with a rubber band for wrestlers); gymnasts perform exercises for flexibility, coordination, balance, etc.

At the end of the pre-training period (more than 2.5 months after the operation), the load on both the general and the operated joint gradually increases, approaching the usual load for a given sport or profession. The rate of restoration of fitness depends on the specialization and qualification of the athlete. Representatives of the martial arts group, complex-coordination and speed-strength sports start training at a later date than those involved in cyclic sports.

The criterion for the admission of an athlete to training is the absence of pain in the area of damage to the capsular-ligamentous apparatus with a load on the joint and tension of the medial ligament, the absence of atrophy of the surrounding muscles, the normalization of their elasticity and bioelectrical activity. The most informative is isometric and isokinetic testing.

M.B. Tsykunov

medbe.ru

Exercises after an elbow injury

Exercise therapy for a bruised elbow joint can be started almost immediately after the injury, but it is better to check with a specialist. Exercises contribute to faster regeneration and return of forearm mobility.

Sit on a stool near the table, turning to it with the side on which the arm was injured. Place your shoulder on the surface so that the armpit lies on the edge of the tabletop, and raise the forearm to a vertical position. Begin to smoothly bend / unbend your arm at the elbow. Do not make sudden movements, and if there is insufficient mobility of the elbow joint, do not help the injured limb with a healthy hand. You should not experience discomfort and especially pain - this is very important! Perform all of the following exercises for 5-8 repetitions.

Take the starting position as in the previous exercise, but do not raise your forearm and take a ball or any rolling toy in your hand. Having fixed the shoulder joint and shoulder, start moving the ball to the left and right so that only the elbow joint works.
Sit or stand up straight and begin to bend and unbend your arm at the elbow. You can take a small weight (ideal dumbbell), for example, a kilogram in each hand.
Stand or sit on a chair and pick up a stick with a grip slightly wider than your shoulders. Begin to perform various movements, bending and unbending the limbs in the elbow joints.
Pick up some ball or tennis ball, and start throwing it up and then catching it. This way you will work on motor skills that may have deteriorated after an injury.
The next exercise exercise therapy for a bruised elbow requires taking a sitting or standing position, and tilting the top of the body forward. Begin to bend-unbend your arms at the elbows. Also try to perform other movements: put the brushes on the back of the head or on the top of the head, linking them into the lock
While in a bath of warm water, perform all kinds of flexion, rotation and extension of the forearms for 10-15 minutes.

Exercise therapy exercises for elbow dislocation

Exercise therapy for the elbow joint with dislocation also includes various exercises to develop the range of motion of the forearm. When training, it is necessary to perform all movements so that there is no pain or even the slightest discomfort. Gradually, the amplitude will increase until it is fully restored.

The following complex of exercise therapy after a dislocation of the elbow joint will not take you much time, but it will help you achieve good results. The number of repetitions in each exercise is 3-5 times.

First you need to slightly warm up the damaged joint, performing circular movements, flexion and extension of the limbs at the elbow. At the same time, change the position of the shoulder by stretching your arms forward, lifting them up or spreading them apart.

A fairly effective exercise from exercise therapy after a dislocation of the elbow are movements with a gymnastic stick. We bring to your attention a simple set of exercises with a gymnastic stick to restore the elbow joint after a dislocation:

Stand up straight, with your feet shoulder-width apart, and take a projectile with both hands (it can even be a mop handle or a shovel handle). Raise the stick above your head and gently lower it behind your head. If you feel uncomfortable, reduce the amplitude or try to lower the projectile to your chest first.
Sit on a stool and rest the stick on the floor at one end, and put your hands on the other. Lean forward, moving your torso forward and shifting the top end of the stick. You will feel tension in the elbow joint of the injured arm as it begins to stretch. Perform the movement smoothly and avoid overstretching.
For this exercise, you will again need a gymnastic stick. Sit on a stool and rest the stick with one end on the floor, and grab the other end with your sore hand. Begin to perform circular rotational movements with a stick so that its lower end does not move.

You can use as a projectile to perform exercises after a dislocation of the elbow and other improvised means. Take an ordinary rolling pin, which should be in the kitchen, and just roll it on the table. When moving away from you, the arms at the elbows will unbend, stretching well, and then bending. This is a great exercise to warm up the elbow joint after a dislocation.

Another great find for exercise therapy after a dislocated elbow is any ball: football, basketball or children's rubber. Start by simply stuffing them from the floor, doing up to 100-200 repetitions for each arm.

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Features of exercise therapy for injuries of the elbow joint

The division of the first period of physiotherapy exercises into 2 stages is accepted. At the first stage, which occurs on the second day after the plaster splint has been applied, in addition to breathing and general developmental exercises, it is planned to perform all kinds of movements in the joints that are free from plaster, the hand should be placed on a pillow behind the head or be in the position of abduction in the shoulder joint. The need for such a position is to prevent the development of edema of the limb, the onset of pain, and also in order to improve blood and lymph circulation. Also, impulses should be sent to the fixed elbow and wrist joints. This refers to the performance of imaginary movements for flexion and extension; tension in the muscles of the forearm and shoulder. At the second stage of the first period, the period of which is determined by the doctor, the plaster splint is bandaged on the forearm to the elbow joint and movements for flexion and extension in the elbow joint are added, the amplitude of movements is 35-45 degrees within the plaster.

The second period includes exercises to develop the elbow joint. It starts from the moment the plaster bandage is removed. The complex of special exercises designed to be performed in the second period with an injury to the elbow joint includes:

sit sideways to the table located on the side of the injured arm. Put the shoulder on the table so that the edge of the table is in the armpit, and the forearm is vertical. It is necessary to actively bend and unbend the arm in the elbow joint, the pace of the exercise should be slow, the little finger should be in projection parallel to the earlobe. When performing this exercise, you can not make jerky movements in the direction of flexion and extension, help yourself with the other hand, forcibly bend and unbend the arm. When performing the exercise, there should be no pain;
sit down, put your forearm on the table, you need to hold a rolling toy in your fingers. The shoulder joint during the exercise must be motionless, in the elbow joint it is necessary to make “swinging” movements for flexion and extension;
sit or stand up and perform exercises on the block - bend and unbend the arm in the elbow joint;
sit down or stand up, take a stick in your hands and perform all kinds of hand movements aimed at flexion and extension;
sit down or stand up, pick up a tennis or rubber ball that you need to throw and catch;
sit or stand with your torso leaning forward. Both arms bend and unbend at the elbow joints. Perform an exercise on weight, putting your hands on your head, behind your head, clasping your hands in a “lock”, etc .;
sit down, placing your hands in warm water, the temperature of which is 35-36 degrees. Perform flexion, extension, turns of the hand with the forearm up and down, circular movements for 10-15 minutes 2 times a day.

