Rehabilitation after fractures

Rehabilitation after fractures using Dikul's method: rehabilitation of the spine, hip, pelvis and other complex injuries. Unique techniques for patients with osteoporosis, osteoarthritis and neurological disorders. Make an appointment for a consultation at a specialised centre!

Dikul's method of rehabilitation after fractures¶

Which injuries with bone fractures can be rehabilitated with the Dikul Method?¶

The Dikul Method is a unique system of restorative exercises developed by Valentin Ivanovich Dikul for rehabilitation after severe injuries to the musculoskeletal system. This approach combines elements of physical therapy, kinesiotherapy, mechanotherapy and psychological support, which makes it effective for various types of fractures, especially those complicated by damage to the nervous system or prolonged immobilisation (immobility).

1. Spinal fractures¶

The Dikul Method was originally created for rehabilitation after spinal injuries, so it is particularly effective for:

Compression fractures of the vertebrae (including osteoporosis)
Fractures with spinal cord damage (partial or full recovery of function)
Conditions after spinal surgery (stabilisation with metal structures, laminectomy).

2. Fractures of large tubular bones¶

Fractures of the femur (including femoral neck)
Tibia and fibula fractures
Fractures of the humerus (including surgical neck)

3. Multiple and compound fractures¶

Polytrauma (e.g. after a road traffic accident or fall from a height)
Pelvic fractures (including damage to the sacrum and coccyx).

4. Fractures with delayed consolidation or false joints¶

The Dikul method helps to stimulate bone regeneration through dosed loading and improved blood circulation.

5. Fractures in patients with comorbidities¶

Osteoporosis (reducing the risk of recurrent fractures)
Osteoarthritis and arthritis (restoring joint mobility)
Consequences of stroke or cerebral palsy (if the fracture is complicated by neurological disorders)

Application

The Dikul's method is used for a wide range of fractures, especially in cases requiring long-term rehabilitation.

Its key advantage is its personalised approach and gradual increase in load, which helps to restore not only bone tissue, but also muscle corset, nerve conduction and overall mobility.

History of the Dikul Method: from spinal injury to a unique rehabilitation system¶

The Dikul Method was developed by Valentin Ivanovich Dikul, a man who experienced a severe spinal injury.

In 1962, while working in a circus, he fell from a height of 13 metres, suffering a compression fracture of the spine and damage to the spinal cord. Doctors believed that he would be confined to a wheelchair forever, but Dikul refused to accept this prognosis and began to develop his own system of recovery.

The basis of the Dikul method¶

The basis of the method was dosed physical loads, mechanotherapy and strict discipline of training.

Dikul experimented with exercises, gradually increasing the load, and after a few years not only regained his ability to walk, but was able to perform in the circus again.

His system was originally created for rehabilitation after spinal fractures, as it is such injuries that most often lead to irreversible consequences without proper recovery.

Development of Dikul's method¶

Over time, the method has been refined and adapted for other types of fractures and diseases of the musculoskeletal system.

Today, it includes a complex of strength, stretching and coordination exercises, as well as special simulators to help restore mobility after severe injuries.

The uniqueness of the approach is in the combination of physical exercise with psychological motivation, which is especially important for patients with long-term rehabilitation.

Recognition of the Dikul Method

The Dikul's method has received official recognition in medicine worldwide and is used in rehabilitation centres after fractures of the spine, pelvis, hip and other complex injuries. Its effectiveness has been confirmed by thousands of patients who have managed to return to active life even after severe injuries.

Physiological and biomechanical processes in the treatment of spinal fractures using the Dikul method¶

1. Vertebral compression fractures (including osteoporotic fractures)¶

Vertebral compression fractures result in a decrease in vertebral height due to axial loading, which disrupts the biomechanics of the spine and can lead to chronic pain.

The Dikul method influences this process through dosed load on paravertebral muscles, which form a natural corset for the damaged vertebrae.

Exercises stimulate blood circulation in the fracture zone, accelerating bone regeneration, and prevent muscle atrophy, which aggravates spinal instability.

