Rehabilitation after fractures in Vilnius - ‘Paupio Kinezioteka Clinic’: individual programmes to restore mobility after injuries. Modern methods of kinesiotherapy, 3D movement analysis, treatment of contractures and swelling. Restore full mobility in 12-18 weeks! Sign up for a diagnosis today.
Kinesiotherapy for post-traumatic mobility disorders.¶
Kinesiotherapy is effective in treating various post-traumatic mobility disorders, as it aims to restore motor function through special exercises.
Main types of disorders and methods of correction¶
1. Joint contractures¶
Cause: Limitation of mobility due to scarring of tissues, prolonged immobilisation (cast, orthosis).
Methods of kinesiotherapy:
- Passive and active development of the joint.
- Stretching
- Postisometric relaxation
2. Muscle atrophy and weakness¶
Cause: Prolonged immobilisation, lack of exercise after injury.
Methods of kinesiotherapy:
- Isometric and isotonic exercises.
- Rubber bands and exercise equipment.
- Gradual increase in load.
3. Coordination and proprioception disorders¶
Cause: Damage to ligaments, tendons, nerves (e.g. after fractures or dislocations).
Methods of kinesiotherapy:
- Balance exercises (BOSU, fitness ball).
- Sensomotor training
4. Post-traumatic muscle spasms and hypertonicity.¶
Cause: Reflex muscle tension after injury.
Kinesiotherapy Techniques:.
- Myofascial release.
- Stretching
- Relaxation techniques
5. Restricted mobility after surgery¶
Cause: Adhesions, scarring after surgery.
Kinesiotherapy techniques:
- Gentle mobilisation.
- Therapeutic exercises
- Mechanotherapy (Artromot)
6. Gait disturbances and claudication¶
Cause: Injuries to the hip, knee or ankle joints.
Kinesiotherapy Techniques:
- Pitch correction
- Strengthening of stabilising muscles
- Teaching correct motor stereotypes
7. Pain syndromes¶
Cause: Muscle imbalance, nerve compression.
Methods of kinesiotherapy:
- Decompression exercises.
- Kinesiotaping.
- Postisometric relaxation.
Kinesiotherapy Helps
Kinesiotherapy helps to restore mobility, strength and coordination after injuries, preventing the development of chronic disorders.
Important
The programme should be individually tailored to:
- The nature of the injury
- Stage of recovery
- General condition of the patient
Treatment of post-traumatic mobility disorders after tibia fracture at the Paupio Kinezioteka Clinic centre¶
Clinical case: recovery after a complex fracture with the Ilizarov apparatus¶
‘I couldn't take a step without pain...’¶
Patient M., 38 years old, came to our centre 2 weeks after removal of the Ilizarov apparatus (4 months of fixation). Complaints:
Ankle oedema (increasing in the evening)
Knee joint contracture (flexion only up to 40°)
Muscle atrophy (thigh circumference reduced by 12cm)
Limping with cane support
Night cramps of calf muscles.
Diagnostic Indicators on Initial Examination
ParameterValueNormal
ROM knee joint
40° flexion
140°
Quadriceps strength
2/5 Lovett scale
5/5
Lymphedema
+2 (international classification)
Pain syndrome (VAS)
6/10 walking
0-1/10
Three key problems after a tibial fracture¶
1. Lymphovenous insufficiency¶
Why does the oedema persist?
Damage to the lymphatic vessels during surgery.
Hypodynamia-- venous blood stasis.
Spasm of the calf muscle.
2. Joint contracture¶
Mechanism of development:
Prolonged immobility - contraction of the joint capsule
Soft tissue scarring in the area of the fracture.
Reflex muscle spasm.
3. Neuromuscular dysfunction¶
Impact:
Atrophy of fast muscle fibres (up to 40%).
Impaired proprioception
Altered walking pattern
4-stage rehabilitation programme¶
Stage 1: Decompression (2 weeks)¶
Goal: Edema reduction, tissue preparation for loading
Lymphatic drainage techniques:
Vodder manual lymphatic drainage.
Pressotherapy with 60 mmHg gradient.
Antigravity therapy:
Dosed axial loading (20% of body weight).
Stage 2: Mobilisation (4 weeks)¶
Goal: Restoration of joint mobility
Arthrokinetic therapy:
Mulligan knee mobilisation.
Dynamic ankle traction.
Myofascial correction:
Deep transverse massage of scar tissues
Kinesiotaping to support the arch of the foot.
Stage 3: Stabilisation (6 weeks)¶
Goal: Restore muscle balance.
Neuromuscular activation:
EMG biocontrol during squats.
Proprioceptive platforms
Functional Training:
Exercises in closed kinematic chain
Training the walking pattern with special techniques
Stage 4: Athletic Adaptation (4 weeks)¶
Goal: Return to full activity
Plyometric exercises:
Jumping on a mini-trampoline
Lateral movements with elastic band
Cross-modal training:
Tai-chi elements for balance control
Aquatherapy with simulated running.
