Tuesday, 21 March 2017

What Can Speed Bone Healing?

I've been fortunate to never have had experienced a bone fracture in my own life. (I figure that I'll probably get hit by a car in the week following this blog post.) I understand how much fractures are a drag, though. Not being able to do anything except immobilize it and let time heal it enough to start doing any rehab.


A topic that's starting to pop up, however, is if there are modalities which can increase the rate of bone healing and accelerate the recovery process. Well, I decided to surf through the research and see what I could dig up.

Exercise

Let's start with the modality that I'm clearly the most focused on. It's common that weight bearing and physical activity will increase the rate of healthy bone formation in healthy populations and those with osteoporosis. But can early exercise while a fracture is still in its healing phase be beneficial?

Unfortunately, there's not a whole lot of research that I could find on exercise, although it's clear that weight-bearing is a definite factor in increase bone formation. Research does suggest that regular contraction of the muscle around the injured bone may decrease the rate of bone loss, but it's not conclusive.


With this information, the only safe advice to give would be that weight-bearing (standing and walking on a fractured leg, for instance) is beneficial to the healing process, but only under the clearance and supervision by a professional when the bone is stable enough for each progression.

Massage

This will be a short and sweet entry. After a scan of journal databases, I found no research directly on the stimulation of soft tissue over the site of a fracture. Being that a fracture is a widely-taught contraindication of massage, we can only assume that manual therapy is off-limits when it comes to bone healing.



Ultrasound

Here's where we can get interesting!

I found one fantastic journal review that compiled everything nicely for us. It cited multiple studies that found a positive effect of specific ultrasound signals on the rate of bone healing. Even when it came to applying the modality to smokers, who are known to have decreased rates of fracture and tissue healing, ultrasound was able to counteract the effect.


It seems that, despite my recent post about why ultrasound probably does nothing for you, that there is probably some use for it after all.

Electrotherapy

The findings here were interesting, as I was taught in college that electrotherapy such as IFC (interferential current) could accelerate the bone healing process. However, this is another modality that does not seem to have much research behind it, What I was able to find was little more than a suggestion that electrotherapy may help prevent complications of fracture non-unions. On the other hand, one newer study seemed to find that IFC made no difference in bone healing times.


Laser

Laser is a newer therapy on the block. With it emerging more recently, there's been a bit more hype to research it.


The research, so far, has been positive when it comes to the effect of laser on the acceleration of bone healing. However, it's important to note that most of the studies to this date have been done on rabbits and rats. Nonetheless, bones are bones, and this find is still a promising one. I'll be careful about getting too excited until I see a bit more evidence, though.


In short, there's still some research to be done before we can say anything for sure. At this time, it's safe to say that weight-bearing to stimulate bone growth using mechanical stress is the best advice to accelerate fracture healing, although ultrasound shows a lot of promise as well. Massage is a no-go, electricity probably has little effect, and we should probably wait on more results about laser.

Regardless, make sure to do your rehab once the cast comes off.



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