Unlike classical Therapeutic exercises, which is often limited to gentle movements, Dikul's method includes a gradual increase in resistance, which is especially important in osteoporosis - weak bone tissue requires strengthening not only through medication, but also through adaptive loading.

Paravertebral muscles

The paravertebral muscles are a group of deep muscles located along the spine. They stretch from the neck to the lower back and work as a natural supportive corset for the back.

Stabilise the spine - prevents the vertebrae from shifting when you move.
Protect against overloading - absorb shocks when walking, running, jumping.
Help keep your posture - without their work the back gets tired faster and curves.

If these muscles are weak (e.g. after an injury or sedentary lifestyle), the intervertebral discs and joints are under increased strain, which can lead to pain and new injuries.

Dikul's method focuses on strengthening these muscles because they are the key to a healthy spine after fractures and surgeries.

2. Fractures with spinal cord injury (partial or full recovery of function)¶

In spinal cord injuries, the key problem is not only mechanical damage, but also impaired neuroplasticity - the ability of the nervous system to reorganise itself.

Dikul's method uses the principle of kinesiotherapy and proprioceptive stimulation to force the nerve pathways to ‘retrain’ through repetitive movements. Even if the spinal cord is partially damaged, the surviving neurons can take over the lost functions, but this requires constant loading.

Exercises are performed in a strict sequence - from passive (with the help of an instructor or simulators) to active exercises with resistance. It is the only methodology that combines strength rehabilitation with neurological recovery, which is critical for patients with paralysis or paresis.

Proprioceptive stimulation

Proprioceptive stimulation is ‘body sense training’.

Imagine closing your eyes and still knowing exactly where your arm or leg is and how it is positioned - this is proprioception (feeling your body in space).

After injury or surgery, this ‘sixth sense’ is often impaired. Proprioceptive stimulation helps to restore it by:

Balance exercises (such as standing on one leg).
Working with unstable surfaces (balls, balancing pads).
Slow, controlled movements (to help the brain re-learn how to feel the body).

3. Conditions after spinal surgery (metal stabilisation, laminectomy)¶

After spinal surgery (e.g. transpedicular fixators or laminectomy) there is an imbalance in the deep muscles - the body ‘switches them off’ due to pain, relying on implants.

The Dikul Method prevents this by restoring coordination between the stabiliser muscles and global motor chains.

Through special exercises emphasising slow, controlled movements, the patient re-learns how to load the spine without the risk of damaging the structure. This fundamentally differentiates the method from standard rehabilitation, where forceful loading is often avoided, leading to chronic instability.

In addition, working on Dikul's simulators minimises axial loading, allowing you to safely strengthen muscles even in the early postoperative period.

Laminectomy

A laminectomy is an operation in which the surgeon removes part of the vertebra (the arch or bony processes) to make room for compressed nerves or the spinal cord.

Surgery is done for:

For herniated discs, when the disc can no longer be preserved.
Injuries where bone fragments threaten the spinal cord.
Stenosis (narrowing of the spinal canal) when there is not enough room for the nerves.

After surgery, the spine becomes less protected, so the Dikul method helps to strengthen the muscles, which now take on the role of ‘new support’.

Why is the Dikul method often the only alternative?¶

For compression fractures - other methods do not provide sufficient stress to stimulate osteogenesis, especially with osteoporosis.

Osteogenesis

Osteogenesis is the process of new bone tissue formation.

When a bone breaks, the body starts ‘repair work’ - it begins to build new bone tissue at the site of the injury.

If osteogenesis is not going well, the bone fuses slowly or incorrectly (false joint).

The Dikul Method accelerates osteogenesis by:

Dosed load (bones need load to become stronger).

Improved blood circulation (blood supplies ‘building materials’ for bone).

In case of spinal cord injury - classical Therapeutic exercises does not provide the necessary intensity for the reorganisation of nerve connections.

After surgery - without recovery of deep muscles, the fixators take up the load, which leads to their loosening and repeated surgeries.

