Pelvic fractures can be painful and debilitating. Major pelvic fractures may require surgery, but minor pelvic fractures can heal themselves without the need for surgical intervention. Physical therapy can only begin when the bones have sufficiently healed. This may take two to three months. During this time, you are typically not allowed to place your full body weight on your feet. Once the bones have healed enough for you to be able to hold your own weight, physical therapy can begin. Always consult with your physician before starting any exercise program.
Phase 1
In the first phase of physical therapy following a pelvic fracture, the physical therapist may employ a wide range of modalities to break up any fibrous scar tissue that has formed around your muscles. Scar tissue limits mobility by hindering the muscles' ability to contract. Contrast therapy, which involves applying ice packs and heat pads to the hips, usually begins in the first phase and lasts throughout your physical therapy treatment. Light stretching and deep tissue massage are done by a physical therapist at this stage.
Phase 2
Several weeks into your physical therapy, you may begin walking. After spending two to three months on crutches or in a wheelchair, your body may have lost the ability to walk normally. The physical therapist may have you walk on a treadmill to get you used to walking again. The therapist will assess your gait to see if you have developed any strength imbalances and can prescribe specific light corrective exercises to minimize those imbalances.
Phase 3
Once the physical therapist has decided you are ready to progress to the next phase, you will begin abdominal and hip exercises using only your body weight. The exercises may include straight leg raises, bicycle kicks, side leg raises and pelvic bridges. Even though you have progressed to the third stage of physical therapy, you may still be required to continue the treatments given in the first and second stages.
Phase 4
After you have built sufficient muscle strength in the abdominals and lower extremities, you can then begin load-bearing exercises. These exercises use your body weight plus additional weight to further challenge your muscles as you get stronger. Some load-bearing exercises include squats, lunges, weighted leg raises and leg presses. At this point, you may be about six to eight months into the physical therapy program. As the muscles that support your pelvis continue to get stronger, you can return to normal activity.
References
- "Essentials of Strength Training and Conditioning"; Thomas R. Baechle and Roger W. Earle; 2000
- "Rehabilitation for the Postsurgical Orthopedic Patient"; Lisa Maxey and Jim Magnusson; 2001
