Convalescence and osteopathic rehabilitation

‘Complete rest will result in decreased endurance levels through reduced muscle strength, metabolic activity and circulation. This can cause a sense of fatigue, affecting the patient’s motivation and leading to a vicious cycle of greater inactivity’                                                                                              Dittmer and Teasell, 1993

“Your body adapts to your physical habits”

Bedrest is often necessary for healing injuries, during sickness and following an operation but extended periods of bedrest can have a detrimental impact on your health. Our bodies are made to move, so if you sit in a chair or lie down all day you’ll essentially become adapted to inactivity.

Bed_rest

This inactivity makes you less adept at normal movement such as standing, walking, squatting and lifting all of which a healthy human should be able to do with ease. Your day to day habits manifest themselves over time, for both good and bad. The most noticeable effects of long periods of immobility are seen in the musculoskeletal system, with the loss of muscle strength and endurance, and bone weakening.

Bones undergo a progressive loss in mass through a condition known as disuse osteoporosis. Bed rest causes the bones to lose density because they aren’t performing their normal weight-bearing function. Bone loss occurs mainly in weight-bearing bones such as the spine, the long bones of the legs and the heels. People with disuse osteoporosis may experience pain when they begin weight-bearing activities again because softer deconditioned bones are more susceptible to compression or fracture. Even minor falls are a risk.

The musculo-skeletal system functions best when supporting the body in natural dynamic and static postures. The muscles of the neck, shoulder blades, abdomen, lower back, buttocks, thighs and calves are particularly important for this purpose. When muscles aren’t used, as with prolonged bed rest they rapidly begin to weaken and waste away.

Diminished muscle strength affects co-ordination and balance, and increases the risk of falls. Immobility can also lead to limited joint movement. The integrity of the joint cartilage begins to weaken, while the fascia and connective tissue stiffens and the muscles shorten and tighten, usually at the hip, knee and shoulder. This negatively affects walking and daily activities. Backache and fatigue during convalescence are often due to disuse atrophy (weakening and wasting) of underlying muscles and localised spinal joint strains rather than the disease or disorder resulting in the bedrest. Postural and locomotive muscles lose their tension-generating capacity, and spinal and abdominal muscles become weak if not used.

The musculoskeletal system provides mobility and the ability to carry out normal daily activities. Any muscle weakness or joint and bone stiffness through immobility or disuse has an impact on these functions and may also increase the risk of injury or physiological dysfunction.

Osteopathic care has also been shown to assist effectively in patient care and treatment and in the case of post‐operative convalescence work in conjunction with conventional medical care. By working together, osteopaths may help reduce the time of convalescence and aid in healing.

The philosophy of Osteopathy is to treat the whole person, not just the symptoms. It places emphasis on the relationships between the body’s structure and function. Recovery from pain and injury occurs by restoring function to the nervous, circulatory, musculoskeletal and lymphatic systems through hands on treatment. A programme of appropriate rehabilitation may help diminish muscle atrophy (weakening and wasting) and other associated effects of convalescence.