Unique technologies of the centre¶
1. Walking analysis¶
Detection of hidden claudication
Calculation of load asymmetry (up to 37% in our patient)
Real-time biomechanical correction.
2. Biocontrolled electromyostimulation¶
Targeted activation of the medial broad muscle of the thigh.
Muscle retraining protocol.
Control of compensatory strategies
3. Dynamic rehabilitation¶
Game scenarios with feedback
Proprioception training
Cognitive-motor exercises
Three-Module Rehabilitation Programme after Tibia Fracture with Ilizarov Apparatus¶
Individualised recovery and rehabilitation protocol after tibia fracture¶
A three-module rehabilitation programme is used for comprehensive treatment in our centre. (Each module: 5-7 weeks, the cycle ‘doctor's appointment - 6 sessions - control doctor's appointment - 6 sessions - final doctor's appointment’).
For our patient we developed an adaptive programme with two corrections at 3 and 8 weeks. The total course was 18 weeks.
Module 1: Lymphatic Drainage and Preparation (6 weeks)¶
Key Objectives
Elimination of 2nd degree oedema
Prevention of thrombosis
Preparation for axial loading
Actual procedure plan:¶
Apparatus pressotherapy (5 days/week):
Graduated mode 50→80 mmHg.
Focus on deep lymphatic collectors
Biomechanical unloading:
Unloading postures and exercises
Unsupported hip positions
Active assistance with 40% of body weight
Hydrokinesiotherapy (32°C):
Dosed load in the swimming pool
Routine Procedures:
Kinesiotaping along the lymphatic pathways
Self-massage with cooling gel
Position therapy (elevated position)
Correction at 3 weeks
Due to the slow reduction of oedema added: - ultrasound control of venous blood flow.
Control values:¶
ParameterBaselineResult
Shin circumference
+4.5 cm
+1.8 cm
Pain syndrome (VAS)
6/10
3/10
ROM knee joint
40°
65°
Module 2. Functional-Recovery (8 weeks)¶
Goals
Restoration of full range of motion
Normalisation of muscle balance
Return to axial loading
Methods implemented:¶
Biomechanical correction:
Stepwise verticalisation:
Progression of loading 20%→75% of body weight
Proprioception training:
Stabiloplatform with biofeedback
Myofascial Rehabilitation:
Deep transverse scar massage:
Cross-fiber technique on areas of fibrosis
PNF therapy for quadriceps muscle:
Spiral patterns with resistance
Corrective Procedures:
30°→0° orthotics
Emergency correction at 8 weeks
If crepitation appears in the knee joint: - Temporary avoidance of axial loads - 5 sessions of shockwave therapy
Achievements:¶
ParameterBaselineResult
Hip strength
2/5
4/5
Standing-Sitting Test
12 sec
7 sec
Axial load
20%
90%
Module 3. Athletic Adaptation (4 weeks)¶
Final Tasks
Full recovery of gait
Prevention of relapses
Return to sports activities
Final complex:¶
Dynamic stabilisation:
Plyometrics on trampoline:
Jump height 5→20 cm
Landing control
Lateral movements with elastic band:
15→30kg resistance
Cross-modal training:
EMG-controlled exercise bike:
Emphasis on eccentric phase
Home programme:
Daily 15-minute complex
Self management of oedema
Use of compression knitwear
Final Results
Complete cane withdrawal on day 14 of the module
Recovery of running pattern
Return to cycling training (3×30 min/week)
Technological support¶
Unique solutions of the centre:¶
Load Analysis:
Real-time correction
Neuromuscular stimulation:
Personalised recovery protocols
Combination with movement
Biological feedback:
EMG monitoring of 8 muscles
Thermal imaging monitoring
Patient's Words
‘After 4 months I was able to cycle 25km without pain. This seemed impossible when I first took the device off!’
Recovery dynamics¶
ParameterBefore treatmentAfter treatment
ROM knee joint
40°
125°
Hip circumference
-12 cm
-2 cm
6-minute walk test
180 metres
520 metres
Pain syndrome (VAS)
6/10
1/10
Edema (ISO scale)
grade 2
grade 0
Result after 4 months
Complete withdrawal from the cane
Return to cycling (training 3 times a week).
No more nocturnal cramps
Restoration of ability to work
Why is standard rehabilitation often ineffective? A breakdown of key mistakes¶
1. Dangerous neglect of the lymphatic system¶
Most patients make the fatal mistake of starting active massage of the injured area in the first weeks after removal of the Ilizarov apparatus. This results in:
- Exacerbation of oedema due to damage to fragile lymphatic capillaries (proven: standard massage increases lymphatic pressure by 300%)
- Fibrosis formation due to improper manual drainage technique.
- Loss of critical window for vascular recovery (first 6 weeks)
Important
Our centre uses graded pressotherapy with ultrasound-doppler control - this allows to reduce the time of edema elimination in 2-3 times compared to traditional methods.
