Injuries happen. But then what? Your efforts at rehabilitation (rehab) can make a giant difference in how much function returns. Preppers need to have some idea on how to rehab to get themselves off the sidelines and back into the game at full strength. There may not always be professionals on hand to guide the process.
The necessary caveat: I am not a physician, or a physical or occupational therapist. I’ve experience in doing rehab myself, helping others rehab and observing a bunch more. All of that lines up perfectly with the basics of how the human body works (and I do know a bit about that). From that I’ve extracted the bones of the rehab process, which I offer here. It’ll be up to you to figure out how to apply those basics to whatever situation you find yourself in.
Salty’s had extensive experience with successful rehab himself. We talk over experiences and principles in this podcast:
This photo brought to you by Salty’s hard work in rehabbing an injury that was ‘supposed’ to lame him.
The first step is first aid as usual
After an injury there may be more going on than a bum limb. The usual check and stabilization procedures are still critical. Remember to consider the possibility of concussion while you’re at it. This step might include immobilizing the injured part until you can get to a professional trained and experienced in treating such things.
Rehab will go better the quicker the realignment happens
I’m not going to go into how to reduce dislocations or compound fractures. There’s no way you’re going to learn it from a blog post, and I wouldn’t be the one to write it anyway. Suffice to say there are two big considerations here:
Experience matters. Every doctor, physician’s assistant, nurse practitioner, or similar has had training in re-alignment. Sad fact of life: The injuries have not read the same books. I’ve seen (way too) many dislocations reduced. The team doc who’d had a lot of hands-on trauma experience made it look easy … but it isn’t. Think about who you can get to who not only has the medical training, but hands-on practice at this kind of injury.
Speed matters. Not so much in minutes – I’d sure take a few to get to someone experienced – but days absolutely matter. That injured part is going to start rebuilding right away, and the less time it spends trying to reattach itself in the wrong spot, the better.
Once things are back in place, make efforts to keep them in place throughout rehab
Whether you’ve got a well-designed, adjustable boot or a SAM splint and some ace wrap, helping the pieces stay aligned is critical. They (the professionals) don’t always want immobility, they just want the alignment to stay correct. For example, the devices Salty was given for knee and ankle rehab have adjustable joints to allow flexing and extending, but solid supports to prevent side to motions that would ruin the alignment.
Here’s an example of a walking boot. It resembles the one the docs gave Salty; I can’t say more than that about the merits of various styles.
The worry is not necessarily the usual motions – so a lucky person might get by without such supports during healing. The problem is with the unexpected and unusual. The foot slips a bit on a wet floor. The load is unwieldy, twisting the wrist to one side. Those movements are much more likely to re-injure during rehab. The braces help stop them.
Salty’s walking boot has been so useful, it could have substituted for the casts if it had to. We’re going to pick up at least one more in my size. You often see them dirt cheap at thrift stores.
Right after the injury, it’s more inflammation control than rehab
The refrain is familiar to anyone who’s had an injury (including a surgical one): Rest. Ice. Elevate. Compress. Anti-inflammatory drugs are often on the menu, too. All of it is in attempt to reduce the inflammation. Sure it’s a natural body response to injury, and some inflammation is necessary to start healing. Don’t worry, you’re not going to be able to get rid of the inflammation anyway. It tends to get too ambitious left to its own devices, so we rein it in some.
Compression by elastic wrap, compression sleeves, or whatever is very useful, but can also be overdone. If the fingers and toes sticking out the other end turn purple and tingle or go numb, it’s probably too tight.
Never stop moving, even if it’s not rehab
The morning after a major chest reconstruction, they let me walk right out of the hospital. Not ride in the stupid chair, but walk. The current rule is to get people moving as soon as possible after surgeries or other injuries. Not in a way that’s going to cause damage of course, but moving. This both reduces the risk of blood clots (pulmonary embolisms are what’s known as a Bad Thing) and promotes healing.
Can’t get up and move around yet? Static cycles of tensing and relaxing muscles still has some benefit. It keeps the blood flowing and reduces the fluid buildup by squeezing lymph back toward the heart.
Rehab is mostly about using the limb in its natural ways, only safer
They start you with small movements. Over time, the movements asked for get more range and force. There are controls in place to prevent the bad motions, but right motions are The Thing. (Controls might include wearing the brace, or using resistance bands or an exercise bike where there’s no risk of accidentally overdoing the motion.)
Rehab because physiology says so
It’s a basic fact of physiology: Bodies are always remodeling. That pelvic bone you’re sitting on is not the same protein fibers and mineral salts that were there a year ago, a decade ago. You’re always taking out and replacing yourself, one tiny bit at a time.
Another basic fact: We remodel in response to recent stresses. Lift weights and damage muscles, they will rebuild stronger. Stop lifting, and they still remodel, but now they don’t bother to replace all the force-generating proteins and you get weaker. The rest of you is no different. Brain to blood vessels, everything’s remodeling itself to deal with the way it’s been used lately.
Add those two facts together and the implication is clear: Especially during healing (when remodeling is faster than usual), using the body part in appropriate ways is going to get it to rebuild to have the best function.
Two months in a cast and look at Salty’s muscle loss. As an aside, on the left leg there’s massive discoloration near the ankle… that was caused by a raging infection from a spider bite four years before this picture was taken, but that’s another article.
Rehab is critical. It is not fun. At all.
Injuries that fifty years ago would have meant permanent disability often return to full function today, even if no high tech medicine is involved. They didn’t know the principles of rehab. We do. Good rehab is literally life-changing and can create massive leaps forward in quality of life for the future of the patient. Ask Salty, who rode more than 6000 miles on a bike a few years after an injury that would have been “You’ll never walk without a cane again” without the rehab.
You’ve got to know this fact and cherish it, because actually doing the rehab stinks muchly. During the active phase of rehab, you’re always driving the body part through discomfort all the way up to the border with the Land of Pain. It’s necessary: You’re breaking free the tightest of the fibers that are rebuilding to allow the joint to regain it’s mobility. It’s not fun.
Frustration, impatience, anger … we’ve all been there. The pace of recovery is fast at first but then slows down. You think you’ll never be right again. If you keep at it though, recovery does continue. It’s just slower. It often takes a full year, sometimes two, after a serious injury to recover all that can be recovered. If you quit rehab before then, you’re leaving gains on the table.
Preppers need to know how to care for themselves, in case the professionals aren’t at hand. If you want best function back, that includes knowing how to run your own rehab. And doing it.
A couple of links with rehab exercises:
https://www.verywellhealth.com/knee-rehab-exercises-2549750
https://relaxtheback.com/blogs/news/injury-recovery-and-rehabilitation-exercises