POST SURGICAL PHYSICAL THERAPY IN NEW YORK CITY

If you have just had surgery or have never fully recovered from a previous surgery, we can get you back to performing at your best

POST SURGICAL PHYSICAL THERAPY IN NEW YORK CITY

If you have just had surgery or have never fully recovered from a previous surgery, we can get you back to performing at your best

We know that undergoing surgery isn’t what you were hoping for, as it can cause weakness, immobility, swelling, pain, and prevent you from moving how you would like. Our highly skilled and knowledgeable Physical Therapists at Perfect Stride are here to help you along every step of your post operative rehabilitation.

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:

After surgery, there is often little to no guidance about what activities are safe to perform, when you will be able to return to certain activities of daily living or sport and how to modify your daily routine while recovering. Our therapists are with you every step of the way and we can help answer these questions and get you moving and feeling better. We are also able to create modified workout plans for you that will support your recovery and maintain your fitness levels while you are recovering.

How do we approach post-surgical rehabilitation?

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!

Post Operative Physical Therapy Improves Recovery Following Many Procedures:

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:

  • Restoring normal movement to your hip
  • Improving your ability to control your hip for overall joint health
  • Increasing circulation and reducing the possibility of blood clots
  • Easing your pain
  • Reducing swelling
  • Strengthening the muscles in your hip
  • Returning you to your previous level of function/sport

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:

  • Improve hip strength and mobility
  • Improve pain-free range of motion
  • Improve strength in surrounding areas and to the spine in order to build resiliency 
  • Improve stability and trunk control
  • Return to daily activities as soon as possible
  • Improve cardiovascular and muscular endurance

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:

Early Phase: 

  • Many precautions emphasize avoiding ambulation without brace locked in full extension prior to about 4 weeks
    • Avoiding active knee flexion and avoiding prolonged standing/walking initially
  • Emphasize passive extension
  • Controlling pain
  • ROM as per surgeon’s guidelines
  • Home Exercise Program (HEP) prescription

Mid-Phase Rehab

  • Restoring full range of motion
  • Increase strengthening
  • Increase weight bearing exercises
  • Proprioceptive training

Late-Phase Rehab 

  • Increase dynamic strengthening 
  • Return to activity and sport emphasis
  • Improve endurance
  • Advance strength and conditioning principles

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:

  • Improve Range of Motion —  Improving flexibility is a primary goal of post-surgical rehabilitation, achieved through targeted stretches and joint mobilization. 
  • Build a stronger shoulder — Post-surgery, rehab timelines can vary. Your shoulder needs to recover from both the procedure and time period (months and sometimes years) of being injured. There will be a variety of exercises given depending on your specific needs, but emphasizing a strong and stable shoulder while moving throughout its’ available range of motion is necessary. 
  • A quicker healing process — While rest is vital, being sedentary is not helpful for healing. Physical therapy increases blood flow, helps to work through muscle and joint restrictions that negatively impact your mobility after your injury, and fortifies muscles to return to their intended function.

 

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

  • Achieving full knee extension, and minimum 90 degrees flexion 
  • Progress weight bearing tolerance
  • Improve quadriceps activation and prevent atrophy
  • Pain control 

Mid-Phase rehab emphasis and goals

  • Attaining full range of motion (ROM)
  • Pain control
  • Increased weight bearing exercises
  • Restore normal gait mechanics
  • Strengthening
  • Functional strengthening (stairs, squatting, kneeling, lunging)

Late Phase rehab emphasis and goals

  • Return to sport training
  • Dynamic strengthening
  • Plyometrics
  • Improve single leg control and neuromuscular reeducation

We help clients recover from many other surgical procedures here at Perfect Stride. Get in touch to find out more.

  • Shoulder Labral Repair

  • Bunionectomy

  • Biceps Tendon Repair

  • Laminectomy

  • Spinal Fusion

  • Spinal Decompression

  • Ulnar Nerve Transposition

  • Carpal Tunnel Surgery

  • PCL/MCL/LCL Repair

  • Achilles Tendon Rupture Repair

  • Knee Arthroscopy

  • Pectoralis Tendon Repair

  • Knee Meniscectomy

  • Patellar Tendon Repair

  • And many others ...

Pre Operative Physical Therapy Improves Recovery Following Many Procedures

Why pre-hab? Studies have shown that participating in physical therapy before surgery can help to mitigate muscle atrophy (loss of muscle size), improve post-surgical outcomes and even assist with returning to sport and prior level of function. Your physical therapist at Perfect Stride will also discuss what to expect immediately following surgery, and ways to help improve your recovery timeline. We also always talk about the “do’s” and “don'ts” following surgery.

What can you expect from post-surgical physical therapy treatment?

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: 

  • Techniques to help reduce swelling and pain such as soft tissue mobilization, taping, Grasston (IASTM), floss band, cupping and more

  • Treatments focused on restoring mobility are utilized to establish the necessary range of motion needed to carry out all movement and activity

  • Motor Control exercises aimed at understanding and controlling newly established ranges of motion 

  • Exercises focused on building tissue resiliency - This will ensure that you are able to better handle the loads and stresses that the real world demands bring your way. As we say at Perfect Stride, “make it take more to break you!”

  • Low-impact cardiovascular exercises such as walking or using an exercise bike have positive effects post operatively as they help to circulate blood and nutrients to the healing tissue. Also, after major surgery, simply taking a few steps is a significant accomplishment, and the sense of achievement patients feel as they progress helps recovery going forward

Post Surgical Rehabilitation Benefits

INCREASES MOBILITY, STRENGTH & BALANCE

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. 

RELIEVES PAIN & REDUCES SWELLING

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. 

REDUCES THE FORMATION OF SCAR TISSUE

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.

DECREASES THE POTENTIAL OF SECONDARY ISSUES

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. 

INCREASES FLEXIBILITY

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.

Read more about post surgery recovery on our Blog

What our clients think

“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.”

5/5

– Regina L   ( 5 Star Google Review)