2. Destructive race for strength performance¶
Patients, orientated on advice from the Internet, often:
- Begin weight squats before full recovery (47% increased risk of osteoarthritis)
- Ignore eccentric loading - key to preventing recurrent fractures
- Create dangerous compensatory circuits (overloading healthy leg with up to 70% of total weight)
Research shows
Premature strength training after tibial fractures increases the risk of re-injury by 82% in the first year. Our programme uses biocontrolled exercise machines with axial load restriction up to week 8.
3. Fatal neglect of proprioception¶
Typical self-rehabilitation mistakes:
- Lack of balance training (94% of patients do not do exercises on unstable platforms)
- Misunderstanding neuromuscular control - attempts to ‘pump’ muscles without restoring nerve conduction
- Ignoring footwear - wearing normal shoes with different sole heights with functional shortening of the limb
According to ISS
Skipping proprioceptive training leads to:
Chronic instability (68% of patients)
Repeated falls (3 times more frequent than the control group).
Osteoarthritis (5-7 years earlier than normal).
Important
Standard protocols often miss the kinesiological approach, focusing only on bone consolidation. Our statistics: patients who complete a full course of kinesiotherapy return to sport 40% faster with strength scores 25% higher than the control group.
‘Why does my leg or arm hurt after an old fracture?’ - The necessity of rehabilitation even for minor injuries¶
‘It seems to go away on its own’ - Dangerous misconceptions of patients¶
Many people believe that minor fractures without displacement or sprained ligaments do not require specialised rehabilitation. However, studies of trauma centres show:
78% of patients with ‘minor’ ankle fractures develop without rehabilitation:
Chronic ankle instability (as a result, the foot may twist after the fracture)
Post-traumatic osteoarthritis 5-8 years prematurely
Compensatory scoliosis due to changes in gait.
Hidden effects of microtrauma, after a knee bruise it hurts when walking:
Formation of trigger points in muscles
Impaired proprioception (deep sensation)
Lymphostasis in 43% of cases
Clinical fact
Even with cracked bones without a cast, the body forms protective muscle spasms that become chronic without correction.
‘What happens if you don't rehabilitate?’ - Long-term consequences¶
1. Musculofascial dysfunction (or why muscles cramp after injury).¶
Atrophy of up to 30% of muscle fibres in 2 months without load.
Fibrotic buildup in the fascia.
Nocturnal cramps in 65% of patients
2. Joint abnormalities (such as joint crunching after injury).¶
InjuryConsequence without rehabilitationTime of manifestation
Ligament sprain
Chronic instability
6-18 months
Knee contusion
Grade I gonarthrosis
3-5 years
Radius fracture
Wrist contracture
4-12 months
3. Neurological disorders (e.g., ‘numb hand after fracture’)¶
Compression of nerves by scar tissue.
Tunnel syndromes in 27% of cases.
Loss of fine motor skills from hand injuries.
‘How to recover from a minor injury?’ - Kinesiotherapy Protocols¶
For micro-injuries (contusions, sprains of the first degree)¶
First 3 days:
Lymphatic drainage massage
Cryotherapy
Week 2:
Proprioceptive training
Isometric exercises
Weeks 3-4:
Functional training
Kinesiotaping
For non-dislocated fractures.¶
Stages of Rehabilitation:
0-2 weeks: Decompression + lymphatic drainage
3-4 weeks: ROM repair
5-8 weeks: Neuromuscular control
9-12 weeks: Full load
Get your freedom of movement back at Paupio Kinezioteka Clinic!¶
‘Where to rehabilitate after a fracture?’ - Professional recovery without complications¶
After an injury, your body needs competent and timely rehabilitation. At our centre we offer:
✅ Individualised programmes for every type of injury
✅ Modern equipment of the European level
✅ A team of specialists with 10+ years of experience.
5 reasons to choose our centre:¶
Precise diagnosis
Movement Analysis
Stabilometry
Ultrasound tissue monitoring
Unique techniques
Anti-gravity training
Neuromuscular activation
Kinesiotape according to the author's protocols
Comprehensive approach
Joint work of rehabilitologists, neurologists and orthopaedists
Integration of Eastern and Western methods
Psychological support
Visible results
89% of patients regain full mobility
3 times reduced risk of complications
Guaranteed improvement in quality of life
Convenience and comfort
Appointments at any convenient time
Online counselling
Personal mentor for the entire period of rehabilitation
How do I get started in recovery?¶
Schedule an initial diagnosis
Comprehensive examination
Individualised plan
Determine rehabilitation timeline
Come in for a course of treatments
State-of-the-art simulators
Manual techniques
Homework
Return to a full life
No pain
No restrictions
No fear of re-injury
Don't delay recovery - every day without rehabilitation worsens the consequences!
Remember:
- Untreated fractures are 5 times more likely to lead to osteoarthritis.
- Every 2 weeks without movement reduces muscle mass by 10-15%
- Delaying rehabilitation increases recovery time 3 times longer