Case Study: Slips, trips and falls – when they don’t just ‘get better’, physiotherapy can help

Rhian Davies, Chartered Physiotherapist and Clinical Director at one2one Therapies in Bridgend, shares how stubborn injuries can respond fast to the right treatment – sometimes, very fast.

 

“I can’t believe I’m in so much pain from a simple trip!”

That’s a regular phrase in any physiotherapy clinic or A&E department.

A fall can happen to anyone of any age.  When it happens as children, our bodies tend to recover very quickly from injury, however as we get older our bodies don’t recover quite so fast, especially if we don’t exercise them often.

Lisa, a 52 year old business owner in South Wales, found this out recently.  Coming home from a night out, she slipped on a patch of water where an ice cube had melted earlier – basically a combination of a very tiny amount of water and very flat shoes.

The resulting slip saw Lisa, who suffers from arthritis, effectively do the splits, banging her elbows, thighs and right knee in the process.  Lisa reports screaming in agony for about 10 minutes.  Lisa says:

“I thought I had broken my left leg, because the only thing that hurt that much previously was breaking my ankle in two places.”

Lisa was unable to walk and her husband took her to A&E but the minor injuries unit was closing and could not see her, and the main A&E unit reported a probable 6 hour wait. Lisa found sitting excruciatingly painful so decided she could not sit in a waiting room for 6 hours so went back home and took strong pain killers and rested.

The following morning, the pain was slightly reduced and Lisa could manage a very small shuffle between the bedroom and bathroom.  Her left thigh was purple from knee to hip.  She decided not to go to A&E, having realised the left leg was not broken and it would have been a painful ordeal as she still could not sit comfortably.  Having some massage training, Lisa knew that whatever the muscle damage, following RICE (rest, ice, compression, elevation) was what she would be advised to do, so she did that.

Lisa rested and applied ice for three days, with her leg higher than her hip, but still could not sit for long periods and struggled to walk at all. Although she tried to return to work, she spent most of her time taking very strong prescription painkillers which limited her ability to work at full-capacity and had to acquire additional support for her business. Her normal daily activities were restricted and her quality of life was significantly reduced.

Six weeks later, Lisa still had very limited mobility, only able to walk to the car with a stick and was struggling to sit without lots of padding. She decided to make an appointment at one2one therapy to see a physiotherapist for an assessment.

On examination, Lisa’s muscles were still in spasm from the fall and because of the pain, Lisa was not really moving them, meaning that without help, she was unlikely to recover.  She could not take large steps and could not place her left leg behind her right at all.

Muscle spasms, no matter where they occur, are extremely painful.  However, it is also possible to tear muscles and sprain ligaments during a fall so just because a bone is not broken does not mean it isn’t an issue.  A qualified physiotherapist can tell the difference between a muscle spasm and a tear and put the right treatment plan in place to facilitate optimum recovery.

Chartered physiotherapist Ritson Lloyd felt that after six weeks of rest and very limited movement, gentle exercises and heat treatment was the best way to start unlocking Lisa’s rigid thigh and hip muscles. Ritson taught Lisa three very simple sets of exercises which she could do often.

Three days later, Lisa reported that she had been able to take her dog for a short walk (after six weeks of only walking as far as the car with a stick), was no longer taking the strong painkillers and was 90% better.

Lisa is now continuing with plans to climb Pen y Fan next April, something which she had planned anyway but had thought would be unthinkable after her fall.

It just shows that physiotherapy can make a huge difference to recovery time and sometimes you don’t need a course of treatment, just some expert advice. Lisa wishes she hadn’t waited in pain for six weeks before seeking professional help and in future will be making that appointment sooner.