Exercise therapy for elbow injury

In the case of a contusion of the elbow joint, the duration of treatment depends on the severity of the contusion, or on the degree of injury received by the ligamentous apparatus. Approximately movements are restored in 2 weeks - 1.5 months. Often, after a bruise of the elbow joint, a person encounters complications: bursitis (accumulation of fluid in the joint bag or near it) and neuritis (inflammation of the nerve), which requires long-term treatment, in which it is contraindicated to load the limb (hanging on the hands, resting on the hands, wearing heavy ). Exercise therapy for a bruised elbow in this case provides for the implementation of only those exercises in which pain does not occur, and the exercises should be performed slowly.

Exercise therapy for dislocation of the elbow joint

In case of dislocation of the elbow joint during exercise therapy, it is contraindicated to make passive movements, overstrain and tire the muscles, wear weights, and perform exercises that can cause pain. In addition, you can not rest on your hands and hang on them. If the warnings are neglected, a number of complications may develop (the occurrence of edema, pain in the joint, reflex muscle contraction leading to contracture of the elbow joint, calcification of the muscles, growth of bone deformities, for example, "spurs"), which are the cause of the development of chronic deforming arthrosis of the elbow joint, when it periodically accumulates liquid. If movements in the elbow joint are limited, then in the third period, exercise therapy should be continued in case of dislocation of the elbow joint in water. In addition, it is planned to carry out physiotherapeutic procedures (mud therapy, paraffin), then a set of physical exercises. Each exercise should be repeated 4-6 times in all periods, and the complex itself should be repeated from 4 to 6 times a day. At all stages of treatment, massage and self-massage are contraindications.

If you notice that the movements associated with flexion and extension of the elbow are more difficult, it may be arthrosis of the elbow joint, the symptoms, treatment and prognosis of which directly depend on the stage of the disease when seeking medical help. The pathological process begins imperceptibly. Quite often, it is preceded by a long-standing dislocation, a fracture, or a fall on an arm bent at the elbow.

The destructive process begins with a gradual loosening and detachment of cartilage scales. They enter the joint fluid and onto the articular surfaces, acting as an abrasive. Because of this, the articular membrane becomes inflamed, an excessive amount of intra-articular fluid is produced, and this aggravates the destruction of cartilage. The joint swells, becomes hot to the touch and begins to hurt. After the bone tissue is exposed, movements in the joint cause unbearable pain, and at night the elbow aches and hurts. As arthrosis develops, bone growths - osteophytes - appear in the joint, which further deforms the joint and leads to restriction of movement (contracture).

Reasons for the onset of arthrosis:

Injuries of varying severity - dislocation, intra-articular fracture, hemorrhage into the joint, ligament rupture, etc.
Systematic increased loads of the elbow joint - overweight, carrying heavy loads, improper exercise program.
Work associated with vibration - blacksmithing, the use of a jackhammer, perforator, etc.
Professional sports - weightlifting, fencing, tennis, etc.
Age-related changes in cartilage tissues after 45-50 years.
Heredity and genetic abnormalities. Joint diseases can haunt members of the same family.

At the very beginning, the disease manifests itself little, changes in the cartilage grow very slowly. Arthrosis of the 1st degree is characterized by muscle weakness. Moreover, the patient himself does not notice this yet, the doctor will notice it after the patient performs a few simple exercises. Sometimes a person experiences pain when putting a hand behind the lower back, when bending and unbending the elbow. It is found when shaving, combing hair, washing hair or putting on make-up.

With arthrosis of the 2nd degree, problems with the hand increase. It is difficult to lift or carry a heavy bag with a sick hand or bend it at the elbow. All movements are accompanied by severe pain and a distinct crunch in the elbow joint. Muscle atrophy increases as the person avoids movements in that arm. On examination, the doctor checks for the presence of Thompson's symptom, when the patient cannot keep his hand clenched into a fist in the dorsiflexion position. Another indicative movement is the simultaneous flexion of the forearms of both hands. Welt's sign is positive when the affected joint responds more slowly to a command.

Arthrosis of the 3rd degree is accompanied by constant pain, it does not go away even during a night's rest. Bone osteophytes cause excruciating pain, there is a restriction in the movement of the joint. To reduce pain, patients with arthrosis often fix their hand in a knitted handkerchief thrown over the neck. If left untreated, contracture of the joint develops, and the arm freezes in a slightly bent position.

Half of all cases of elbow arthrosis are deforming arthrosis. This form of the disease is characterized by bone growths already at the first stage. They appear on the distal epiphysis of the humerus and around the joint of the elbow bone. If the osteophytes are pressed into the cubital fossa, there is limited movement. At the second stage, osteophytes evenly surround the entire elbow joint, stiffness of movements is aggravated. At the third stage of deforming arthritis, sclerosis of adjacent bones is added to osteophytes. The inability to move the hand and severe pain can only be eliminated after surgery.

To make a diagnosis, the doctor will send you for an X-ray examination of the elbow joint. The main signs of arthrosis are a decrease in the joint space, the presence of bone growths, and deformation changes in the articular surfaces and bones. In addition to this, you need to submit general analysis blood. With arthrosis of the elbow joint, the indicators are normal. If there is inflammation in the joint, the ESR will increase.

After receiving an x-ray, the doctor will determine at what stage the disease is. Some narrowing of the joint space is observed already at the first stage of arthrosis.

The treatment regimen for osteoarthritis of the elbow joint can be presented something like this:

Medical therapy for pain relief.
Activities aimed at the complete restoration of the motor functions of the elbow.
Prevention of the disease to avoid relapse.

With mild pain, local preparations are used - ointments and gels containing Ortofen, Indomethacin, Diclofenac, Ibuprofen. If this is not enough, they take tablets of non-steroidal anti-inflammatory drugs - Nimesulide, Ketonal, Movalis, etc. The same drugs can be used as intramuscular injections. To be cured, several courses are required.

