A seven year old boy breaks his tibia and requires immobilization by a hard cast for six weeks until the break heals. A potential consequence of this therapy is atrophy of the
leg
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More specifically, the muscles of the injured leg.
muscles surrounding the casted leg, known as disuse muscle atrophy. This occurs when the muscles are not being used for an extended period, leading to a loss of muscle mass, strength, and functionality.
To understand why this happens, let's dive into the process of muscle atrophy. Our muscles are composed of bundles of muscle fibers, which contract and generate force when we move. Regular movement and exercise are essential for maintaining muscle health and function. However, when a limb is immobilized by a cast, the muscles associated with that limb are not being used as they normally would be.
Lack of muscle activity leads to various changes within the muscle tissue. First, there is a reduction in muscle protein synthesis, which is the process of building new proteins needed for muscle growth and maintenance. Secondly, there is an increase in muscle protein breakdown, meaning that the body starts breaking down muscle proteins to meet other energy requirements. These two processes combined result in a net loss of muscle protein, causing the muscles to shrink and weaken.
Additionally, disuse muscle atrophy also affects other structures associated with the muscle, such as tendons and bones. Tendons, which connect muscles to bones, can become weaker and stiffer due to lack of movement. Bones can also undergo changes, such as decreased mineral density, leading to potential bone loss or osteoporosis.
To prevent or minimize muscle atrophy during immobilization, it is important to engage in certain interventions:
1. Physical therapy: A physical therapist can design a program of exercises that target the specific muscles affected by the cast. These exercises can include isometric contractions (contracting the muscle without movement) or resistance exercises using bands or weights. The goal is to stimulate the muscles and maintain muscle tone and strength.
2. Range of motion exercises: Moving the joints within their normal range of motion helps maintain joint mobility and prevents stiffening of the tendons and ligaments.
3. Electrical muscle stimulation: Also known as neuromuscular electrical stimulation, this involves applying small electrical currents to the muscles via electrodes placed on the skin. This can help provoke muscle contractions and reduce muscle atrophy.
It is crucial to follow the guidance and recommendations of healthcare professionals, such as doctors and physical therapists, to ensure proper management and prevention of muscle atrophy during cast immobilization.