Scarring
Wound healing describes the process that results in a scar following an injury/surgery & this ability is essential. Scars develop as a result of wound healing. The ideal result is tissue regeneration with the new tissue having the same structure & characteristics as the undamaged skin. In normal scarring the quantity of newly synthesised collagen is not excessive. The tissue should settle to a thin, pale mobile scar, which does not limit joint ROM. Normal scar maturation can take up to 18-24 months & optimal scarring normally occurs in wounds, which have not been infected & been closed & well aligned. Abnormal scarring occurs when there is a defect in the wound healing process including an increase in the amount of collagen produced & a reduction in the amount of collagen being broken down thus a formation of raised, red & tethered scar. As the wound continues to heal inflammation subsides, the number of fibroblasts & endothelial cells decrease & the newly laid down collagen develops into thick, adhesive bundles.
Factors which influence the development of abnormal scarring includes wound depth, wound healing time (wound healing longer than 2 weeks increased risk of hypertrophic scarring), skin colour (fair skin & dark skin has an increased risk of developing hypertrophic scarring), smoking, diabetes & infections. There are 2 types of abnormal scar tissue Hypertrophic & Keloid:
Knowing about how & when to intervene in the wound healing process, is fundamental to achieving optimal function following injury/surgery:
• Therapeutic Aims of Scar Management Maintain and restore function
• Maintain gliding of healing or surrounding structures and promote tissue strength
• Maintain functional positions during immobilisation
• Progressive remodelling of collagen tissue, replicating normal structure and tissue it replaces
• Prevent scar contracture (preventing tension to maintain movement)
• Progressive devascularisation
• Improve cosmetic appearance, pale, flatter more mobile scar. nbsp; nbsp; ACL Injury
ACL Injury
The Anterior Cruciate Ligament (ACL) is one of four major ligaments in the knee, the others being the Posterior Cruciate, Medical Collateral and Lateral Collateral Ligaments. The ACL runs within the knee joint in a diagonal direction from the posterior aspect of the femur to the anterior aspect of the tibia,
The ACL is commonly injured in sport, particularly during activities involving deceleration, pivoting and landing. Injuries such as a partial tear or a full rupture to the ACL commonly result in pain, extensive swelling, instability of the knee, loss of movement and reduced function. ACL injuries can be treated with rehabilitation, or with surgical intervention by means of a ligament reconstruction depending on the severity of the symptoms and instability.
One of the most important components of physiotherapy and rehabilitation following ACL injury, whether surgical intervention is required or not, is the strengthening of key muscle groups to help stabilise and support the knee.
One of the muscle groups commonly affected both post injury and post surgery is the quadriceps muscle group. In particular the action of the VMO fibres (Vastus Medialis Oblique fibres) can be impaired or become atrophied, or the timing of the contraction can become altered, leading to ongoing pain and altered biomechanics of the knee.
Using the Knee-hab muscle stimulation unit either post injury, whilst preparing for surgery, or when recovering from surgery will help to maintain the activity of the quadriceps, in particular the VMO fibres.
Knee-hab can be used for any knee injury or rehabilitation, whereby stimulation of the quadriceps and the VMO is required, and due to its unique design, the Knee-hab ensures correct timing of the contraction of the VMO fibres before the contraction of the rest of the Quadriceps muscle group, to help ensure more effective rehabilitation.
Other key Mobilis Rolyan products relating to knee injuries include CPM machines (post injury or post surgery), orthopaedic braces (post op and post injury), electrotherapy (other muscle stim units) , and equipment to improve proprioception (wobble boards, balance discs, balance beams, trampets).