With obvious swelling and inflammation, corticosteroids are injected into the joint - 2 injections, interspersed with a break of 8-10 days. In advanced cases, novocaine blockade of the joint can be performed.

In the acute period of the disease, the hand should not be loaded. It is better to fix it in a special bandage or scarf thrown over the neck.

Physiotherapy gives a good result - electrophoresis with hydrocortisone, cryotherapy, paraffin, laser and acupuncture. After the pain is relieved, the restoration of motor activity and the build-up of muscle mass. For this, massage, manual therapy and physiotherapy exercises are carried out.

To stop the destruction of cartilage tissue and reverse the process, it is necessary to take chondroprotectors - Glucosamine sulfate, Chondroitin sulfate (Struktum, Artra, Ostenil, Teraflex, Kondronova). These drugs can be used orally, intramuscularly and intraarticularly in stages 1 and 2 of the disease.

To prevent recurrence, all patients with arthrosis are recommended to undergo sanatorium treatment annually.

Most often, conservative treatment is sufficient. Surgical intervention is resorted to in case of progressive neuromuscular atrophy and the inability to relieve pain with drug therapy.

Folk remedies

There are patients who prefer traditional recipes to drug treatment. They are available to make at home, and they really help some people, but still discuss the chosen remedy with your doctor first.

Treatment with folk remedies:

Bischofite compresses. From the bischofite purchased at the pharmacy, make compresses for the night. Pour some of the solution onto the rolled cheesecloth, wrap around your elbow, and cover with cling film on top. To keep the compress warm, wrap your hand in a warm handkerchief. Treat 10-14 days.
Tincture of spring lilac flower buds. Collect the lilac flower buds that have not yet blossomed into a liter jar and pour 0.5 liters of vodka. Insist in a dark cool place for 12-14 days. Then strain and store in the refrigerator. The resulting tincture can be rubbed on the affected joint several times a day.
Ointment of white lilac flowers. At the first sign of pain in the elbow, you can use the remedy home cooking. Pour white lilac flowers into a small flat dish and fill them with melted butter(or vaseline) at the rate of 1:1. After a week, the ointment can be used.
The use of tincture from the fruits of sophora. The fruits of Japanese Sophora are poured into a tightly closed liter jar. The jar is filled to the top with vodka, kept in a dark place for 3-4 weeks, shaking occasionally. Then the solution is filtered and taken before meals, 0.5 tsp. 3 times a day, washed down with sweet rosehip tincture. The course of treatment is 3 weeks.

Don't ignore the pain signals your body sends. Osteoarthritis of the elbow joint is an insidious disease, its symptoms become noticeable when the joint is already damaged, and this requires urgent medical intervention.

Treatment according to the method of Bubnovsky hip joint

Arthrosis is a generalized name for diseases of the joints, as a result of which the degeneration of cartilage in the joints begins, which leads to their thinning and separation, which exposes the underlying bones. As a rule, the knee and hip joints are deformed, since the greatest load occurs on the lower limbs.

- Stages of arthrosis of the hip joint
- Exercise therapy in the treatment of arthrosis of the hip joint
- Recommendations of Dr. Bubnovsky on exercises for coxarthrosis of the hip joints
- Exercises for the treatment of the hip joint
Summarizing

Today, there are many ways to treat osteoarthritis of the hip joint. At the same time, the treatment of coxarthrosis according to Bubnovsky is considered by physicians to be the most effective way to combat this disease. Coxarthrosis is called deforming arthrosis of the joints of the hip.

The course and symptoms of coxarthrosis

It is customary to classify coxarthrosis into primary and secondary degrees. Most often, coxarthrosis begins to develop slowly and almost imperceptibly for a person. There are times when the patient feels unpleasant pain in the groin area or directly near the joint, but does not pay attention to it.

After a certain time, pain appears during movement and subsides only at rest. The presence of these signs already indicates the development of the disease. At the initial stage, the pain subsides at rest. Clinical symptoms manifest themselves after 45 years.

The causes of the secondary degree of coxarthrosis may be congenital deformity of the hip joint, signs of this form of development can appear even at a very early age, from 18 to 25 years.

Common signs of the development of this disease are pain, which is felt not only during movements, but also during rest, a noticeable shortening of the affected leg, limping, and the appearance of a certain stiffness in the movements.

In the process of progression of coxarthrosis, feelings of pain often appear on their own, and even during sleep, when a person is at rest, the use of painkillers will less and less help. With the most advanced degree of the disease, the patient may even need crutches.

Stages of arthrosis of the hip joint

At the first stage of coxarthrosis, pain is observed after physical exertion (race walking, jumping, running). The x-ray of this patient shows the beginning of small growths on the bones that have not yet touched the femur.

At the second stage, the pains become stronger, move to the groin area, and lameness is likely to appear during a long walk. On x-rays, thickening of the neck of the femoral bone and severe deformity of the hip joint can be observed.

At the third stage, pain is permanent, often patients need to resort to movement with crutches. On x-ray, you can see a significant expansion of the neck of the femur and extensive bone growths. Coxarthrosis at the third stage is treated only surgically with partial or complete replacement of the joint.

Treatment of arthrosis of the hip joint

It is necessary to approach the treatment of arthrosis of the hip joint very responsibly, first of all, directly to the patient. There are many methods of treatment, both physiotherapy and medication. A separate place is given to yoga. Exercises for diseases of the hip joint must be prescribed only by a doctor. Taking into account the degree of the disease, the doctor will prescribe the necessary set of exercises. For the patient, you need to perform several sessions with the doctor so as not to make mistakes that can subsequently provoke an exacerbation of the disease.

Exercise therapy in the treatment of arthrosis of the hip joint

Exercise therapy for arthrosis of the hip joint is the most common and effective therapy, which includes exercises specially designed to improve the condition of a patient who complains of even very acute pain. Particular preference should be given to exercises performed from a standing position, as well as lying on the stomach.

Therapeutic preventive yoga occupies a separate place in a number of methods for the treatment of coxarthrosis. Many doctors advise yoga for coxarthrosis. It must be remembered that any yoga exercises must be agreed with the doctor and be only sparing.