Physiology and biomechanics of fixator loosening after spine surgery¶

After surgery with metal hardware (e.g. transpedicular screws or plates), the fixators initially take up to 70-80% of the load that should normally be distributed between the bones, muscles and ligaments. This leads to two key problems:

Atrophy of deep muscles - paravertebral and autochthonous muscles, not receiving the load, weaken on a ‘use it or lose it’ basis.
The bone around the screws undergoes resorption (resorption) due to the ‘stress shielding’ effect - the metal takes the mechanical stress and the body ‘decides’ that the bone is no longer needed. As a result, the fixators lose support and loosen.

How does the Dikul method prevent these complications?¶

Gradual transfer of load from the fixators to the muscles - special exercises (isometric, eccentric) activate the deep layers of muscles, making them participate in supporting the spine again. This reduces pressure on the metalwork.
Stimulation of Bone Remodelling - Dosed forceful loads create microvibrations in the bone, which triggers osteogenesis around the screws. Osteoblast cells are signalled to strengthen bone tissue rather than resorb it.
Restoration of proprioception - Dikul's simulators with balancing elements ‘teach’ the muscles to distribute the load correctly, preventing point overload in the area of the implants.

The Importance of the Dikul Method

The method does not simply replace physical therapy, but reprogrammes the biomechanics of the body, returning the spine to its natural support system and extending the life of the fixators.

Dikul's method for rehabilitation of fractures of large tubular bones: physiology and biomechanics of recovery¶

1. Peculiarities of rehabilitation of large tubular bones¶

Large tubular bones (femur, tibia, fibula, humerus) have the main supporting and motor function. Their fractures cause critical biomechanical disorders:

Axial load disturbance - after a fracture, the bone loses its natural architectonics and the load is distributed unevenly
Muscle imbalance - prolonged immobilisation leads to atrophy of stabilising muscles (especially in femoral neck fractures).
Change in joint biomechanics - neighbouring joints are compensatory overloaded.

2. Physiological effects of the Dikul's method¶

Stimulation of osteogenesis:
- Dosed forceful loads create a piezoelectric effect in the bone tissue, activating osteoblasts
- Gradual increase of resistance (from 30% to 100% of body weight) provides optimal conditions for bone remodelling
Muscle corset recovery:
- Selective working of deep muscles (e.g. medial broad muscle of the thigh in hip fractures)
- Restoration of proprioception through balance exercises
- Sequential activation of muscle chains (from static to dynamic loads)
Load redistribution:
- Dikul's special simulators allow the load to be applied in physiological vectors of movement
- Phased induction of axial loading (especially important in tibial fractures)

3. Why are traditional methods inferior to the Dikul method for rehabilitation of large tubular bones?¶

Classical Therapeutic exercises:

Often limited to passive movements in the early period
Does not provide sufficient load to stimulate osteogenesis
Does not restore neuromuscular control

Physiotherapy:

Has a supportive value, but does not solve the problem of muscle atrophy
Does not affect load redistribution

Massage:

Improves trophics, but does not restore biomechanics.

The key difference of the Dikul's method

The method does not just develop the joints, but restructures the entire biomechanical chain, restoring:

Physiological load axis
Muscular balance
Proprioceptive control

Rehabilitation of multiple and combined fractures using the Dikul's method (Polytrauma, pelvic, sacrum and coccyx fractures)¶

1. Peculiarities of rehabilitation in polytraumas and pelvic fractures¶

In case of multiple fractures (especially after road accidents or falls), the body faces a complex violation of biomechanics:

Dysfunction of the pelvic ring - with pelvic fractures, the synchronised operation of the sacroiliac joints is disturbed, which affects the entire posture.
Violation of the support function - the pelvis ceases to be a ‘bridge’ between the spine and legs, the load is distributed incorrectly.
Muscular fascial dysfunction - prolonged immobilisation (restricted mobility) leads to atrophy of the gluteal, lumbar and abdominal muscles that stabilise the pelvis.

