So what's does the physician or surgeon does? or what's the medical management. Well in many cases the broken bones, ligaments, or nerve are kept in the right place. That is the 2 broken parts are kept closure and stopped from moving- I.E the cast. The next is they keep the environment clean so that healing is not impeded. That is keep away infections. In the last 50 years we have learnt and can do keeping the infection of the bay very well. The healing happens by itself- that's biology for you.
The first lesson is: in many instances surgery for fracture, helps you reduce the period you have to be in bed. When I went to college- if you have broken your femur (thigh bone) you will be bound to your bed for 8 week sometimes longer. Modern surgeries can allow you to walk maybe from 3-4 weeks. So the cost of hospitalization is tremendously less. The need for round the clock nursing and strain on care givers is reduced. In case of upper limb the jury is still out if surgery is better. Especially for fracture of your wrist if it is not compounded surgery may not add much value.
Right! this is not about evidence based ortho surgery. Its about healing. If you do surgery or just a cast- the healing of your bones happens naturally- that period of healing- hastening it cannot be done. We don't have drugs for the ligaments, bones or nerve to grow (faster)
Apply the same logic. The IFT, US we give you dont do anything to healing. They happen to by themselves. The drugs you are prescribed dont heal you- they make you comfortable during healing. Some of the drugs are also like ritualistic. They are prescribed to fill the prescription sheet. They may include what is colloquially called sathu mathirai. They can be your vitamins or calcium if it is done by a ortho surgeons. They are usually B- complex (which you can get it if you eat), Vitamin D (thats the newest nonsense, just pure nonsense) and then there is calcium for any related to muscle or bones. Most of you- i mean nearly everyone who reads this may not need any of these chalk powder.
So what does Ultra sound does- well nothing. They are as good as put a mud pack on your dog. IFT can or may produce a small relief in pain- but with a very small and variable half life period. what i mean half life period is the amount of anti- pain producing hormones secreted in your brain to reduce to half it quantity (basically how fast you will get your pain back).
What are you blabbering, i had IFT last time and my pain went away after ten days. I had knee pain and had IFT it went away. Well it seems even if you did not have those you could have got better- as it is the nature of the disease. If you had covid in the 3 wave you could remember- if you had gone to a uneducated doctor and he could have prescribed antibiotics for a viral infection (our country is full of these highly amusing fellows who will not study after 12 std where they got 110 out of 100 in all the subjects to get into medical school.) and you could have recovered in 7- 10 days. If you had gone to a properly educated doctor he could have told you eat some soup, take rest and monitor yourself. Then also you could have recovered in 7- 10 days. The only thing you did by going to the doctor is help the bacteria to evolve and become a supervillain. So that is what a IFT or any other machine does to you- a ritual with little or no effect- while the system heals.
Rubbing the muscles - the so called trigger point, cupping or needling does not heal anything. Again healing happens naturally. They all produce a sensory stimulus which can sometimes produce a pain reduction albeit temporarily.
So, what does exercise do for you? Well in one word it helps your change your perception of pain. Most of what you do in our department is not enough to change your strength (most of the time), or anything in the muscle. The pain is perceived in your brain- so exercise sort of relaxes you and makes you less dis-comfortable- whilst the body heals. This is most of the time true- after you had a surgery or just pain. Sometimes we may put you into a vigorous regime of exercise- to increase your strength of your muscles or your lungs and heart ( well the technical term is endurance).
More medical literacy for patients who attend PT department soon.
Love
Hariohm
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