Yoga classes are carried out exclusively with an instructor who knows about the patient's condition, monitors the body's reactions and corrects the patient's load. When doing yoga exercises, you need to properly observe breathing. But not all doctors recommend yoga. This is probably due to insufficient information about it in our country.

Exercise therapy during coxarthrosis of the hip joint has long shown itself to be the most effective method disease prevention and treatment. The movements that the patient makes during these exercises make it possible to remove swelling, and at the same time restore the trophism of the deformed joint. During a set of exercises, the fluid from the joint washes all the tissues of the articular cartilage, significantly speeding up the healing process and reducing pain.

We must not forget that exercises for this disease should be connected only after a complete diagnosis, which can only be carried out by a qualified doctor. All physical activity must be agreed with the doctor. In the case of increased pain, gymnastics is immediately completed until the causes of this increase are fully determined.

In theoretical terms, medicine classifies 5 stages of coxarthrosis. The definition of the disease begins at the zero stage, when there are no pathological changes yet, and is completed at the fifth stage, when the disease is already clearly expressed. In practical terms, doctors use stage 3 coxarthrosis to determine the diagnosis. Each stage is determined by x-ray. The most common is coxarthrosis of 2-3 degrees.

Gymnastics of Professor Bubnovsky

Not many people know that Dr. Bubnovsky himself was written off from active life after a car accident. Being an invalid, he decided to fight on his own, and go to the end. Created exercises for the spine, completely recovered, and now helps people. Bubnovsky was able to help thousands of people, among whom were those who were abandoned by other doctors.

Bubnovsky in his method of treatment does not use any ultra-modern medical means, the scheme of his work is as follows:

an x-ray is taken;
the state of the human muscular system is determined;
an exercise program is being developed by a doctor;
a clear adjustment of the execution of movements is made;
adaptation of a person with a minimum load is performed;
an individual load program is created for any person;
the patient's breathing is clearly controlled;
a set of exercises is performed with increasing load.

The gymnastics of Professor Bubnovsky in the treatment of arthrosis of the hip joint includes 20 basic exercises that are performed on special simulators created by Bubnovsky himself.

The task of therapeutic exercises is to revitalize the joint, as well as make it work. Positive development is not observed immediately. Gymnastics exercises were developed by Bubnovsky for various age categories. In its complex there are methods of treatment for pregnant women, children, athletes, men and women of the middle age group. Therapeutic gymnastics consists of simple exercises in a standing position, lying down, on your side, sitting on your heels. Each exercise is based on slow movements, complete relaxation of all muscles, proper breathing.

Recommendations of Dr. Bubnovsky on exercises for coxarthrosis of the hip joints

Before considering a set of gymnastic exercises to improve the condition of the ligaments, muscles and joints, it is not superfluous to determine general rules doing classes:

Exercises for the treatment of the hip joint

Now consider the exercises proposed in the system of Dr. Bubnovsky for the treatment of arthrosis of the hip joint:

Back arch and relaxation. Get on all fours, while exhaling, arch your back, while inhaling, bend. Do the exercise 20 times.
Muscle stretching. The starting position is the same. Stretch the left leg back, slowly sitting down on the right leg. Pull the left leg according to your strength. Do this for both legs 20 times.
Tilts. Stand on all fours, pull the body forward as much as possible, without arching in the lower back. Maintain balance.
Stretching the back muscles. Get on all fours, while exhaling in the elbow joints, bend your arms, pulling the body to the floor. While exhaling, stretch your arms, while sitting on your heels. Do this exercise 5 times.
"Half bridge". Take a pose lying on your back, hands are along the body. During exhalation, raise the pelvis as high as possible, thus performing a “half-bridge”, while inhaling, lower the pelvis. Do this exercise 20 times.

During the performance of all exercises, it is necessary to control the mode of breathing and observe the slowness of your movements. Only in this form, therapeutic exercises can bring long-awaited relief.

Summarizing

Coxarthrosis of the hip joint is a rather serious disease, which should be treated immediately, at an early stage of this disease. At the same time, the disease needs a responsible and immediate approach to its treatment. Methods of treatment and symptoms of the disease are quite subjective and individual.

The unique method of Professor Bubnovsky makes it possible to put the patient on his feet. To restore health to the spinal column, the doctor developed a complex called "Sport for yourself." Most diseases of the spine are the result of blockage of muscle tissue, not disk deformity. Bubnovsky's gymnastics is based on toning the tendon and ligamentous apparatus, when tissues that lack oxygen due to pain symptoms or inactivity begin to function and, tensing, begin to restore deformed vessels.

Many medical institutions adopted the method of treating Bubnovsky. Gymnastics is effective and simple, it implies not only treatment, but also excellent prevention for the musculoskeletal system.

“Everything for the treatment of a person is in himself,” says Professor Bubnovsky. And his way of treatment really allows patients to reveal the hidden possibilities of the body and redirect them in the right direction. Every person who wants to live without pain, even if the body does not want to obey, needs to pay attention to this gymnastics and devote several hours a day to effective and simple exercises, at least 3 days a week. Only after that the body will begin to slowly “come to life”.

Arthrosis of the elbow joint: causes, symptoms, treatment, diagnosis, full description of the disease

Arthrosis is a chronic pathology of the joints, proceeding according to the degenerative-dystrophic type, due to a number of provoking factors. Osteoarthritis of the elbow joint is diagnosed less frequently than lesions of other large articular joints, due to less stress on this joint. This diagnosis makes up a significant percentage of diagnoses of articular pathologies in older patients.

Reasons for the development of the disease

Osteoarthritis is characterized by a decrease in synovial fluid production, which causes increased friction of the articular surfaces, a decrease in the joint space, and the growth of bone spikes. These processes lead to problems with the mobility of the elbow joint, cause pain and dry crunch during motor activity. Arthrosis affects all articular elements, nearby muscles and tendons, epiphyses of bones.

In case of untimely visit to the doctor, the joint may lose its mobility completely, the pain phenomena grow in intensity, which greatly impairs the patient's quality of life and leads to disability.

Causes and provoking factors for the appearance of arthrosis:

Elbow injuries: fractures, bruises, dislocations, damage to the meniscus, torn ligaments. Traumatization can occur at a young age and make itself felt many years later, when post-traumatic arthrosis develops.
Metabolic pathologies that cause malnutrition of the articular tissues.
Rheumatoid arthritis - with this pathology, the elbow joint is affected among others.
Low fluid intake in the body, alimentary insufficiency (deficiency of essential substances).

