Physio Talks: Move Wonky, Heal Wonky

A basic principle of healing goes by the fancy title Wolf’s Law. It states that the way tissue heals results from the stresses put on them during the healing process. This was dramatically shown in burn victims who typically developed serious scarring that further disfigured their bodies. If the scar was placed under pressure it flattened, smoothed out, and softened. If not, it was hard, drawn and inflexible.
Well, if you have seen me in the clinic for an injury somewhere in your leg, you’ve heard me preaching, “Don’t limp”. If crutches or a cane are needed in order for the patient to walk without limping that’s what we use. If the patient gets impatient (little health care joke there) and starts limping because he/she gave up the crutches I HIGHLY recommend using them again, until the walking is a normal pattern without them.
Why? Because, if you walk wonky, you heal wonky. Just like the burn scar you can see on the skin, the scar inside, around the injured part, responds to the stress you put on it by either healing in a higgledy piggledy unorganized fashion or with fibers aligned in the direction of the original tissue that was injured. Disorganized scar is weak, short and inflexible while scar organized along the lines of the original tissue is much stronger (not as strong as the original tissue but stronger than disorganized).
So, what ever part is injured, if the injury involves the ligaments, tendons or muscles around one or more joints make sure that the movement you impose on the area resembles a normal movement while the healing is going on. For instance, if you have to take smaller steps in order for them to look normal, take smaller one until there is enough healing to take larger ones. If you can’t lift your hand high enough and far enough back to wash the back of your head without contortions and serious pain, find another way to get the washing done until there is enough healing to allow the normal motion the whole way up. The alternative is an incomplete healing with a weak result and increased likelihood of reinjury. I suspect no one really wants to go through the process a second time. Patience is a virtue, for a reason.
These comments are general in nature. Be sure to check with your physio or doctor if you are not sure whether they apply to your situation.

Dave RoheDave Rohe is a recently retired physio having practiced in New Zealand since 2004.  He originally qualified in the USA, subsequently practicing in Malawi, Egypt and Cambodia prior to emigrating to New Zealand in 2003.  He has enjoyed management positions in pediatric and adult outpatient facilities as well as taught physiotherapy for 15 years at the University of Georgia.  He is currently living in Parakai with his wife, Sharon Robinson, a local midwife, near his adult children who are working, and one of whom is studying to qualify as a physio through the programme at the University of Otago.  His articles previously appeared in local newspapers in Taranaki and on the blog site sponsored by NZSPT.

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