Reflex Sympathetic Dystrophy (RSD and CRPS) Reflex Sympathetic Dystrophy (Complex Regional Pain Syndromes Type I) and Causalgia (Complex Regional Pain Syndromes Type II)(RSD and CRPS)


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Old 09-09-2016, 06:22 PM #1
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Default Muscle Recovery and Pain Relief

So today at physical therapy, my son's therapist said it would probably take about 2 years to regain full muscle strength. That was kind of a shocker for both of us. I'm so grateful he will eventually get there, I was just so surprised at the time frame she expected. I'm hoping she's overestimating!

But it made me wonder, for those who have been able to regain some degree of function, what have you found to be the best ways to relieve muscle pain and help the process along? He's taking things gently and slowly because his foot is still very sensitive to weight bearing, using crutches to assist walking a little bit, etc.

Thanks!
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Old 09-10-2016, 07:17 AM #2
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Quote:
Originally Posted by swimtime View Post
So today at physical therapy, my son's therapist said it would probably take about 2 years to regain full muscle strength. That was kind of a shocker for both of us. I'm so grateful he will eventually get there, I was just so surprised at the time frame she expected. I'm hoping she's overestimating!

But it made me wonder, for those who have been able to regain some degree of function, what have you found to be the best ways to relieve muscle pain and help the process along? He's taking things gently and slowly because his foot is still very sensitive to weight bearing, using crutches to assist walking a little bit, etc.

Thanks!
Yes, it took about that time for me as well. Paced, light exercise, but all throughout the day instead of 30 min. of full-blown I-don't-know-what!

I didn't regain strength, or function, but my upper thigh muscles at least they both look like "legs". It's odd how that goes in RSD that has traveled all the phases (in my case). No, I didn't regain function, unfortunately.

You have to keep going to your doctors and to your pain clinic, and they of course also have to be willing to listen to the patient. In my case, I had more pain w/ the exercise than without. Lots of anti-inflammatories, I can tell you that much.

At that time I wasn't even diagnosed yet and didn't have much else in the sense of pain relief. So all those saying you have to remain within the pain limit. I suffered!
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Work related (car) accident September 21, 1995, consequences:
- chondromalacia patellae both knees
- RSD both legs (late diagnosis, almost 3 years into RSD) & spread to arms/hands as of 2008
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Old 09-10-2016, 08:54 AM #3
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Ah the pain of recovery and healing!

The PT's estimate is not outside the expectations even for "regular" orthopedic injuries. I have a neighbor; a healthy cross country/marathon runner who was told up to 3 years for full muscle return after a femur fracture.

The muscles of my affected foot have not beefed up quite the same as they were although it is strong on resistance testing and much better than it was. However, my nerve conduction study shows that the signal is compromised in the plantar nerves, so no surprise my foot muscles are not as "swoll". I was able to get my calves/soleus/tibialis measuring the same in under two years and strength seems to be about equal. I had a lot of atrophy from extended non-weightbearing but you can't see it at 2 years out other than the reduced signal foot (and even that looks way better). A lot of function has returned and I actually feel better if I work out. The endorphins and circulation boost help a lot of my symptoms. It's just finding the balance...

It took a year plus easily for me to feel that the myriad ligaments in my foot were up to par as far as flexibility and capacity to carry load. There is such a lot going on in there and the mechanical stresses being re-introduced can cause a fair amount of discomfort as the system remodels. This is where continuing with the gentle slow progression is so important. He'll know when he has done too much and should continue to listen to those signals. The gains WILL come over time. One day he will look down and his leg will look like the other one and you won't be able to pinpoint exactly when it happened.

I'm sure his PT will have a lot of advice for this exciting period. There are many little tricks used during rehab and some tips to be taken from a pure training point of view. ie: static stretches decrease muscle strength firing significantly for up to 30 minutes afterwards. (research done with EMG) This does not help muscle build. Dynamic stretch before exercise and static stretch after or at any other time. Testing for general muscle imbalances and tightness in the entire kinetic chain of the leg is also a good idea.

I highly recommend eccentric training methods such as eccentric calf raises. These strengthen the muscles and tendons with less loaded strain while stretching the soft tissues at the same time. They are often used in injury recovery to improve strength and reduce pain. So much is contracted after lack of use. He might like foam rollers or massage too. Anti-inflammatories are great as CRPSbe said. Myofascial work and stretching are also helpful. Just don't stretch too much too soon. All in good time. He'll be doing laps around all of us before you know it.

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Old 09-10-2016, 11:55 AM #4
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I find aqua therapy to be great too. Just putting my foot in a bucket of water to do some of my exercises. And I've had many podiatrists highly recommend doing it as the best therapy for my CRPS. So that's another tidbit.
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Old 09-10-2016, 04:27 PM #5
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I understand your shock of hearing that it could take 2 years to regain full muscle strength. Try not to focus too much on time frames. After my own initial shock regarding progress and goals of therapy, I just decided to stay focused on what I needed to do to make progress. Try to celebrate even tiny bits of progress. In other words, stay positive.

With regard to muscle pain and helping the process along, gently and slowly is fine. Personally I found sticking to my daily at home therapy exercises really helped with progress. Just doing the exercises at therapy was not enough. I also found very gentle stretches, moist heat, and desensitization very helpful. I have an air bathtub at home and that has really helped with muscle and CRPS pain. This tub has tiny holes around the lower walls and an air compressor to blow bubbles through the water. It is different from a whirlpool which I find very painful. They also have mats with compressors for tubs to give a similar effect. I don't know how well they work. I did a lot of my home therapy program in that tub.

One other thing that helped with the pain of therapy was a TENS unit. If I could connect the TENS before the pain got too high, it really helped me. I still use it when I am riding in the car because vibration will cause a flare up. Some people cannot tolerate TENS, and I understand that because if my pain levels are too high, I can't use it either.

My thoughts and prayers are with your son and you. Hang in there.

Shay
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