Chronic processes - tonsillitis, dental caries, gastritis, cholecystitis.
Infectious inflammation of the elements of the joint, bursitis.
Changes in muscle and bone tissue associated with age.
Working conditions, lifestyle, inappropriate loads - while the right elbow suffers more often, as the most loaded, the left less often.
Heredity.
Intoxication in case of poisoning.
Diseases associated with impaired blood clotting.
Frequent acute respiratory infections.

Osteoarthritis of the elbow is also triggered by hormonal imbalance in menopausal women.

Neurologist M.M. Sperling from Novosibirsk on his video channel talks about the most serious problem - arthrosis of the joints:

Clinical picture

The symptoms accompanying arthrosis of the elbow joint are divided into four main groups:

Pain. It is noted in motion, at the moment of flexion of the arm, extension, when turning the limb and walking. At the first stages of the development of pathology, pain symptoms are not particularly pronounced, they appear only with additional load. The progression of the degree of arthrosis is expressed in almost constant pain, and at rest. The pain may radiate to the neck and be felt with pressure on the elbow area.
Crunch. The sound of a dry crunch is due to the friction of the bone surfaces of the joint. As the process of arthrosis worsens, the crunch becomes more audible, with the addition of pain. Sometimes a crunch is confused with clicking in the joint when performing any movement with the elbow, but clicks are normal and are not signs of illness.
Limited movement of the elbow. It becomes difficult for the patient to move his hand, turn it. It is caused by a violation of the motor amplitude, the growth of osteophytes, a reduction in the size of the joint space, muscle spasms. With elbow arthrosis, Thompson's symptom is noted: the patient cannot hold the hand in the fist in the back position, and he quickly spreads his fingers. Another typical symptom of elbow arthrosis is Wetl's symptom, which is characterized by the inability to freely bend and unbend the limb at the level of the lower jaw.
Elbow joint deformity. Due to the erratic growth of osteophytes, inflammation, which increases the volume of joint fluid, the joint swells, outwardly this manifests itself as tubercles on the surface of the elbow, redness of the skin.

The severity of the clinic depends on the severity of the disease. Osteoarthritis of the elbow joint develops in the stages described below:

1 degree

Unexpressed pain in the joint during physical effort, outwardly arthrosis does not manifest itself in any way. The doctor may note a slight decrease in muscle tone and some difficulty in moving the arm back, the processes of flexion and extension in the elbow area. With such symptoms, additional instrumental studies are already required. X-ray shows a slight narrowing of the space between the articular surfaces. Arthrosis at this stage must be differentiated from carpal tunnel syndrome and cervical osteochondrosis.

2 degree

There are noticeable pains, so patients are already turning to doctors for help and starting to be treated. Pain and discomfort are felt even at rest, they are joined by a dry crunch during movements in the joint. The patient is practically unable to bend the arm at the elbow or take it back. There is a slight atrophy of the muscles, it becomes difficult for the patient to do simple household things, which greatly affects the quality of life.

The picture shows multiple osteophytes, articular tissues are deformed. External changes are not yet observed or swelling of the skin in the elbow area is noted, as a rule - during periods of exacerbation.

3 degree

The pains accompany the patient almost constantly, including at night, becoming aching and intense. The range of motion is severely limited. In the absence of appropriate treatment, some patients fix the limb so that pain symptoms decrease.

The radiograph shows the destroyed cartilage, the absence of the joint space, many overgrown osteophytes. Changes in the shape of the articular joint are also noticeable externally - in addition to the edematous elbow joint, one arm becomes shorter than the other, the muscles are atrophied. The patient can no longer perform the usual household activities. At this stage, full recovery is almost impossible.

In this video, for you, passive gymnastics for the elbow joints, which can also be used for arthrosis:

Deforming arthrosis of the elbow joint

About 50% of the identified arthrosis are deforming arthrosis. Patients complain of the presence of pain in the joint, with increasing intensity as the pathology develops. The radiograph shows signs of joint deformity in the following stages of development:

Osteophytes are localized in the area of the distal epiphysis of the humerus, although there is no significant increase in this segment throughout the course of the disease, in contrast to the joint area, where the growth of bone spikes can complicate hand movements already at the onset of the disease. The depression of osteophytes into the cubital fossa and their localization in the region of the coronoid process of the humerus do not allow patients to extend the arm.
Bone growths are distributed evenly around the elbow joint, movements in the elbow are still observed. Dysfunction comes on gradually. Osteophytes may affect the head of the radius.
Sclerosis of adjacent bone lobes joins the overgrown osteophytes.

The periphery of the humerus is mainly deformed, osteophytes mostly grow near the articular cavity. Painful symptoms and a severe limitation of motor amplitude in deforming arthrosis are indications for surgery.

Diagnosis and treatment of elbow arthrosis

The diagnosis is made on the basis of anamnesis, x-ray picture, laboratory tests. If necessary, arthroscopy and MRI may be additionally prescribed.

Treatment of arthrosis of the elbow joint in the undeveloped stages is carried out by conservative methods. The goal of treatment is to eliminate pain symptoms and limited movement. Treatment of arthrosis is complex and long-term, including several methods at once. For the duration of treatment, the arm is immobilized with a special bandage.

Principles of treatment of arthrosis:

Performing physical exercises to restore the mobility of the diseased joint;
Exclusion of loads on the joint;
Medical treatment to relieve inflammation and pain.

If conservative treatment fails, surgery is indicated. Also, patients can treat arthrosis with traditional medicine at home to alleviate the condition.

Medical therapy

The drugs for the treatment of elbow arthrosis include the following:

NSAIDs.
Ointments containing medicinal substances.
Chondroprotectors.

Non-steroidal anti-inflammatory drugs for the treatment of joints relieving inflammation and pain. They can be prescribed in the form of injections intramuscularly and into the joint capsule, tablets and locally acting ointments. The most commonly used drugs are diclofenac, indomethacin and their analogues - voltaren, orthofen, ibuprofen. In the acute period of the disease, it is advisable to inject NSAIDs, after a few days switching to tablet forms, as inflammation subsides. It should be borne in mind that too long a course of treatment with NSAIDs can adversely affect the gastric mucosa.

