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Should I immobilise following an injury?

The basic definition of immobilisation is preventing the affected muscle, limb or joint from moving or bearing weight in order to stabilise and rest the injury, and allow it to heal. Immobilisation can help prevent further damage by reducing the degree to which you can move an injured limb or joint. However, some injuries, such as mild sprains, are better treated by gently moving the joint as soon as you can do so without feeling significant pain. Let’s take a look at some of the methods of immobilisation and what they can do to help the healing process for different kinds of injuries.

How does it treat the injury?

In the case of broken bones, dislocated joints, and injuries to soft tissue, tendons and ligaments, immobilisation can help reduce swelling, pain, and muscle spasm. Immobilisation devices such as splints, braces and casts provide protection and proper alignment in the early stages of healing. Immobilisation should generally extend from the joint above the injury to the joint below it.

After a cast or splint has been fitted, the injured limb should be kept elevated for 24 to 72 hours, and ideally it should be raised above the level of the heart. This elevation, combined with rest, will reduce pain and speed up the healing process by minimising the onset of inflammation and swelling. Once the splint, cast, or brace has been removed, gradual exercise helps to regain muscle strength and full range of movement. At this point a doctor might also recommend heat treatments, hydrotherapy, or other forms of physical therapy.

Young people with broken hands at surgery Young people with broken hands at surgery

What are the benefits and limitations?

The most obvious benefit of immobilisation is that it prevents further damage being done to an injured body part while it heals, and in the case of serious injuries such as broken bones, allows the healing process to progress correctly.

Aside from the obvious limitations of restricting the movement of a limb, problems can arise from more serious forms of immobilisation. Some of these, such as traction, require long periods of bed rest: lying in the same position in bed for an extended period of time can result in the formation of decubitus ulcers, otherwise known as bed sores, and potentially skin infections. Urinary infection can also occur as a result of extended bed rest, as can a build-up of fluid in the lungs or an infection such as pneumonia. Severe forms of immobilisation such as traction can also have a psychological impact, as a person may become bored, frustrated, depressed and stressed as they are restricted to the bed.

If you have a cast, splint or brace, you will most likely spend several weeks without using the injured limb, which can lead to decreased muscle tone and even shrinkage of the muscle (atrophy). However, rehabilitation and physical therapy can usually regain lost muscle after the injury has healed. There is also a risk of decreased circulation if a cast, splint or brace is fitted too tightly, and excessive pressure over a nerve can cause irritation and long-term damage if not corrected. Furthermore, it is important to keep an eye on casts, splints and braces, because if they break or malfunction, the healing process of the soft tissue or bone can be disrupted and can lead to deformity.

Elderly lady wearing a Rebound Diabetic Walker sat in a chair reading

What devices are used for immobilisation?

Casts: if you have a broken bone, you will most likely be fitted with a cast once the ends of the bone have been realigned. Casts can be made of fibreglass or plaster, and are designed specifically to fit one individual person. Once the cast has been fitted, it will hold the broken bone in place and allow it to heal again.

Splints: these are generally used for smaller fractures, such as broken fingers, and for dislocations. A splint is used to stabilise the injured bone or joint, and is sometimes used as an immediate temporary measure before a cast can be fitted. Splints may be made of polyethylene foam, acrylic, plaster of Paris, or aluminium.

Slings: for injuries to the arm, wrist or shoulder, a sling may be used to immobilise the area. Slings are often used to provide support for an arm when a cast has been fitted, but can also be used alone for less serious injuries. These can be used as a temporary measure in an emergency to immobilise the injured arm until the person can be seen by a doctor. Slings can be as simple as a triangular bandage placed under the arm and tied around the neck, but are also available as full sleeves for the arm with straps.

Collars: for neck injuries, collars are used to support the neck and head and stabilise the area. A collar will also limit your ability to move your head, which will prevent the neck injury from being exacerbated by continual movement. Soft collars can relieve pain by restricting movement of the head and the neck, and they can also transfer some of the weight of the head to the chest. Stiff collars tend to be used to support the head and neck when there has been a fracture to one of the bones in the neck. Cervical collars, otherwise known as neck braces, are often used as immediate treatment by emergency services when there is a potential neck or head injury.

Braces: a brace is commonly used to hold bones in place and support the surrounding areas following injuries to the spine, leg or arm. Braces can be made from carbon fibre to protect against impact in the extreme sports world. Some braces can be easily taken off and put back on again, and can be adjusted to allow for a specified degree of movement, so braces are often used when a person needs physical therapy or a small amount of exercise of the limb during the healing process. Braces can be custom made to fit individuals, or can be purchased off the shelf in a range of adjustable sizes.

Supports: supports are made for injuries to joints in a variety of areas of the body, from the ankle and knee to the shoulder, wrist or thumb, and everywhere in between. Supports can be used to treat anything from a mild sprain to a complete ligament rupture, providing compression to manage inflammation as well as keeping the joint stable and restricting movement in more severe injuries. Supports are often akin to a lighter version of a splint.

Traction: in more serious injuries, traction may be required to help the body heal properly. Traction involves applying tension to allow bones to align correctly and to heal. The most severe form of traction calls for a stainless steel pin to be inserted into the broken bone, which is attached to a pulley and weights suspended above the patient’s bed. All methods of traction demand careful observation by doctors and nurses to maintain the balance of the weights with the injury.

Skin traction: in cases where only a small amount of traction is needed, this can be performed by using a combination of a splint and strips of adhesive tape, moleskin, or foam rubber traction tape placed on the skin of the affected area.

Mobility aids: as your body recovers from an injury, you may find that you need to use mobility aids to help you get around while your joint, limb or muscle is immobilised. These can range from crutches and walking sticks to wheelchairs. These aids can ensure that you are still able to perform daily tasks despite being immobilised, and that the injured body part is not under any pressure from bearing weight. This leads to a faster recovery and prevents further damage.