Contracture is a condition where the mobility of the joints is limited, they are bent with difficulty and with pain. This violation is typical of many ailments.

Types of contractures

Contractures appear as a result of diseases or after trauma. The most common non-traumatic diseases that cause contractures are age-related ailments: arthritis and arthrosis. Other diseases such as stroke, lack of blood supply and muscle inflammation, damage to peripheral nerves and even ... hysteria lead to stiffness of the joints.

Therefore, it is impossible to cure any resistant contracture without finding out the diagnosis! However, in conjunction with the treatment of the underlying ailment, which is always selective, there are common means to combat contractures.

It is caused by the fact that all these violations have a common path of development. Soft tissues of the musculoskeletal system need constant movement and do not tolerate long inactivity. Each of them corresponds to a characteristic breakdown. The joint capsule is wrinkled and then thickens. Muscles atrophy. There are adhesions between tendons and surrounding tissues. The most pernicious outcome of any contracture is ankylosis of the joint, that is, complete loss of mobility.

If the injury (subluxation, sprain, bruise) was not strong, the body will cope with the damage itself. The pain will help to exclude those movements that prevent the proper healing of tissues. And gradually, as the functions will return to normal, the pain stops will turn off. As a result, the movement is broken for a short time, persistent contracture does not have time to mature.

Multiple micro-trauma causes a contracture of the hand called Dupuytren's disease. It may seem that if the injuries are "microscopic," then the disease is easily treated, but it's far from being so! Of all the contractures, this is definitely the most dangerous.

Prevention of disease

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 heavy truck drivers, tractor drivers, combine operators, turners, milling machines, locksmiths). Permanent injuries lead to permanent damage to the tendons of the hand.

Fingers freeze in a bent position. And it is impossible to unbend them arbitrarily.

For the prevention of Dupuytren's disease, it is recommended to use mittens when working (especially with metal), with the most dense tissue, as far as the fineness of your work permits. Even under the mittens, apply to the skin an emollient and protective cream that can be bought at every pharmacy. Without a cream, cracks quickly appear, through which various damaging factors easily penetrate deep into the tissues. After working with materials that can leave aggressive substances on your skin, splinters, all kinds of shavings, be sure to wash your hands with soap and, better, with cleaning paste that you can buy at auto parts stores. Then wipe your palms with a sponge or a soft cloth. The long and strained bent position of the hand (the driver holds the steering wheel) increases the risk of this illness. During each hour of such work, at least 5-7 minutes do gymnastics, bending and flexing the brush.

Try to protect your hands carefully, do not forget about exercises and you can prevent this disease! A feature of the destructive process in tissues under Dupuytren's contracture is that it moves forward with extraordinary perseverance. And even when a person changes jobs and starts conservative treatment, which helps cure all other contractures! In more than 90% of cases, a surgical operation is necessary here. But she, because of the great complexity and fragility of the tendon mechanism of the brush, only in rare cases will restore her movements completely.

Movement for treatment

In their own way, contractions that result from severe "one-time" injuries (such as fractures, dislocations) are dangerous. Here, as the recovery drags on, we permanently select for the injured limb a position that the pain will dictate to us. And this is often an incorrect and unnatural position. A damaged joint quickly gets used to it. After a while, it becomes very difficult to change the position. And after six or eight weeks of fixing the joint in the wrong position, contracture can be eliminated only by intensive and prolonged conservative treatment or surgery.

That is why, after a serious injury, even if there was no fracture, it is necessary, as soon as possible, using a gypsum tire or a dense bandage, to fix the limb in the correct position. Although fixing is not the best way out of the situation, but such a problem as "working out" a severely sick joint - will cause even more destructive consequences ...

Nevertheless, there are universal principles of combating stiffness of the joint. Their basis is the use of two polar techniques: to give the joint rest in the right position, but at the same time as soon as possible begin to perform the exercises, that is, proceed to kinesitherapy. This is what treatment is called by means of various types of joint movements.