Containing salicylates and relieving inflammation. Works well for bruises. These are salicylic ointment, solcokerasal, hemosol.
Containing capsaicin and due to this, they warm up the diseased area, which stimulates blood supply, improves tissue trophism and relieves pain. These ointments include nikoflex, nizer, nise, kutenza, espol.
Containing biologically active substances, based on bee or snake venom, with a combined effect - they relieve swelling and pain, warm and reduce the likelihood of tissue necrosis. Known representatives of the group: apizatron, viprosal, ungapiven.

Chondroprotectors

Chondroprotectors for joints- substances that contribute to the restoration of cartilage tissue of the joint. They are prescribed in the form of injections into the joint capsule and in the form of ointments. Of the drugs, it is most often recommended to treat joint diseases with glucosamine sulfate, chondroxide, ostenil and structum. Chondroprotectors are used for a long time, the course of treatment is usually at least six months.

Physiotherapeutic methods of treatment are used during the period of subsiding of acute phenomena and during rehabilitation after treatment. Of the applied methods are effective:

Paraffin therapy, which warms the soft tissues in the joint area and thereby stimulates blood flow;
Electrophoresis with drugs, for their penetration into the joint capsule;
Laser - reduces the growth of osteophytes and destroys existing ones, due to which the joint regains mobility;
Mud compresses prescribed to eliminate atrophic changes in tissues;
Acupuncture - the impact of needles on certain points projected onto the body, which reduces pain, reduces inflammation, restores muscle tone;

Massage - at the stage of rehabilitation, manual techniques have a beneficial effect on the condition of the joint and surrounding muscles, restoring limb mobility and relieving pain;
Therapeutic gymnastics is a special set of exercise therapy exercises, which is compiled by a specialist, exercises are also performed under the supervision of an instructor, they can be done both at home and in the clinic.

Additional treatments for arthrosis

Formula can be used to reduce pain and swelling folk treatment, these are ointments, compresses, baths and tinctures:

Propolis ointment: mix 50 grams of vegetable oil and propolis, dissolve in a water bath. Rub the resulting product into the elbow at night, after closing it with a piece of polyethylene and wrapping it with a towel.
Compress from birch leaves: pour dry or fresh leaves with boiling water and leave to infuse for 2-3 hours, then drain the water. Apply the leaves to the sore joint, wrap with gauze and a warm cloth.
Bath of needles: boil spruce, pine needles in water for 10 minutes, cool slightly, lower the sore arm into the bath so that the elbow is covered with water.
Infusion of herbs: for the treatment of arthrosis, you can make infusions of elecampane and cinquefoil.

Folk remedies for the treatment of arthrosis should complement the main course. In addition to the medical complex, annual sanatorium treatment is recommended for patients with arthrosis of the elbow joint.

Gymnastics for the treatment of pain in the elbow and elbow joints from Dr. Evdokimenko:

Injuries to the elbow joint can be of three groups, which include bruises, dislocations and fractures. Obtaining any injury to the elbow joint involves the imposition of a plaster splint. Exercise therapy for an injury to the elbow joint can be practiced already on the first or second day after it was received. After removing the plaster cast, it is recommended to perform exercises for the elbow joint, including flexion, extension, turning the forearm with the palm up and down, and circular movements. The same movements must be performed in water, for which a wide deep basin or bath is suitable.

Features of exercise therapy for injuries of the elbow joint

sit sideways to the table located on the side of the injured arm. Put the shoulder on the table so that the edge of the table is in the armpit, and the forearm is vertical. It is necessary to actively bend and unbend the arm in the elbow joint, the pace of the exercise should be slow, the little finger should be in projection parallel to the earlobe. When performing this exercise, you can not make jerky movements in the direction of flexion and extension, help yourself with the other hand, forcibly bend and unbend the arm. When performing the exercise, there should be no pain;
sit down, put your forearm on the table, you need to hold a rolling toy in your fingers. The shoulder joint during the exercise must be motionless, in the elbow joint it is necessary to make “swinging” movements for flexion and extension;
sit or stand up and perform exercises on the block - bend and unbend the arm in the elbow joint;
sit down or stand up, take a stick in your hands and perform all kinds of hand movements aimed at flexion and extension;
sit down or stand up, pick up a tennis or rubber ball that you need to throw and catch;
sit or stand with your torso leaning forward. Both arms bend and unbend at the elbow joints. Perform an exercise on weight, putting your hands on your head, behind your head, clasping your hands in a “lock”, etc .;
sit down, placing your hands in warm water, the temperature of which is 35-36 degrees. Perform flexion, extension, turns of the hand with the forearm up and down, circular movements for 10-15 minutes 2 times a day.

Exercise therapy for elbow injury

Exercise therapy for dislocation of the elbow joint

Exercise therapy for a fracture of the elbow joint

In the event of a fracture of the elbow joint, the recommendations relating to dislocation of the elbow joint regarding arm tension should be followed. In the second period, with a fracture of the olecranon, flexion in the elbow joint is not allowed, since a repeated fracture is possible. If there was a fracture of the coronoid process, then, on the contrary, such movements are recommended, since they contribute to the healing of the damaged bone. In the third period, if movements in the elbow joint are limited, exercise therapy should be continued in case of a fracture of the elbow joint in water, physiotherapy procedures (mud therapy, paraffin) should be carried out, after which a set of physical exercises is provided. Each exercise should be repeated 4-6 times in all periods, and the complex should be repeated 4-6 times a day.

Traumatic injuries of the elbow joint are divided into bruises, fractures and dislocations.

The following types of fractures of the elbow joint are distinguished: fractures of the lower epiphysis of the humerus (isolated fractures of the epicondyles and condyles, T- and U-shaped fractures of the condyles), fractures of the capitate elevation, fractures of the upper epiphyses of the bones of the forearm (ulna and coronoid processes of the ulna, head of the radius) , combined fractures of the lower epiphysis of the humerus and the upper epiphyses of the bones of the forearm (fracture of the internal condyle and head of the radius, etc.). For bruises, fractures and dislocations of the elbow joint, a posterior plaster splint is applied from the base of the fingers to the upper third of the humerus (the arm is bent at the elbow joint at an angle of 90 °).

