More and more, both doctors and patients are understanding how physical therapy is an essential component of a healthy and successful outcome post-surgery.
A Study by the National Institutes of Health (NIH) demonstrated a lack of movement after surgery causes loss of function, muscle weakness, and increased postoperative complications. When patients remain immobilized and on bed rest, they tend to lose muscle strength and heart & lung capacity due to a lack of physical activity. The best solution to avert this problematic outcome is a carefully planned and supervised physical therapy program for those recovering from surgery.
At Perfect Stride, we understand your desire for a complete and rapid recovery post-surgery so you can return to the activities and sports you love. Our individually tailored one to one care can help you:
We constantly analyze the current literature as well for up-to-date research regarding post-surgical recovery. We look at full body movement with walking, running, fundamental and sports specific movement patterns to determine improper patterns at each joint. For instance, you may have a tight ankle joint that has been shown to correlate with hip mobility and could influence your movement up the kinetic chain. Many individuals have difficulties with compensatory movements that result in discomfort, as some of those joints and muscle tissues are not used to being loaded in those positions. Something like this can influence tasks such as squatting, lunging or walking (to name a few). We know the importance of a full body movement exam, as there are times when the source of the limitation or increased stress that resulted in a surgery was in a surrounding joint. This concept, titled regional interdependence, is key when rehabbing from surgery. We perform in-depth evaluation from big movements down to specific joint health movements, strength and mobility analysis in order to make you a more efficient mover!
Physical therapy prior to hip surgery commonly accelerates speed of recovery. After surgery, physical therapy is initiated within the first few days of the procedure. Your therapist will work with you to understand what you can and can not do. They will also provide the appropriate level of movement/exercise throughout the course of your rehab. Physical therapy after hip labral repair surgery will help in:
Participating in physical therapy post-surgery will enable you to perform tailored stabilization exercises, increase the flexibility of muscles and tissues surrounding your spine, and practice loading techniques to safely increase the resiliency of the recovering structures. Improving hip mobility and the surrounding areas of the spine is imperative to returning to improved function and mobility. Some of the most common spine surgeries we see include: Fusions, laminectomies, discectomies, and spinal decompressions. Each of these has their own healing timelines and protocols, but the keys are:
siliency of the recovering structures. We look at full body movement with walking, running, fundamental and sports specific movement patterns to determine improper patterns at each joint. For instance, you may have a tight ankle joint that is causing your hip to perform a compensatory movement that is putting your lower back in a compromising position with a task such as squatting. Physical therapy will ‘course correct’ this and any other abnormal movement threatening your rapid recovery from your specific back surgery.
The meniscus has an important weight-bearing function, and those with symptomatic tears (many are asymptomatic) may experience pain with turning/pivoting, stairs, squatting, kneeling or feeling their knee lock up. For those who go through conservative management options that do not result in optimal outcomes, you and your orthopedist may determine a meniscus repair is an excellent option for you. While arthroscopic meniscectomy is the most performed orthopedic procedure in the world currently, newer research is showing that a meniscus repair is a more reliable surgical procedure in comparison. The goals are to achieve meniscus healing and congruency in the joint while being able to return to pain-free activity.
Physical Therapy post Meniscal Repair typically emphasizes:
From a biomechanical point of view, the shoulder is said to be one of the least stable structures. It relies on dynamic and static soft tissue structures to achieve good stability as the shoulder and arm moves in space. The shoulder is one of the most commonly operated on areas. There are many different operations that one could receive, with general goals of PT after surgery to:
Rotator Cuff Surgery
The rotator cuff consists of four muscles and serves as an important stabilizing group for the shoulder. They help move the shoulder in different positions, work with surrounding muscles and joints to provide optimal movement for the shoulder. The rotator cuff is a commonly injured area. While many rotator cuff tears are found to be asymptomatic- up to 39% of tears found in a study were asymptomatic- some do result in pain and decreased function.
A Study by Gallagher et al 2015 looked to determine if there are differences between early and delayed physical therapy rehabilitation after arthroscopic rotator cuff repair in terms of clinical outcomes and healing. The study reported significantly increased functional scores within the first 3-6 months with early passive range of motion physical therapy rehabilitation compared to the delayed group. After a rotator cuff repair, physical therapy is necessary to help improve the range of motion and strength of your shoulder. You can expect to work with your PT for eight to twelve weeks (maybe longer depending on your goals) after a rotator cuff repair.