Remember that the correct position (and not the one that the joint chooses himself), eliminating edema, ischemia, tension of the joint capsule, can only tell the trauma doctor. For example, for the shoulder joint - this is a 45 degree deflection of the shoulder, bending by 40 degrees and turning the limb inward by 40 degrees. Even if you correctly calculate these angles, you still do not construct the fixing device yourself, and most importantly, do not determine the period during which it should be applied. Therefore, never postpone the trip to the emergency room after any severe trauma or even, in your opinion, not serious, but such, after which the tight mobility for some reason does not pass.

Self-treatment is unacceptable

Let us now turn to kinesitherapy. The lion's part of patients' appeals to a traumatologist about contractures are such cases. The knotted joint is triturated with an ointment, taken as an analgesic, alcohol and jerk straightens the limb. The result can be multiple disruptions of muscles, tendons, ligaments and the need for surgery! Even if you do not damage soft tissues, contracture caused by reflex muscle spasm (pseudo-paralysis of muscles) can develop. It is difficult to treat, often "remembered" by the centers of nervous regulation and comes back in the most dangerous way, say, while swimming in cool water.

At the same time, the early appointment of physiologically justified and correct movements is the best method of prevention and treatment of contractures. Reduction of muscles and movement in the joints strengthens the nutrition of tissues and metabolism, preventing the onset of stiffness.

Treatment with movements in contractures is carried out in the form of passive and active therapeutic gymnastics. With the help of passive physical exercises, and also massage try to stretch the contracted muscles and periarticular tissues. In the case, for example, of the already familiar to us Dupuytren's contractures, massage the muscles of the forearm near the wrist with stroking and rubbing movements. In between the massage, using a healthy arm, passively develop the bent fingers of the affected hand. They smoothly unbend before the appearance of tolerable pain. In each of your exercises with a total duration of up to 20 minutes, there should be 5-6 massages and the same extensor charge.

Exercises and procedures

In the case of any stiffness, things will go faster if you do the exercises in a warm bath and also after warm wrapping of the limb or mud applications. There are many useful additives that enhance the therapeutic effect of such baths (aromatic oils and extracts of eucalyptus, alfalfa, birch buds, cowberry, chag, nettle, needles, chlorides and sulfates of silver, potassium, magnesium, copper, sodium, salt of the Dead Sea).

But it does not hurt and go to physiotherapy . After all, when running contractures, curative substances must penetrate deep into tissues in sufficient quantities. And this can be achieved only by applying electrophoresis or another method for "pushing" molecules into tissues. In extreme cases, the doctor uses injections, for example, in the formed scars. In order to soften the scar tissue, the enzyme lidaz is injected. Local application of dressings with another enzyme - ronidase - is shown. They are applied to the scar area for at least two weeks. For injections, use also extracts of aloe, which contains powerful softening agents.

Active exercises with stiffness should not only stretch the shortened tissues, improve their metabolism, but also increase the strength of stretched muscles that counteract contracture. So, with flexion contractures, the extensor muscles "swing" and vice versa.

Especially useful exercises with resistance on the simulators. With persistent and diligent use (at least 5 times a day, but each session is no longer than 15-20 minutes, the total duration of the training is not less than a month), it is enough for those rubber or spring simulators-expander or special balls for the brush, which are sold in sports stores. However, if you have the opportunity to study in the physiotherapy room, do not miss it! Even obsolete block devices have the advantage that the load on the joint can be clearly dosed. Thus, you can set a new task for each exercise, slightly raising the "bar". Overcoming it, you will feel how you overcome the ailment, and this will be an essential psychological help in your recovery.

Folk remedies for contractures

• To treat the joints can be a warming fritters, which is prepared as follows. Mix 250 ml of sunflower oil, 250 ml of kerosene, and 5-10 (depending on the desired strength) pods of red hot pepper, ground on a meat grinder. Insist in a warm place for 9 days, shaking daily. Then filter. Rub in the painful area with light stroking movements and wrap the sore spot with hair.
• 300 g of horse chestnut fruits peeled off, finely chopped. Pour into a dark half-liter bottle, pour over the neck of vodka, close the cork. Insist 2 weeks in a dark, warm place, shaking every day. Patient, stiff joints rub off at night every day.
• 50 g of fruits or flowers of horse chestnut on 0.6 liters of vodka. Infuse for 2 weeks in a warm place, shaking daily. Then filter, store in a dark place. Take 30-40 drops 3-4 times a day for 3-4 weeks. "