Produced: Jan 2015 Ref: 233/01 Author: Clinical Support Review: Jan 2017 Royal Orthopaedic Hospital NHS Foundation Trust Patient Information Leg Lengthening - Exercise Information Welcome to the Royal Orthopaedic Hospital (ROH). For further information please visit www.roh.nhs.uk The importance of exercising with your frame The purpose of a frame is to help the bone grow, but when the frame is in place the soft tissues surrounding the bone, such as muscles and ligaments, can become weak due to inactivity. Completing your exercises will help to keep them strong; so that when the frame is removed your recovery is faster and easier. There is a theory, known as Wolff s law, which explains that our bone adapts to the loads under which it is placed. This means that the bone remodels itself and becomes stronger when it is put under more stress, i.e. when you exercise. So when you exercise, not only do your muscles get stronger, but your bones get stronger too. Your bone can be lengthened by up to 1mm per day - the soft tissue around the bone only lengthens by up to 0.75mm which can cause joint stiffness. It is important to carry out your stretches daily to allow the soft tissue to catch up with the increased bone length. This will reduce your muscle tightness, improving your ability to walk on both legs and return to your usual activities. Your physiotherapist will assess your weight bearing status, the type of frame you have and which joints are affected by the frame and then show you which exercises you need to do. It is important that the correct repetitions of exercises are completed daily in order to experience the best possible outcome. This booklet outlines a number of different exercises which are designed to help keep your muscles and bone strong during the lengthening process. You can use the exercise diary attached to note down the number of repetitions you have done each day and keep track of your progress. If you have any queries about your physiotherapy, please contact the physiotherapy gym on 0121 685 4126 Page 1
Exercise Diary: Inner range quadriceps Date Knee flexion Squats Ankle range of movement Front knee bend Step ups Ankle stretch Heel raises Front knee bend stretch with towel Wall slides Seated knee bend Seated knee extension Hip abduction Hip extension Lying hip stretch Hip abduction in side lying Tip toe walking Wobble board Bridging Marching on the spot Additional Exercises: Page 2
Leg lengthening Exercise Information Leg Lengthening - Exercise Information Leg Lengthening - Exercise Information Exercise Diary: Date Page 3
Personal Exercise Program Epiphyseodesis Royal Orthopaedic Hospital NHS Foundation Trust Royal Orthopaedic Hospital Bristol Road South, Northfield, B31 2AP, Birmingham, United Kingdom Knee straighten in lying Lying on your back or sitting up. Put a rolled up towel or cushion under your knee. Straighten your knee by pulling up your toes, tensing your thigh muscle at the front of your leg. Hold for 3 seconds and then slowly relax. Knee bend in standing Standing in front of a chair or a sturdy work surface, bend your knee, bringing your frame up behind you. Hold for 3 seconds and gently bring it back down. Sit to stand Sitting with your arms crossed. Slowly stand up and then sit back down. Make sure this is done slowly, don t collapse back down on the chair, try to control the movement as much as possible. Pointing your toes Sitting up on a chair with your feet up on a stool.bend your ankle by bringing your toes up towards you, then point your toes by pushing them away from you. Page 4
Hip extension in lying Lying on your front with your frame knee bent up with your foot pointing upwards. Tighten your bottom muscles and lift the frame up, with your toes going towards the ceiling. Slowly relax back down. Step ups Using the bottom step at home, step up and back down. Ankle stretch onto step Put your foot up on a step. Lean forward to bend your ankle, keeping the heel on the step. Tip toe standing Standing in front of a chair, push up on to your tip toes and come back down slowly. Knee bend in lying Lying on your tummy, use a rolled up towel to pull your heel towards your bottom. You should feel a stretch in the front of your thigh. Hold for 30 seconds. Page 5
Wall slides Standing with your back flat against the wall, feet hip width apart and feet away from the wall. Slide down to a mini sitting/ squat position, then slowly come back up. Knee bend in sitting Describe the product, service, or event here. Include a brief description and any features. Knee straighten in sitting Sit with your foot rested on a chair. Straighten your knee by squashing your knee downwards. Hold for 10-20seconds. Hip abduction in standing Standing next to a chair, holding on for support, take your frame out to the side. Make sure the movement is only coming from your hip, don t bend your back. Hip extension in standing Standing in front of a chair, bring your frame backwards, keeping your body straight. Don t lean your body forwards. Page 6
Hip stretch in lying Lying on your back, hug onto the knee (opposite knee to the frame) and let your leg hang down. You should feel a stretch at the front of your hip. Hip abduction in side lying Lying on your side with your frame on top. Lift you r frame up in the air without letting your hip rock backwards. Tip toe walking Going up on your tip toes, walking on your toes. Hold on to a work surface for balance if needs be Wobble board Standing on a wobble board and try to keep your balance. Hold on to something for support if needs be. Bridging Lying on your back with your knees bent up and your feet flat on the floor. Slowly lift your bottom off the floor. Hold in a bridge position for 3 seconds and then slowly come back down. Marching on the spot Marching on the spot. Page 7