This educational service is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon.
Physiotherapist is the best professional to conduct the mobilization program after a fracture or for pain relief and Range-of-Motion exercises.
SMOKING DELAYS INJURY, WOUND & FRACTURE HEALING
Posture Check
Stand in front of a mirror, turn on your side, imagine a plumb line dropped from the center of the head and see if it passes through through the points shown in the picture.
Maintain good posture at all times
.
Picture below show incorrect and correct posture for lifting of weight.
Incorrect and Correct sitting posture as seen below.
SPINE / BACK EXERCISES
http://www.nhs.uk/Livewell/Backpain/Pages/low-back-pain-exercises.aspx
http://www.knowyourback.org/Pages/Brochures/Default.aspx
Please follow the instructions for the use of these brochures, as advised by them you could download and print one copy for your personal use. The contents are for information purpose only. Please read carefully their terms of use.
KNEE EXERCISES
My knee hurts, why should I exercise?
Having strong, flexible muscles is a good way to keep knees healthy and prevent further damage . Symptoms improve by 50 percent with exercises in most cases.
Muscle Strength
Strengthening muscles that support your knee will reduce stress on your knee joint. Strong muscles in the front of thigh (quadriceps) and back of thigh (hamstrings) help knee joint to absorb shock. The reduced strain on the knee increases the chances for pain relief and prevents further injury.
Flexibility of Muscles
Stretching the muscles that are strengthened can prevent further injury. Strengthening exercises build muscle to support the knee, but can also make the muscles taut and more prone to injury. Gentle stretching after strengthening exercise reduces muscle fatigue and will keep the muscles flexible.
Quadriceps muscles are in front of thigh.
Hamstring muscles are at back of thigh.
Find out which exercises are right for you from your doctor.
Take time to build muscle strength slowly. As you get strength,gradually increase the number of exercise cycles and gradually add strap-on weight to an exercise.
Accept mild discomfort but do not ignore appreciable pain in an exercise. If an exercise hurts, stop the exercise for a while and Rest the knee till the soreness goes.
Strengthening Exercises
Walking and cycling for 5-7 mins is good for warm up before these exercises.
Straight-Leg Raise (SLR)
Lie on your back with one leg bent and the other straight. Slowly raise the straight leg for 1-2 feet off the floor. Hold it for 30 to 45 seconds or less. Slowly lower your leg to the base. Repeat and switch sides.
Switch to lie on your stomach and do the same for hamstring muscles
Tighten your stomach or back muscles to keep your low back/stomach flat against the floor or bed.
Add weights gradually if you can. Keep your knees close together.
Focus on your supporting leg. It is working just as hard as the moving leg.
Wall Squat
Please do only when specifically asked by your doctor
Stand with your head, back, and hips against a wall. Step your feet out about 1.5 feet from the wall, hipwidth apart. Slowly slide down the wall until you are almost in a sitting position. Hold for 5 to 10 seconds upto 30 seconds if you can, then slowly slide up. Repeat.
Keep your abdominal muscles tight. Hold the position longer as you get stronger.
Step Ups
Use a small stool or platform. Step one foot onto the platform. Lift your other foot off the floor, letting it hang loosely off the platform. Try to hold for 5 -7 seconds. Slowly lower your hanging foot to the floor, then bring your stepping foot down. Repeat and switch sides.
Take care to put whole foot is on the platform.
Stretching Exercises
Quadricep Stretch
Hold on to a wall or the back of a chair for balance. Lift one foot and bring your heel up toward your buttocks. Grasp your ankle with your hand and pull your heel closer to your body. Hold the stretch for 30-40 seconds.
Stop bringing your heel closer when you feel the stretch.
Hamstring Stretch
Sit up tall with both legs extended straight in front of you. Your feet are neutral — not pointed or flexed. Place your palms on the floor and slide your hands toward your ankles. Hold for 30 seconds.
Keep your chest open and back long. Reach from your hips. Stop sliding your palms forward when you feel the stretch.
Shoulder Exercises
After Fracture
After a fracture of the head of humerus esp. a Four-Part-Fracture or Fracture of Neck Humerus when your treating doctor has initiated
Phase 1 of the exercise program:
Apply ” Cuff and Collar ” sling. 
This allows the weight of the arm to pull the humerus downwards with gravity support. The downward pull helps the fractured bones to heal in the aligned position and prevents angulation. Keep moving your fingers, wrist and hand whilst in the Sling to prevent stiffness and swelling.
Your doctor will advise you when it is safe to start Range-of-Motion, Active-Assisted, Active and then Progressive Muscle strengthening exercises. DO NOT attempt to do too much too soon or you may harm your shoulder fracture.
Pendulum Exercises
Exercise from 15-20 minutes 2 or 3 times a day during your early recovery period.
Bend forward 90 degrees at the waist, using a table for support.
Move arm in a circular pattern to move arm clockwise 10 times, then counterclockwise 10 times. Do 3 -4 sessions a day.
Phase 2
Your surgeon and Physio will have a tailor-made program for functional restoration.
Assisted shoulder flexion, abduction, and rotation should begin at 1-week post injury. Isometric deltoid and cuff exercises should be initiated at 3 weeks, and progressive strengthening and stretching can usually be initiated between 6 and 12 weeks.
Eight to twelve weeks after injury, your strength and mobility should improve enough to allow for normal function of your arm. Your pain level should be minimal as well. At this time, your physical therapy program may be done intermittently. You may still be required to perform exercises at home for a few months to maximize mobility. Understand exactly what to do and what to expect.
Factors such as malunion, capsular contracture, rotator-cuff tendinitis, regional pain syndrome, sub-acromial impingement, delayed rehabilitation, and non-compliance with rehabilitation all contribute to the development of stiffness. Ultimately, early mobilization is the appropriate method preventing stiffness in the proximal humerus fracture treated without surgery.
Recovery can take upto a year.
Forearm and Wrist Exercises
After Fracture of Radius &Ulna and Fractures around Wrist
A. Pronation B. Supination
C. Wrist Dorsiflexion D. Wrist Plantar flexion
Back exercises
http://www.nhs.uk/Livewell/Backpain/Pages/low-back-pain-exercises.aspx
http://www.knowyourback.org/Pages/Brochures/Default.aspx
Knee Exercises
http://www.nhs.uk/Livewell/c25k/Pages/knee-exercises.aspx
Stroke Recovery Exercises
Follow the link below for the exercise plan when your treating doctor has recommended them. Do not initiate the program youself. Abide by the sites privacy policy.
http://www.stroke.org/stroke-resources/library/hope-stroke-recovery-guide
Useful Exercises in Gym for Upper and Lower limb – Movie Clip by Dr. Kapil Bakshi
Avoid Commercial Protein Supplements
Stretching Exercises with stretch band.Useful links for exercises from Singapore General Hospital – Sing Health.
Upper Limb Exercises
Dr. Kapil Bakshi (Bakshi Orthopaedics - A Patient Education & Guidance Resource) 