NEURAL COMPONENT OF ORTHOPAEDIC INJURIES
Neural Component of Orthopaedic Injuries
by ACE Physical Therapy and Sports Medicine Institute
Tid Bits of Info.
- Muscles do nothing on their own, they are “run” by the nervous system.
- The nervous system can transmit signals at speeds of 100 meters (328 feet) per second.
- There are around 650 skeletal muscles in the human body.
- Muscle makes up around half of the total human body weight.
- Physical Therapists can help rehabilitate the neuromuscular activity in the human body.
Every day we stand up, sit down, walk, and move all our body parts. We rely on an entire system of muscles, joints, nerves, and the brain. Orthopaedic injuries effect the entire system. Treatment for orthopaedic injuries should also include the entire system. Recently, healthcare professionals are looking at different ways to help restore or re-educate the way the brain and entire nervous system works after an orthopaedic injury occurs to a body part.
Muscles are responsible for movement and stability of the different body parts and joints, but they cannot act alone and need a signal from the nervous system to operate. When the nervous system is not sending the proper signals to the muscles for numerous reasons, the body part does not move or function properly.
In orthopaedic healthcare, the focus is on the bones and soft tissues (muscles and connective tissue) and how they function together to perform the different tasks of everyday life. The joints of the body are the junction of bones and the areas that move via muscle action. When an injury occurs to a joint, the muscle’s ability to function is limited by a decrease or change in neurological communication to it. The inflammatory process is thought to have profound effect on neurological input to a muscle. The muscle can be over or under stimulated and the result is polar opposites.
The under stimulation of a muscle renders it nearly useless and unable to contract and generate force. This phenomenon is clearly visible following a surgery on a particular joint. In most instances, the muscles surrounding the involved joint are not able to be voluntarily recruited by the patient. The pain and swelling associated with a post op status are thought to be the stimulus for the “shut down” of that particular body part.
Over stimulation of a particular muscle following and injury can result in spasm and a “locking up” of the muscles. This condition is quite frequently encountered following a severe strain to the lumbar spine (low back) or a fractured long bone. In these cases of severe trauma which produce an intense amount of pain and inflammation, the body’s defense is to try to protect from further damage by limiting motion. The severity of the injury will determine the amplitude of the body’s response in most cases.
A Physical Therapist is trained to re-educate and stimulate the nervous system to achieve a particular result. The orthopaedic Physical Therapist specializes in restoring normal movement and function of the injured body part. The specialist will design a rehabilitation program that involves strengthening and stretching exercises and activities that are geared towards restoring normal function. They will focus on the injured body part, but will include a holistic approach to link the injured body part to the rest of the body. The nervous system controls movement and all body parts are linked together which has to be considered when going through rehabilitation. The body is similar to a chain of links which can be greatly affected if one link is out of synch.
Recently, studies and treatment are focusing more and more on the way the body works together as a unit and “kinetic chain”. Every body part can affect the way another body part “works” therefore the rehabilitation program must take this into consideration to be comprehensive and successful.
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