Injuries are a constant threat when participating in our sport. With the advent for HMOs (Health Maintenance Organizations) and other types of managed care, it is critical that patients are knowledgeable about the types of devices that are available. Knowing what types of equipment are available to aid in your recovery, and knowing your options, allows you to take the right steps to a full and timely recovery.
Managed care seems to be reluctant to offer anything but bare-bones care (no pun intended). You shouldn’t be afraid to discuss with your doctor or therapist what the proper equipment is to aid in your rehabilitation. The variety of rehabilitation products and equipment choices available can really make a difference in the time it takes to heal, and improve the overall result of rehabilitation.
Continuous Passive Motion, or CPM has been around for about ten years, but is still relatively unknown to the general public. The CPM machine slowly moves the respective joint continuously and increases range of motion after surgery. The use of CPM after joint surgery, in addition to physical or occupational therapy’s strengthening regimen, will lead to a much faster and more complete recovery. There are CPM devices available for every synovial joint (joints that secrete fluid) in the body. The knee CPM is the most commonly used, but there are also CPMs for the hand, wrist, elbow, shoulder, ankle, and even the big toe.
The concept of continuous motion of the joint after surgery is one of common sense. Joints are meant to move. In the 70s Dr. Robert Salter, a renowned Canadian orthopedic surgeon, found that continuous motion after surgery enabled the joint to heal much faster and more completely (and without adhesion formation) than joints that were immobilized after surgery. The first CPM devices were crude, consisting of not much more than a bicycle wheel with a motor attached. Today’s CPMs are comfortable, computerized machines that can be programmed for each patient’s needs. Depending on type of surgery, the CPM device can be prescribed by your surgeon and may be used from one week to as much as two months.
Another device available to help in the rehab process is controlled cryo therapy, or a cold therapy device. Post operative swelling and pain is dramatically reduced by cold therapy. The controlled cryo therapy device looks like a twelve pack ice chest. An inner pump and hose system connect to a cold pad that is put on the injury after surgery. This kind of device regulates constant temperature as opposed to just putting an ice bag on the injury. Direct ice cannot be used for long periods of time as it can cause the skin and injured tissue to freeze, leading to complications. The cold-therapy unit maintains 40 degrees, which is the optimum environment for pain control and healing. It can be used three to four days or as long as two weeks.
Electrotherapy is another category of rehabilitation equipment. There are many different types of electronic devices for pain control, edema (swelling) control, healing, and muscle strengthening. The most simple and commonly used electrotherapy is a TENS (Transcutaneous Electronic Nerve Stimulator) device. Basically, this unit sends an electronic charge to the affected nerve blocking the sensation of pain-working somewhat like an aspirin or painkiller. EMS (Electronic Muscle Stimulator) stimulates atrophied muscle and helps to start building the muscle back up after it hasn’t been used for a while due to inactivity after surgery.
There are some newer and more sophisticated electrotherapy devices on the market today, including high-volt galvanic stimulators and interferential devices. The more complicated electronic waves given off by these devices have a more profound effect on the healing tissue, including reducing edema and affecting the source of the problem, not just blocking the pain.
Of course there are also many different types of post-operative braces that can bee used to help in your rehabilitation process: including hard and soft bracing for all joints and the back, which help protect and support injured areas.
Most of the devices that have been described are covered under insurance plans, if the plan includes DME (Durable Medical Equipment) coverage. Just asking to have these types of devices prescribed for you will most likely get what you need and deserve.
Don’t be afraid to ask. Your health and your future are your primary concern!