Therapeutic Physical Culture for all traumatic injuries of the elbow joint, it is prescribed for 1-2 days after the injury.

When an elbow joint is bruised against the background of general developmental and breathing exercises, special exercises are used for the injured arm in all joints free from immobilization, as well as exercises in sending nerve impulses to immobilized joints. The duration of the periods depends on the strength of the bruise or the degree of stretching of the ligamentous apparatus. After immobilization is removed, the following are prescribed: therapeutic exercises, gymnastics in water and physiotherapy, which contribute to the restoration of movements in the elbow joint. Recovery time (approximately) from 2 weeks to 1.5 months. sports training are resolved by the doctor individually 3 months after the injury.

Elbow fractures can be non-displaced or displaced. Fractures without displacement are immobilized with a posterior plaster splint (the arm is bent at the elbow joint at an angle of 90°). With displaced fractures (except for a fracture of the olecranon), manual comparison of the fragments or surgical reposition is performed with a strong fixation of the fragments with metal needles, screws or bone pins and immobilization of the posterior plaster splint. In case of conservative treatment of a fracture of the olecranon, a posterior plaster splint is applied in the position of flexion in the elbow joint at an angle of 150-160°, and during surgical reposition - suturing of the olecranon - at an angle of 100-110°.

After dislocation of the elbow joint, it is repositioned and fixed with a posterior plaster splint in the position of flexion in the elbow joint at an angle of 90°.

Therapeutic physical culture is carried out in three periods.

Period I is divided into two stages. At the 1st stage (absolute immobilization), on the 2nd day after a fracture or reduced dislocation, against the background of general developmental and breathing exercises, exercises are prescribed for plaster-free joints of the fingers and shoulder joint, as well as treatment with a position (the hand is placed on a pillow behind the head or in abduction position - to combat limb edema, pain syndrome, to improve blood and lymph circulation); sending impulses to immobilized joints; isometric tension of the muscles of the shoulder and forearm; ideomotor movements in the elbow joint. At the 2nd stage, with an unbandaged splint on the forearm (according to the terms indicated by the doctor), in addition to the listed exercises, flexion and extension in the elbow joint within the cast (35-45 °) are performed.

Rice. 16. Initial position of the arm during training in the II period with a fracture of the elbow joint

In the II period, after the removal of immobilization, exercises are included to develop the elbow joint in the following initial positions: 1) sitting, the shoulder of the diseased arm lies on the table (the edge of the table is in the armpit), the forearm is in a vertical position (Fig. 16) - flexion and extension in the elbow joint (the little finger should projectively run parallel to the earlobe); 2) sitting, the forearm lies on the table (Fig. 10.5), in the fingers a children's rolling toy - fixing the shoulder, the patient "rolls" the forearm with the help of a toy; 3) sitting or standing, exercises on the block - flexion and extension in the elbow joint; 4) sitting or standing - all kinds of exercises with a stick, rubber or volleyball; 5) sitting - exercises in warm water (10-15 minutes) at a temperature of 35-36 ° 2 times a day (morning and evening); 6) standing or sitting with the body tilted forward - flexion and extension in the elbow joint, performed in conjunction with a healthy arm, flexion and extension of two arms hanging, flexion and extension in the elbow joints, taking them "in the lock", raising them on the head, behind the head, etc. In the II and III periods, exercises are performed in the water; flexion and extension, pronation and supination in the elbow joint.

In the treatment of a fracture of the olecranon in the II period, it is impossible to force the function of flexion, since a repeated fracture may occur. In the II period, in the treatment of a fracture of the coronoid process, exercises for flexion of the forearm should be performed, since they contribute to the fusion of the process.

In the III period, with limitation of movements in the elbow joint, especially after dislocation, physiotherapy treatment (mud, paraffin, ozocerite) is recommended, after which repeated therapeutic exercises are carried out. Classes should be carried out 4 times a day.

The number of repetitions of each exercise in all periods is 4-6 times. Classes are held 4-6 times a day.

In case of any fracture or dislocation of the elbow joint, passive movements, muscle overwork, carrying weights, hanging, rests, exercises that cause pain are contraindicated. All this can cause swelling, pain in the joint, reflex contraction of muscles, calcification of muscles, growth of bone deformities: “mustache”, “spur”, etc. Massage is also contraindicated at all stages of treatment.

Nizhny Novgorod State Technical University

Department of "Physical Culture"

On the topic "Therapeutic physical culture for injuries of the elbow joint"

Prepared by: student gr. 07-EES

Nedorezov Yu.A.

Checked by: Dolzhunkova I.P.

N. Novgorod 2009

Dislocation of the elbow joint as an injury.

Dislocations in the elbow joint ranked second in frequency. There are dislocations of both bones of the forearm posteriorly, anteriorly, outward, inward, divergent dislocation of one radius anteriorly, posteriorly, outward; dislocation of one elbow. The most common are posterior dislocations of both bones of the forearm (90%) and dislocation of one radius anteriorly. The elbow joint has a complex structure with many articular surfaces, is rich in vegetative innervation, is very reactive and easily reacts to damage by limiting movement. This joint is sensitive to immobilization and relatively quickly becomes stiff. Therefore, with dislocations of the elbow joint, functional treatment always comes to the fore. To protect the elbow joint from the development of contracture, short-term immobilization and early rehabilitation, carried out even at the stage of initial unstable contracture, are essential.

The reduction of the posterior dislocation is preferably carried out under anesthesia. The elbow bent at an acute angle is immobilized with a back plaster splint for 7 days, after which therapeutic exercises are prescribed, combining it with thermal procedures. After reduction of the anterior dislocation, the forearm is unbent to an obtuse angle, fixed with a posterior plaster splint with the supinated forearm for 10-12 days. When rehabilitating after reduction of a dislocation of the elbow joint, it must be taken into account that sharp irritations in the joint area (mechanical - massage, redressing - forcible elimination of contracture with the help of plaster casts, instruments and apparatus, thermal procedures high temperature etc.) can enhance contracture and stimulate pathological changes in tissues.

Rehabilitation periods for dislocation of the elbow joint

During rehabilitation, periods are distinguished absolute immobilization And relative immobilization(the limb is temporarily released from the plaster splint for physical exercises). The duration of the periods of absolute and relative immobilization is determined by the method of treatment (conservative or operative), the nature of the damage. With simple dislocations of the bones of the forearm and conservative treatment, the period of absolute immobilization lasts 3-4 days, relative - 14-15 days.

