Physiotherapy in the SED

It can, if done well, help to improve the proprioceptive state through massage techniques, hydrotherapy, isometric contractions, postural rehabilitation on special trays, in front of a mirror, in unstable balance (inspired by Tai Chi Chuan).

Kabat-type facilitation techniques, imagined movement techniques, bio-feed-back, virtual re-education ... are all methods to be explored, exploited and codified by a physiotherapy that must never be painful and must be extracted from the scro-saint concept of "bodybuilding".

Pressotherapy brings real relief in some lower limb pain.

Lymphatic drainage can also be attempted in front of certain oedemas that have the characteristics of lymphatic oedemas.

The effort rehabilitation often advocated in the face of permanent fatigue does not have the same indications here as in the states of disadaptation usually observed.

On the other hand, strenuous activities (swimming, cycling, etc.) probably have a proprioceptive effect that should not be neglected.

In terms of breathing, the " unblocking" maneuvers must be known: " stop breathing for a few seconds, then slowly exhale slightly and stop for a few seconds. Then inhale slightly. Stop. Continue, until spontaneous ventilation is restored. »

We have called this changing from automatic pilot breathing to voluntary control(manual for an airplane pilot).


Rehabilitation has a dual proprioceptive and analgesic effect:

  • Most patients have a TENS which is to be used during the sessions to reduce pain and increase proprioceptivity.
  • they are often equipped with proprioceptive orthotics (insoles, special or support clothing, lumbar belt (which does not "melt" the muscles, on the contrary), knee orthotics, ankle braces, elbow braces, bracelets, etc., which are to be kept on during the exercise sessions, whose effects they increase.
  • Rehabilitation must be isometric, repeated movements and heavy constraints (e.g. weight lifting) accentuate the painful phenomena in patients who are, to a very great extent, more exposed to pain.

The aim is to restore sensations to a body that perceives them badly or in a deformed way due to the mechanical characteristics of connective tissues that have lost their reactivity and elasticity.

The classic rehabilitation techniques that have proved their worth in sprains can be taken up and adapted here (be aware of the onset of pain and the instability of these patients).

Mirror control, catching up, imagined movement, relaxation have their place.

The cutaneous sensations, play a big role in the appropriation of the sensations of the body, the cutaneous and musculo tendinous massage has, here its place, it must take into account the pain, it is not here, a simple gesture of comfort. For this same reason, water (hot balneotherapy), underwater showers, play a very positive role.

The heat is, generally speaking, very much appreciated and the traditional parafango (or equivalent) has its place here.

One particular point: some patients have hamstring retractions for which postures and auto postures are indicated.

There is a lot of difficulty with bowel movement and abdominal massage, combined with heat, has a positive effect on bloating and constipation.

Directed ventilation is also beneficial to regain ventilatory sensations (breathing on the back with sandbags on the stomach, for example) and prevent blockages and dyspnea.

Sports are not recommended as they help maintain proprioception.

Manipulations are contraindicated (especially those of the neck, which are very dangerous for the arteries irrigating the brain stem and brain).

 back to "SED CARE