ACL Reconstruction: Following repair to the ACL (Anterior Cruciate Ligament) in the knee along with tears to the meniscal cartilage (which can be independent of each other), physical therapy is required. The reduction of swelling and restoration of range of motion is one of the primary early objectives in recovery from ACL surgery. Generally without the guidance of a physical therapist, a large portion of one's day consists of the knee being kept in one position immediately following surgery. However, leaving the knee in a fixed position risks the development of increased scar tissue and mobility related issues, making long-term recovery more difficult. Hence, physical therapy focuses on restoring range of motion, reducing edema and ultimately promoting a seamless recovery. While tenderness, stiffness, pain and weakness are common post surgery, you may be able to bear some weight on your repaired knee with the assistance of crutches and a brace following surgery. The objective of exercises during the first month of therapy is to begin to improve your range of motion in the joint, increase muscle control in your leg, ensure the patella does not lose mobility, promote strength in the hip and ankle, begin weight bearing and gait training, and improve your stability. We emphasize the importance of ‘criteria for progression’, where one must achieve all prerequisites prior to moving on to the next phase of rehab. Healing timelines are very helpful early on, but each patient will progress at their own pace and will have different strengths/weaknesses that require an individualized plan.
Physical Therapy post ACL Reconstruction typically emphasizes:
Early Goals (0-3 weeks typically): In the first few weeks , goals in PT are
Mid-Phase rehab emphasis and goals
Late Phase rehab emphasis and goals
Your course of rehab after surgery will vary depending on the surgical procedure you had performed, your response to the surgery and your rehabilitation. However, your Physical Therapist at Perfect Stride will be working alongside you each step of the way. They will progress you accordingly and get you back to performing at your best.
Some common post surgery physical therapy techniques we use include:
Surgery can result in limited mobility in the affected region or body part (as the body’s natural response is to protect the area of trauma). This can produce swelling, muscle/tissue tightness, spasms and limited range of motion. Physical therapy can help patients regain mobility through movement, strengthening exercises, manual therapy techniques and various modalities. It’s also worth noting exercises to strengthen and stabilize muscles in the surrounding regions can greatly improve recovery at the surgical site.
Swelling post surgery is an expected part of the healing process and can vary greatly from person to person. Chemicals that stimulate nerve endings are released, and the excess inflammation compresses the nerves, creating pain. A reduction in swelling accelerates healing and improves mobility, both of which diminish overall pain. Movement and exercise as part of your rehabilitation program can help reduce swelling and prevent any pains from surgery becoming chronic.In sum, after surgery, physical therapy rehabilitation accelerates the healing process, and gives you insight on the best approach to self-care and a successful return to your daily activities.
Post injury or surgery, scar tissue commonly forms, and soft tissue typically contracts as part of the natural healing process. Surgery anywhere on the body can produce excess scar tissue reducing movement and function for months or longer after a procedure. A physical therapist can perform many types of tissue mobilization techniques, including Grassston (IASTM), floss bands, cupping, taping and various manual therapy techniques to restore joint mechanics, mobility and return patients to optimal functioning.
Blood clots, infection, and other debilitating secondary complications can occasionally occur after surgery. Your Doctor of Physical Therapy will tailor a plan of care for your unique situation and monitor your progress to greatly reduce the risk for infection, blood clot and contractures.
Being inactive can lead to weakened muscles and increased stiffness, which can contribute to further injury. When muscles are restricted and joints are stiff, normal daily activities such as reaching overhead, climbing stairs and rising from a seated position can be severely affected. Among the first activities introduced after surgery are gentle mobility exercises designed to keep vulnerable muscles and joints mobile.
Bouldering, a sport that combines physical strength and problem solving skills, has grown immensely in popularity over recent years, especially with its sports debut in
“I have had an excellent experience at Perfect Stride following foot surgery. It’s a well organized practice and a friendly and comfortable environment. Megan is an outstanding therapist. She is thorough, great at identifying key issues and explaining things thoroughly, and follows up continuously. I highly recommend her and Perfect Stridewas nothing short of excellent. I would highly recommend Perfect Stride to anyone in need of physical therapy, especially athletes.”
– Regina L ( 5 Star Google Review)