Rehabilitation Guidelines After Surgery

Rehab after surgery can be as important as the surgery itself !  Especially when it comes to knees and shoulders, time spent working on motion and strength makes the difference between an ok outcome and a great one.  Almost all of my patients need to do some form of rehabilitation following surgery and I an a huge fan of using physical therapists – experts in movement and recovery – to guide you.

Physical Therapy
Rehabilitation after surgery starts right away.  In fact, after some knee surgeries, we try to get you up and walking within hours of the procedure.  Overall, the goals are to get you moving safely as soon as possible. While each patient and procedure are unique, the end goal is the same:  To get you back to normal activity as soon as possible.  In another post, I address equipment you might need following surgery.  Here, I want to go over the general outline for rehab. The first phase involves decreasing pain and swelling, getting some motion going, and minimizing complications from surgery.  Getting up soon after surgery can help decrease the risks of blood clots, lower your chances of infections, allow you to eat more normally sooner and more.

Step One: Decrease pain and swelling

This is step one.  Use Ice packs and keep your extremity up and elevated. Talk to your doctor about medication you may need.  This takes time !  Your phyiscal therapist may use other treatments to help with this like ultrasound or ice massage.  Be patient.

Step Two: Work on movement

Joints are designed to move.  Work on flexibility soon after surgery – the first few days – once your swelling allows.  There may be limits to your motion depending on the surgery performed.  Stretch and stretch again !  I have my total knee patients stretch up to 20 times a day !  Motion helps prevent tissue layers from scarring together.  Less scaring means a better final result.  This may take 6 weeks or more.

Step Three: Work on strength

Once you have all your motion, it’s time to work on strength. Most people are weak after having a procedure and working out all the stiffness.  Go slow, and expect not to see much change for the first 4 weeks.  Again, strengthening takes time.  Invest in yourself and stick with it.  You will see the difference.  Often we will place limits on when this can start and what you can do based on your specific condition.  Be sure to ask your doctor when it is safe and in most cases, ask for a referral to a physical therapist so you have coach to show you how to do it all right. 

Step Four: Gain endurance

As the strength returns, you need to be able to sustain it over time.  Slowly add time to your cardio conditioning and increase your strength level and number of reps.

Step Five: Restore your agility

Agility is a combination of strength and muscular control.  I think this usually comes last.  This step develops how your muscles are controlled.  Think of a soccer player performing quick moving drills across a field.  This takes your agility to do this.  Once you’ve regained this quickness, it may be time to go back to your sport!  You’ve done it !

Make it a lifelong habit

Now that you’ve invested so much time in yourself, dont loose it.  Keep going.  Make your workout routine a habit.  Keep your conditioning, endurance and agility.  This will help prevent later injuries and keep you out of my office.