There is also a third (training) period, in which the function of the elbow joint is finally restored. The breathing exercise alternates with three special or general developmental exercises.

1. The period of absolute immobilization.

Physiotherapy exercises are prescribed from the 2nd day after the application of a plaster splint. Against the background of general developmental and breathing exercises, active movements in joints free from immobilization, ideomotor exercises, isometric muscle tension of the shoulder and forearm are used. Since the muscles of the shoulder are most susceptible to atrophy during dislocations of the elbow joint, it is necessary first of all to teach patients rhythmic tension to relax precisely these muscles. Rhythmic tension of the muscles of the forearm is carried out due to flexion-extension movements in the fingers. The rehabilitation technique should proceed from the state of the biceps muscle of the shoulder, with a spasm of which it is necessary to carry out exercises to relax it. It is recommended to carry out extension exercises in the elbow joint simultaneously with pronation (elimination of increased tone). To strengthen weakened extensors, exercise against maximum (but not causing pain) resistance. Elbow extensor resistance exercises also help reduce flexor spasm.

First period physiotherapy exercises is divided into two stages. At the first stage (on the second day after the application of the plaster splint), in addition to general developmental and breathing exercises, all kinds of movements are performed in the joints free from plaster (for the fingers, hand and shoulder joint) and the hand is placed on a pillow behind the head or in the position of abduction in the shoulder joint. This position is necessary so that swelling of the limb does not develop, pain does not occur, and blood and lymph circulation improves. They also send impulses to the fixed elbow and wrist joints (imaginary movements for flexion and extension; tension in the muscles of the shoulder and forearm).

At the second stage of the first period (about 12 days), the plaster splint is unbandaged on the forearm to the elbow joint, and movements for flexion and extension in the elbow joint with an amplitude of 35-45 degrees within the plaster are added to the set of exercises.

Redressing passive exercises that cause pain and microtrauma of the structures of the elbow joint are not shown; This leads to a protective increase in the tone of the biceps brachii and fixation of the contracture.

Sometimes a certain stagnation occurs during rehabilitation - the range of motion achieved during the procedure is again limited after a few hours. In such a case, an extensor splint with elastic traction may be useful in order to maintain the achieved volume of motion. During the day, it is recommended to give the injured limb an elevated position, since such a position, especially in the early stages of a traumatic disease, helps to reduce swelling, pain and prevent stiffness.

Therapeutic exercises are carried out 2-3 times a day. The duration of classes in the first 2-3 days is 10-15, then 20-30 minutes.

2. Period of relative immobilization

During the period of relative immobilization, the main task of exercise therapy is the gradual restoration of joint mobility and the normalization of the function of the muscular apparatus of the limb. Since the consolidation processes have not yet been completed at this time, therapeutic exercises are carried out subject to a number of conditions:

The patient performs all exercises from lightweight starting positions, leaning his hand on the surface of the table or immersing it in water;

Movements should only be active;

The amplitude of movements should be within the limits necessary for soft and painless stretching of tense muscles;

Passive movements, weights, joint massage and vigorous thermal procedures are excluded.

A set of special exercises for elbow joint injury in the second period.

I. Simplified methodology (in the early stages of the 2nd period)

1. I. p. - sitting sideways to the table from the side of the sore arm, the shoulder of which lies on the table so that the edge of the table is in the armpit, and the forearm is in a vertical position, Active flexion and extension in the elbow joint at a slow pace (little finger in the projection parallel to the earlobe) (fig. on the left). When performing this exercise, jerking movements in the direction of flexion and extension, assistance with the other hand, pain and forced flexion or extension are not allowed.

2. I. p. - sitting, the forearm lies on the table, a rolling toy in the fingers. "Swinging" movements (flexion and extension) in the elbow joint - the shoulder joint is motionless (Fig. below).

3. I. p. - sitting or standing. Movement on the block - flexion and extension in the elbow joint.

4. I. p. - sitting or standing, holding a stick. All kinds of hand movements for flexion and extension in the elbow joint.

5. I. p. - sitting or standing, in the hands of a large rubber or tennis ball. Throw and catch the ball.

6. I. p. - sitting or standing, tilting the torso forward. Bend and straighten the arms in the elbow joints (simultaneously with a healthy arm): on weight, clasping hands in a “lock”, placing them on the head, behind the head, etc.

7. I. p. - sitting, hands down in warm water (temperature 35-36 degrees). 2 times a day (morning or afternoon and evening) for 10-15 minutes, perform flexion, extension, circular movements, turns of the hand with the forearm with the palm up and down.

II. Extended methodology (at the end stages of the second period)

2. When the torso is tilted forward, the hands are “locked”, swaying the arms up and down.

3. The diseased arm is bent at the elbow joint, with the support of a healthy arm, abduction of the injured arm to the side.

4. Brushes to the shoulders, abduction of the elbows to the sides.

5. Hands in front of the chest, pulling the elbows back, connecting the shoulder blades.

6. Hands "in the castle" at the bottom. Raise your arms up, bend behind your head, straightening your arms up, palms up, return to and. P.

Exercises with a gymnastic stick

7. Stick horizontally at the bottom with a grip on the ends, moving the sore arm to the side, pushing it with a healthy hand with a stick.

8. Stick horizontally at the bottom, turning the stick to a vertical position, injured arm on top.

9. Stick horizontally at the bottom, lift the stick up, put it on the shoulder blades and return to and. P.

10. Stick horizontally below the back at the width of the pelvis, raise the stick as far as possible, return to and. P.

Exercises on the gymnastic wall.

11. Standing facing the gymnastic wall, alternately intercept hands up on each rail, return to and. P.

12. Standing facing the wall, hands at shoulder level with an overhand grip, half squat and squat.

13. Standing with your back to the wall, hands grip from above at the level of the pelvis, bend over and stretch your arms.

Exercises with dumbbells (0.5-1 kg)

14. Flexion and extension of the arm in the elbow joint.

15. Hand down, slowly raise your hand, shoulder parallel to the floor, bend at the elbow, slowly lower down.

Exercises with a ball (volleyball or rubber)