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Physiotherapy & Rehabilitation

Physiotherapy and rehabilitation with the following available;

  • Core stability class
  • Hydrotherapy class
  • Neurological rehabilitation
  • Paediatric rehabilitation
  • Muscular skeletal rehabilitation

To clear chest secretions;

Perform deep breathing exercises to help mobilize the secretions in the airway that accumulate due to prolonged bed rest and lying on your back during theatre.

Take a deep breath in through the nose to fill your lungs with air, hold for at least 5 seconds and slowly breath out through the mouth. Do this 3-4 times slowly and then cough.

If you have an abdominal incision and need to cough, remember to bend your knees, put your hand or a pillow over the incision site and hold firmly before you cough.

To reduce swelling in the limbs, perform the following exercises;

For the arm.

  • Always keep the arm elevated on the pillow.
  • Bend and straighten the fingers
  • Make a tight fist, hold for about 20 seconds and relax

Do this 10 times hourly.

For the legs

Sitting or lying with your knees straight,

  • Move your feet up and down at the ankle
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  • Make circling movements at the ankle
  • Alternate knee bending and stretching

Do this 10 times hourly.

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Remember to always keep your legs elevated in sitting and lying until the swelling resolves.

  • If no fracture in the legs, try to stand and walk around.

To improve your muscle strength:

Start with gentle exercises to avoid pain at the incision. These help to align the muscle fibres well during the healing process so that contractures and adherent scars don’t form and the muscles regain their original property and function.

Exercises to strengthen the abdominal muscles

Transversus abdominis

Lying on your back, knees bent and feet on the bed, gently pull the lower abdominal muscles in, hold for 10 seconds and relax. Remember to keep breathing in and out normally as you pull the abdominal muscles in.

47To be sure if you are doing the right exercise, feel the muscles of the lower abdomen by putting your fingers on the pelvic bones and move inside. You should feel them tighten as you pull the abdominal muscles in.

 

Pelvic rocking

Lying on your back, knees bent and feet on the bed, reduce the curve of your back by tucking the bottom and increase the curve by sticking the bottom out the other way.

Bridging.

48Lying on your back, knees bent, feet on the bed and arms spread on the sides of the body. Bend and push through your elbows, tighten your bottom muscles as you lift your bottom off the bed. Hold for 20 seconds and then lower slowly. Repeat this exercise five times and gradually increase to ten times after every 2 hours.

Patients with fractures in the lower limbs shouldn’t do this exercise unless reviewed by the physiotherapist.

Turning in bed

After any surgery at the back or abdomen it is important to minimize any movements involving twisting of the back, which will cause pain. When turning from supine to side lying, bend the knee that is opposite to the side you are to lie, turn the head towards the side you are to lie and gently roll this knee and corresponding arm simultaneously to lie on the side.

Getting out of bed

Lying on your side, move your legs off the bed edge allowing them to swing. Bend and push through the elbow of the lower arm. With the upper arm at the front, push through its hand to get into a sitting position. To go back to bed, reverse this process.

To improve on the general body strength

  • Always spend more time sitting than lying in bed.
  • If no fracture in the lower limbs, no/mild dizziness on sitting on the bed edge, try a stand and even walking around the ward.

For the first time, you may need close monitoring by the attendant incase you lose balance.

You should try to start gentle exercises after the birth of your baby.   Most hospitals offer physiotherapy services or classes.   Before you go home it is a good idea to go to these classes as you will be able to find out if you are doing the exercises correctly.

The exercises in this booklet can be started the day after your baby is born.

Breathing Exercises

When you spend many hours lying on your back during your delivery the lungs push on the back and they can not expand fully and there is a tendency to retain secretions in your chest.   Deep breathing exercises and supported cough help to reduce secretions.

Take a big breath in, trying to fill the bottom of your lungs, hold it for 5 seconds and breathe out slowly.   Do this 4 times then cough, When coughing always hold the site of your operation to avoid pain.   You can also use a pillow to support the site of operation.

Repeat the deep breathing and coughing exercise above every hour.

Circulation Exercises

During pregnancy there is an increase in the fluid in the body and mothers tend to have swollen legs.   The following exercises help to reduce swelling.

  1. Move the feet up and down, and in circles
  2. Bending and straighten the legs
  3. Try to walk around
  4. When resting elevate the legs

Repeat the circulation exercises every hour.

Back care and Posture.

It is necessary for mothers to care about their backs and posture after giving birth.   During their pregnancy their posture is altered due to the weight of the baby.   The abdominal muscles are stretched and this forces the curve in the lower back to increase which can cause back pain.

