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• My 84 year old mother was living at home when she fell and fractured her pelvis. Now she is in long-term care. What can your team do for my mother? Is there any chance that she may be able to move back home if her recovery goes well?

Treatment plan

A fractured pelvis will take a lengthy amount of time to recover. It may be painful to mobilize the affected joint and to receive treatments for a few months but it must be done if she wants to recover. Physical therapy is a great idea and it has numerous benefits for pelvic fractures. If there was no Hardware (screws, plates and nails) she will have to keep most weight off the fractured side for the time being until some strength and stability have been attained from exercises and as she can tolerate. If she did receive hardware during the surgery there is then less restrictions on weight bearing activities, and weight can be put on the affected leg on an as tolerated basis.

The treatment that would be included would be sessions from us 2-3 times per week for the duration of 30 minutes. Our sessions will be exercises that need to be done with a therapist to assist and give direction, such as walking. We will also give your mother exercises that can be done once every day on an as tolerated basis.

Some of the exercises that we would perform would be:

1. The first few weeks would be feather weight bearing activities on the pelvis including strengthening the muscles of the lower extremities.

  • Straight Leg raises while lying down
  • Quad Contractions lying down
  • Knee bends (heel to bum) exercises lying down
  • Leg abduction/Adduction, lying down
  • Bum/glute squeezes lying down
  • Ankle pumps sitting or lying down

Do these exercises 2-3 x 10 reps with rehabilitation therapist or on your own. Do for each leg.

Time frame for these exercises may vary due to age, motivation and general health of your mother. This could take between 4-8 weeks.

2. Once pain subsides and the lower extremity muscles become stronger, transfers and sitting to standing exercises and practice will take place. Teaching your mother how to properly get in and out of bed/toilet/car etc. Some of these exercises may be started on an as tolerated basis within the first 4-8 weeks as well.

After standing and transfers are proficient then a walking program will commence. Start small and build up the amount of distance done week to week. Start with walker, until enough strength and stamina has been gained then canes can be used only if strength and stability is there.

3. As strength and stability gradually improve over the next 8-12 weeks from doing these exercises, sit to stands and walking. Then the addition of weights and bands can be implemented as well. Also the addition of walking up and down stairs and commence with caution.

Your mother can get better with physical therapy but it will be a lengthy process and it will take lots of time. The amount of time will depend on the severity of the fracture, motivation of your mother, as well as the general health of your mother. However the goals she has for being able to move back home and live an independent life are attainable and will take lots of hard work. Her pelvis may not be the same and her gait and strength may not recover fully but being able to walk with an assistive device such as a walker or cane can be done and possibly eventually without an assistive device. The main goal is to improve her independence and quality of life. Physical therapy can help attain that.