Limb plastering: the key to improving range of motion in physiotherapy

Why is plastering important in physiotherapy?

It is a common misconception that limb plastering is only used to stabilize fractures, immobilize and prohibit weight bearing on the plastered limb. However, this is not true. Plastering is increasingly used in physiotherapy, especially when manual or physical methods are insufficient to lengthen and relax tissues. In such a situation, the plaster allows stretching the contracted tissues, securing the limb in a new elongation and keeping it in the right position until the next therapy. Such measures in the bigger picture allow the patient to increase his range of motion. At the same time, this does not mean that the patient remains motionless until the protection is removed. The opposite is true - plaster casts in physiotherapy immobilize a specific body part, while allowing work on other key areas. Physiotherapy can then focus on knee extension, hip extension or trunk stabilization. Importantly, once the cast is removed, the patient is still under the care of a physiotherapist. At this point, muscle strengthening is added to the exercise repertoire after tissue extension.

Why is plastering so important in physiotherapy? Can't you get similar results with exercises and orthoses alone? Definitely not! First of all, this is due to the fact that it is difficult to maintain adequate elongation of tissues for the time required to stretch them. The patient will unconsciously contract the limbs during sleep, which will thus begin to return to their previous range of motion. Why not use orthoses in this case? In such a situation, they seem to be the ideal solution, which is less invasive than plaster casts. However, there is no guarantee that the patient will not take them off, disrupting the entire healing process. In the case of a cast, this is impossible. Therefore, the physiotherapist is assured that the limb remains in the correct position throughout the therapy. An additional advantage of plastering is that, as tissue stretching progresses, another plaster can be placed in a new range or in a more corrected position of the limb. It would be difficult to achieve this effect with orthoses.

The effects of plastering are often spectacular, and the result can last for months if the limb after plastering is secured with a properly fitted orthosis. In addition, plastering is extremely versatile and can be applied to various parts of the body. It is perfect for the lower extremities, for the ankle and knee, but also for the upper extremities, for the wrist or elbow.

Plastering in physiotherapy is a procedure that can be used for different purposes and with different techniques, depending on the needs of the patient. There are primarily two main types of plastering: serial and inhibitory, which differ in both their application and the effects they produce.

1. Serial plastering is used to gradually increase the range of motion in joints or correct deformities resulting from contracture of muscles or other soft tissues. The technique involves applying a series of plaster casts, where each successive bandage is applied in a slightly greater range of motion or more corrected position. In this way, the contracted tissues can be gradually stretched in a controlled and safe manner for the patient, leading to improved range of motion and alignment of the limb. Serial plastering can be used for patients with muscle contractures, limb deformities, as well as for children with cerebral palsy to promote their motor development.
2. Inhibitory plastering is aimed at reducing muscle tension, which is often increased in the course of neurological disease and can lead to restricted mobility and stiffness. Pathological muscle tension is characteristic of some neurological conditions, such as after a stroke or in the case of children with cerebral palsy. Inhibition plastering stabilizes and immobilizes selected parts of the body in a specific position, allowing other, areas of the body to be worked on. Through such therapy, patients learn to better control their movements, which contributes to improved functioning in daily life.

Summary

Gypsum casting in physiotherapy is a significant and versatile procedure in support of pediatric orthopedics, which, like stabilization of fractures by a doctor, requires knowledge and experience from the practitioner. It has a wide range of applications, from gradually increasing the range of motion in the joints, to correcting deformities and reducing pathological muscle tension, to improving movement patterns through a combination of appropriately selected exercises. Serial and hamstring plastering are techniques that, when applied on the basis of the physiotherapist's extensive knowledge and experience and in accordance with the patient's needs, can produce spectacular results in improving mobility and function, contributing to a significant improvement in the quality of life of people affected by a variety of conditions.