Good posture is maintaining the natural curves of the spine.   Pull in your abdominal muscles when standing and sitting and imagine growing tall.   Aim to always have these abdominals working, particularly if you are carrying or lifting the baby.

Tips for back care

  1. Wash clothes with the basin on the table
  2. Don’t carry anything heavier than your baby
  3. Lift your baby towards your breast for feeding, sit straight and don’t lean forward – try using pillows for support
  4. Use a broom with a long handle when cleaning the house
  5. When cleaning or changing your baby put them on the table instead of the floor
  6. Bend your knees when picking objects from the floor

Pelvic Floor Muscles

When you have a baby all the abdominal muscles and pelvic floor muscles become weak which can lead to leakage of urine.

The pelvic floor muscles are made up of layers of muscles which stretch from the pubic bone to the tail bone. They support the uterus, bladder, bowel, vagina, anus and urethra.

The pelvic floor muscles are some of the most important muscles a woman has, yet because they are not visible, they are often neglected.   Pregnancy and childbirth can weaken these muscles.

Importance of the exercises

  1. Increases the tone of abdominal muscles
  2. Prevents low back pain
  3. Prevents the formation of scar at the operation site
  4. Improves blood and fluid circulation in the body to allow quick healing
  5. Strengthen the pelvic floor muscles to prevent incontinence
  6. Help with good posture
  7. Increases metabolism and prevents constipation

General exercise

  • Start your walks slowly, and increase the speed, time and distance of your walks as you feel comfortable
  • Swimming is another great exercise following birth
  • Riding a bike is okay, as soon as you are comfortable.
  • Check with your Midwife / Doctor prior to commencing exercise.

Other Information

  • Tying the stomach does not reduce the stomach because it’s a dormant way of reducing and it tends to weaken your abdominal muscles which can cause back pain
  • Sitting or soaking the perineum (the birth canal area) during pregnancy and after delivery damages the tissue around and interferes with the healing process

Back pain is very common and affects around 3 out of 4 people at least once during their lifetime. How you use your back, both at work and at home can determine your likelihood of developing back problems.

With the right approach, simple back pain can be avoided. This leaflet provides information on what to do to help prevent back pain and also gives advice on managing your symptoms.

The spine is made up of 33 bones called vertebrae. These are seperated by discs, which act as shock absorbers and allow the spine to move. This structure of vertebrae and discs is supported along its length by muscles and ligaments. The spinal cord threads through the centre of each vertebra, carrying nerves from the brain to the rest of the body.

Your spine is not straight, but is actually an  'S'  shape This gives the spine more stability and provides a degree of shock absorption. Not all backs are the same ' S ' shape but they are usually curved with a hollow in the base of your neck and another in the small of your back. This shape should be kept in mind as it is important to keep the natural curves in your spine, whatever you are doing.

Triggers for simple back pain

  • Incorrect posture
  • Standing, sitting or bending down for long periods
  • Lifting, carrying, pushing or pulling loads that are too heavy or with poor technique

Avoid slouching

Experts now recognise that the increasingly sedentary lives that we lead contribute greatly to the increase in reported back pain. An office worker can spend anything from 25 to 40 hours a week in a static position working at a computer. Without any structured forms of exercise the muscles around the back start to become weak, failing to provide the back with its necessary stability and increasing the likelihood of injury.

Poor posture while driving will strain your back.

Preventing further episodes of simple back pain

Ensure you continue to avoid the triggers for simple back pain, paying attention to your posture with every task. Strengthening the muscles that support your back and keeping fit is important. Walking is usually helpful; start slowly on flat ground, building up to longer walks and gentle slopes. Swimming is also excellent exercise and helps keep the back strong and mobile.

General posture

Try to use good posture and maintain all the natural curves of your spine, rather than slumping in your chair or walking around with your shoulders hunched up. Imagine there is an invisible cord from the top of your head to the ceiling lifting you into a tall, relaxed posture.

Lifting and carrying

When lifting keep your feet wide apart to help you feel stable. Bend your knees, not your back. In this way, you are using your strong leg muscles and not straining your back. Carry the object close to your body and bend at the knees to put the object down.

Our Location

Plot 4686 St Barnabas Road, Kisugu - Namuwongo.
P.O.Box 8177 Kampala, Uganda

Contacts

Tel: +256 312 200 400. Mail: ihk@img.co.ug
Emergency Ambulance Lines
+256 772 200 400 / +256 712 200 400

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