TISSUE HEALING
Traditionally Western medicine has
counselled immobilisation and rest for the pain and tenderness of injury.
However, research over decades has shown
1 that maintenance of the
structure and composition of the bony and soft tissues of the skeleton requires
repetitive use.
Growing,
immature and repair tissues are more sensitive than normal to such work
and movement. Sensitivity may decrease with advancing age.
Pointer
Injured bone and soft skeletal tissue
heals fastest with early loading and movement rather than rest and immobility
Prolonged
rest has an adverse effect on tissue repair and healing; cyclical work (loading)
and movement promotes optimal healing. Even for joints recently operated
or adjacent to fractured bones, early Continuous Passive Motion is both
congruent with that research and has been shown empirically to encourage more
rapid healing 2.
Clearly the loading of injured parts
can be premature or excessive and must be tempered by reason. However,
insufficient research has been undertaken in differing injuries to determine how
much work and movement is too much.
Pointer
Directed relaxation and regular exercise
may significantly improve the work capacity of employees with musculosketal complaints
In
a recent Norwegian study 3,
workers with musculoskeletal problems who undertook a programme of supervised
relaxation and directed home exercises for thirty minutes thrice weekly
had a dramatic and long-term reduction in sickness absenteeism compared
with similarly injured workers not involved in the programme.
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Copyright © 2009 Electronic Handbook of Legal Medicine