If the deep pelvic muscles and the deep muscles in the centre of the body that stabilise the spine, the pelvis and torso as a natural ‘corset’ are not restored:

Chronic low back pain (due to overloading of the spine).
Changes in gait (shortening of stride, limping).
Pelvic instability (risk of hip osteoarthritis).

2. How does the Dikul's method restore biomechanics?¶

Stage 1. Pelvic Stabilisation (early period)¶

Isometric exercises - tension of the pelvic floor muscles, transverse abdominal muscles without movement (so as not to load the ununited bones).
Breathing biomechanics - diaphragmatic breathing + activation of the internal oblique abdominal muscles to support the pelvis.

Stage 2: Muscle corset recovery (middle period)¶

Eccentric loads - slowly lowering the legs from an elevated position (trains the gluteal and adductor muscles without impact loading).
Rubber harness work - side steps, hip thrusts (restores balance between adductors and abductors).

Stage 3: Load Redistribution (late period)¶

Dikul's exercise machines with block systems - allow you to give load to the legs and pelvis without axial pressure.
Balance exercises (on unstable platforms) - restores proprioception and teaches the pelvis to ‘engage’ in movement.

The key difference of the Dikul Method

The method does not just ‘develop’ the pelvis, but retrains the body to distribute the load correctly:

✅ Restores the connection ‘pelvis - spine - legs’.
✅ Prevents the development of coxarthrosis and scoliosis.
✅ Returns the natural biomechanics of walking.

Example: After a pelvic fracture, patients often walk with their body ‘tilted’ to one side. The Dikul Method eliminates this habit through dosed resistance so that the load is placed on the muscles rather than on the joints.

Why is it difficult to rehabilitate fractures in patients with comorbidities?¶

Rehabilitating fractures in people with osteoporosis, osteoarthritis, stroke or cerebral palsy is always a challenge. Because the fracture itself is only the tip of the iceberg.

1. Osteoporosis: brittle bones and fear of strain¶

With osteoporosis, bones become as brittle as dried clay, and traditional rehabilitation methods are often at a standstill - doctors limit exercise for fear of new fractures, but this only makes the problem worse.

Without reasonable physical stimulation, bone tissue continues to lose density, muscles atrophy, and a person falls into a vicious circle: the less movement, the weaker the bones, and the weaker the bones, the scarier it is to move.

Even the most effective calcium preparations cannot be fully assimilated without mechanical action on the bones - they remain as building materials without workers to lay them down properly.

Dikul's method breaks this dangerous paradigm by offering a scientifically grounded approach: special simulators with precisely calculated resistance create micro-vibrations in the bones, which serve as a signal to the body - ‘it's time to get stronger’.

This is like a smart alarm clock for sleeping osteoblasts, the cells that build bone tissue.

At the same time, it strengthens the muscular corset, which takes on some of the load, relieving the vulnerable parts of the skeleton.

So, instead of avoiding loads (which only accelerates bone mass loss), Dikul's method uses them like medicine - dosed, precisely calculated and scientifically proven. It's not just rehabilitation, it's reprogramming the body to recover.

2. Osteoarthritis and arthritis: pain and stiff joints¶

Osteoarthritis and arthritis turn joints into a source of constant pain and stiffness - cartilage deteriorates, inflammation makes every movement painful, and after a fracture the situation becomes critical.

Prolonged immobilisation in a cast literally ‘cements’ the joint, depriving it of any remaining mobility, and improper rehabilitation techniques with sudden movements only add trauma to the already damaged tissues.

It seems as if the joint is trapped in a double trap - on the one hand it is bound by the disease, on the other hand - forced immobility after injury, and the longer it goes on, the deeper you get stuck in this swamp of pain and limitations.

The Dikul's method offers a reasonable way out of this impasse through an elaborate system of gentle mechanotherapy.

Special simulators take on axial load, allowing the muscles to work without destructive pressure on the painful joint, like a clever shock absorber that dampens harmful effects, but preserves beneficial ones.

The joint is not pulled or tugged - it is gently ‘defrosted’, gradually increasing the amplitude, like melting ice with warm breath.

