Exercise and stretching with burn injuries

Why do I need to stretch and exercise after a burn injury?

Acute or early on after the injury

When somebody has a burn injury the body reacts in ways that lead to loss of movement, loss of muscle strength and endurance. This is due to a combination pain, prolonged bed rest and not moving as one would normally do. Also with large burns the body reacts by using more energy than usual and it is often challenging to eat enough food to match the energy being consumed.

It is common to have swelling where the burn is and surrounding areas. Exercise is a very good way of reducing any swelling that occurs.

After the burn has healed

When burn injuries heal, the body commonly reacts by making scars that want to tighten and cause the skin to lose its ability to stretch and move as it would normally do. This along with any weakness that comes after the time in hospital recovering means that regular exercise becomes very important to recovery and getting back to life after a burn. It may take some time before you are back to normal activity after the burn has healed so exercise is very important in achieving this.

What exercises do I need to do?

Acute or early on after the injury

When your burn injuries are healing the therapist will be guiding you on specific exercises for you and your injury and wounds. They will start immediately and will be aimed at maintaining all the movement you had before the injury. Getting up and walking around and doing as much of the normal activities such as feeding yourself, washing and dressing as you can is very important. As well you will have specific exercises for the areas of the body that are burned which are important. The more moving and exercising that you do the more likely that recovery from the injury will be good.

There is often pain and discomfort with burn injuries while they are healing. It is important that pain does not stop stretching and exercises being done. The timing of any pain relief medication needs to be managed so that the exercises can be done to there best effect. Also incorporating exercises into an activity that is useful or fun can be a distraction from any pain or discomfort. Generally the more frequent the exercises are done the easier and more comfortable they become.

There may be times while the burn wound is healing that you will not be able to move that part of the body such as after a skin grafting operation. This is important for healing and the health team caring for you will give specific instructions on what can be done or not done with stretching and exercises.

After the burn has healed

Exercise and stretches continue to be very important after the burn wound has healed, particularly if the body is making scar tissue. Scar tissue causes the skin to be tight and less stretchable. This ‘active’ tightening of the scars and skin commonly goes on for 12 to 18 months. The burn therapist will give specific stretching exercises for each person depending on where the burn injury is, how long it took to heal and if operations were required to heal the burn.

The newly healed skin can often feel tight and can feel like a ‘burning’ sensation during exercises that stretch the skin. This is because the scars are actively trying to tighten and shorten.

The newly healed skin can often be dry so it is important that stretching exercises are done when the skin has had moisturiser rubbed in as this will help with the exercises and protect the skin from damaging.

With large area burn injuries the new scarred skin may not be able to sweat and therefore help your body to cool itself when exercising. It may be important that you do exercises in cooler environments such as air-conditioning, making sure you drink plenty of water and minimising the amount of clothing you have on while exercising.

Exercise and stretching will be aimed at maintaining and improving movement, and maintaining strength and endurance. Don’t forget, incorporating exercises into an activity that is useful or fun can be a distraction from any pain or discomfort and the more frequent the exercises are done the easier and more comfortable they become.

When to seek further assistance:

 

• If you are finding it difficult to do the stretches and exercises that your therapist has given to you to do
• If your movement and ability to do things for yourself is getting worse
• If you have new wounds or skin breakdown

When any of the above occurs or for further assistance contact your treating therapist or the medical team that looked after your burn.