Why do our joints creak
The condition when the mobility of the joints is limited: they bend with difficulty and pain, is called contracture. This violation is characteristic of many ailments. What if this happened? Why can not you “tear” the ossified joint or, conversely, leave it motionless for a long time? Readers Medpulse meets the trauma surgeon, Ph.D. Lev Ustimenko.
Contractures result from illness or after injuries. The most common non-traumatic diseases causing contractures are age-related ailments: arthritis and arthrosis. But other diseases also lead to joint stiffness: stroke, lack of blood supply and muscle inflammation, damage to peripheral nerves, and even … hysteria.
Therefore, it is impossible to cure any persistent contracture without a diagnosis! However, in parallel with the treatment of the underlying ailment, which is always selective, there are common ways to combat contractures.
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This is due to the fact that all these violations have a common path of development. Soft tissues of the musculoskeletal system do not suffer long inactivity. Each of them responds with a characteristic breakdown. The capsule of the joint shrinks and thickens. The muscles atrophy. Adhesions arise between the tendons and the surrounding tissues. The most destructive result of any contracture is ankylosis of the joint, that is, a complete loss of mobility.
If the injury (sprain, subluxation, bruise) was not severe, the body itself will cope with the damage. “Clever pain” will specifically exclude from the repertoire of movements those that interfere with the proper healing of tissues. And as functions return to normal, pain brakes will begin to turn off. As a result of movement, they are violated for a short time; persistent contracture will not have time to ripen.
Multiple microtraumas also cause hand contracture, called Dupuytren’s disease. If the injuries are “microscopic”, then the disease is easily treated? But of all the contractures, this is perhaps the most dangerous.
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Dupuytren’s disease usually occurs on the right hand in men over 40 years old, who have been engaged in manual labor for many years (primarily, drivers of heavy vehicles, tractor drivers, combine harvesters, turners, milling machines, locksmiths). Permanent injuries lead to permanent damage to the tendons of the hand. Fingers are frozen in a bent position. It is impossible to straighten them out with an arbitrary movement.
For the prevention of Dupuytren’s disease, use gloves when working, especially with metal, with as much dense tissue as the subtlety of your work allows. Even under mittens, apply softening and protective cream to the skin, which is in every pharmacy. Without cream, cracks quickly form through which all kinds of damaging factors easily penetrate deep into the tissues. After working with materials from which aggressive substances, splinters, all kinds of shavings can remain on the skin, wash your hands with soap and, better, with cleansing paste, which can be bought at auto parts stores. Then wipe your palms with a sponge or soft cloth. A long tense bent position of the hand (the driver holds the steering wheel) increases the risk of this disease. During each hour of such work, at least 5-7 minutes, do gymnastics, bending and unbending the brush.
The insidious contractures
In their own way, contractures arising as a result of severe “instantaneous” injuries are also dangerous. Here, since the recovery is delayed, for a long time we choose a position for the injured limb that will dictate us pain. And this is almost always an unnatural, wrong pose. A damaged joint quickly gets used to it. After a while, changing the pose becomes very difficult. And after six-eight-week fixation of the limb in a vicious position, contracture can be eliminated only with the help of intensive and prolonged conservative treatment or surgery.
That is why after a serious injury, even if there was no fracture, it is necessary to fix the limb in the correct position using a gypsum splint or a tight bandage. Although immobilization is not the best way out, another evil – that is, the “development” of a seriously ill joint – will cause even more devastating consequences …
However, there are universal principles to combat joint stiffness. Their basis is the use of two polar techniques: to give the joint rest in the correct position, but at the same time to “puzzle” it with movements as early as possible, that is, to begin kinesitherapy. So called treatment through various types of articular movements.
Remember that the correct position (and not the joint that he chooses), excluding edema, ischemia, tension of the joint capsule, can only tell the trauma doctor. For example, for the shoulder joint – this is the abduction of the shoulder by 45 degrees, bending by 40 degrees, and turning the limb inward also by 40 degrees. Even if you correctly calculate these angles, you are unlikely to construct a fixing device yourself, and most importantly, determine the period for which it must be applied.