At the same time, special attention is paid to strengthening ligaments and tendons - they become natural ‘dampers’ of the load, redirecting it from the damaged joint to the muscles. This is not just joint development - it is a reboot of the entire biomechanics of movement, where each element begins to work in concert, as in a well-oiled mechanism.

3. Stroke and cerebral palsy: when the brain can't hear the body¶

In the case of stroke or cerebral palsy, the fracture becomes not just a mechanical injury, but a complex puzzle for the body - the nervous system, which is already struggling to control the body, receives a new powerful blow.

Spastic muscles, constantly in hypertonus, literally ‘pull’ the broken bone, preventing it from fusing properly, and the disturbed sense of body in space turns every movement into a potential threat of a new fall. This is compounded by inherently limited mobility, creating a vicious circle: the less a person moved before the injury, the more difficult it is to start recovery processes after it, and the longer the immobilisation lasts, the more deeply rooted pathological motor stereotypes become.

Dikul's method approaches this problem in a complex way, using the principle of neuroplasticity - the brain's ability to rebuild damaged connections.

Through special exercises with dosed resistance, the nervous system is ‘reprogrammed’ - it re-learns to feel and control the body, overcoming spasticity and restoring lost motor functions.

Special attention is paid to proprioceptive training - developing a sense of balance and body position in space, which is critical to prevent re-injury. This is not just rehabilitation after a fracture - it is a profound restructuring of the entire movement control system, where every element, from the brain to the muscles, is re-learnt to work in concert.

Dikul's scientific approach to fracture recovery:¶

Dikul's method is not just a set of exercises, but a well-thought-out scientific system where the principles of neurorehabilitation and kinesiotherapy work in tandem.

Through specially selected movements with dosed resistance, a real ‘rewiring’ of nerve connections takes place - the brain re-learns how to control the body, overcoming the consequences of trauma.

The approach is based on a deep understanding of biomechanics and physiology - loads are selected not empirically, but on the basis of strict medical criteria.

Dikul's trainers, with their unique system of blocks and counterweights, allow muscles to be given the necessary work while simultaneously relieving the damaged parts of the skeleton.

This creates optimal conditions for recovery: the bones receive the right stimulation for fusion, and the nervous system receives the right ‘commands’ to regain lost functions.

Why does the Dikul Method work where others fail?¶

Dikul's method demonstrates astonishing effectiveness where traditional rehabilitation fails, because it is not just afraid of loads, but uses them like a precise medicine - dosed and scientifically substantiated, turning each exercise machine into a tool for fine-tuning the body.

There are no template solutions in this approach: in osteoporosis it gently stimulates bone tissue, in osteoarthritis it redistributes the load from diseased joints, and in neurological disorders like cerebral palsy it actually reprograms nerve connections, making them work in a new way.

There is more than just theory behind this - thousands of stories of patients with ‘hopeless’ diagnoses who have been able to return to full movement prove that when medicine combines a deep understanding of physiology with a personalised approach, even the most difficult cases are no longer a verdict.

Philosophy of Method

‘You cannot strengthen the bones without strengthening the muscles. You can't repair a joint without teaching your brain how to control it’.

This is not just physical training - it is a system of rebooting the musculoskeletal system, where each exercise works to correct a specific breakdown in the body.

Entrust your fracture recovery to professionals!¶

If you or your loved ones have suffered a fracture (of the spine, hip, pelvis, arm or leg) and want to return to a full life without pain and restrictions - the rehabilitation centre ‘Paupio Kinezioteka Clinic’ will help you to return to a full life using Dikul's method!

Individual programmes - for each patient the course is selected taking into account the type of fracture, age and concomitant diseases (osteoporosis, osteoarthritis, stroke consequences, etc.).
Scientifically proven effectiveness - unique simulators and techniques developed by Valentin Dikul trigger natural processes of bone, muscle and nervous system recovery.
Safety and comfort - dosed loads under the control of experienced specialists exclude the risk of complications.