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Limb lengthening is a complex procedure performed on individuals with congenital defects or skeletal abnormalities. After a lengthening procedure, physical therapy is performed to rehabilitate the patient in order to maximize the benefits of the lengthening surgery, and to return the patient to an optimal functional level. Here at Virginia Therapy & Fitness Center, we have several physical therapists that specialize in limb lengthening therapy.

Q: WHAT RESULTS CAN BE EXPECTED THROUGH PHYSICAL THERAPY FOR LIMB LENGTHENING?

A: Individuals who undergo limb lengthening procedures typically do so because their shortened limb(s) inhibits them from being able to perform everyday activities. During the rehabilitation process physical therapy will focus on:

• restoring mobility within the surrounding joints
• ​improving the length of the soft tissue structures
• re-establishing independence with transfers and mobility
• providing education and guidance for the patient and support system

The ultimate goal of limb lengthening physical therapy is to decrease the limb length discrepancy in order to restore functional independence for individuals with these conditions.

Q: WHAT DOES MY REHABILITATION PLAN LOOK LIKE FOR LIMB LENGTHENING PHYSICAL THERAPY?

A: To start the rehabilitation process, an initial physical therapy evaluation will be performed. This will allow the physical therapist to assess the patient’s range of motion, strength and mobility, and any restrictions, precautions, or concerns that the patient may have.

After the initial evaluation, a plan of care will be developed with the goal of improving the patient’s strength and functional mobility, maximizing the patient’s range of motion, prevent contractures, and monitoring the patient for any complications that may occur during the lengthening process. In order to achieve this, the physical therapist will incorporate a multitude of interventions into each session:

• Soft Tissue Mobilization and Stretching
  As a bone grows during the lengthening process, it increases the amount of tension on the surrounding soft tissue structures. Working to improve the soft tissue mobility, along with stretching surrounding musculature, will make it easier for these structures to lengthen with the bone.
• Gait Training
  Walking will often be difficult, or restricted, during the lengthening process. Gait training will encompass a multitude of interventions – from educating the patient on the use of assistive devices, to normalizing a patient’s gait cycle in order to prevent compensatory patterns.

• ​​Joint Mobilization
  During an elongation process, the surrounding joints of the targeted bone can become stiff and cause decreased range of motion. Joint mobilization and distraction can help prevent contractures and maintain joint mobility.
• Exercises
  Exercises will become an important part of the rehabilitation process to address the patient’s range of motion, strength, and functional abilities.

Q: WHAT IS A TYPICAL TIMELINE FOR PHYSICAL THERAPY AFTER LIMB LENGTHENING SURGERY?

A: After a limb lengthening procedure, a physical therapy initial evaluation should be performed 1-2 days after discharge from the hospital. At this initial evaluation, a plan of care will be developed between the physical therapist, patient, and support system. Follow up physical therapy appointments should then be performed 5x/week for approximately 3 months, depending on the goal length. Outside of physical therapy, the patient can expect to spend 1-3 additional hours per day performing their home exercises and stretching program. This is a vital component to the lengthening process, and is important for maximizing the benefit of the lengthening procedure.

Q: WHY SHOULD I COME TO VIRGINIA THERAPY & FITNESS CENTER FOR LIMB LENGTHENING PHYSICAL THERAPY?

A: While limb lengthening is not always a common procedure in the orthopedic field, VTFC recognized the need for physical therapists that are specialized in this procedure’s rehabilitation plan. Several of our therapists have completed an advanced course series from the Paley Institute, a world-renowned rehabilitation center in the reconstructive orthopedic field. This has allowed our therapists to gain specialized training in rehabbing patients undergoing limb lengthening surgery. Due to the delicate nature of this surgery, it is important to find a therapist that is well-educated on the rehab process.