Physiotherapy after Surgery
For patients undergoing orthopaedic surgery the post-operative physiotherapy protocol that they follow will be critical to the result that they achieve. Often there is an established guideline or protocol for the Physiotherapist to follow if you are having a common surgery such as a hip replacement, knee replacement or ACL reconstruction. Your Physiotherapist should be familiar with this protocol and be able to adjust your program based on your specific circumstances.
Generally speaking post-operative physiotherapy occurs in three phases. The early recovery phase, the strength and range of motion phase and lastly the functional restoration phase.
Physiotherapy in the Early Recovery Phase
This phase begins as soon as you are discharged from surgery and carries on until your tissues have healed, the swelling from surgery has dissipated and the pain associated with the surgery has mostly resolved. During this period of time your Physiotherapist will be focused on the following;
- Pain relief
- Reducing swelling
- Gentle manual therapy to restore joint range of motion
- Assistance with early walking
- Prescribing gait aids like walkers or canes and instructing on their use
- Simple exercises to begin to regain muscle function without disrupting healing
Physiotherapy in the Strength and Range of Motion Phase
Once you have reached the appropriate milestones for your specific surgery and the post-op pain and swelling have reduced your physiotherapy program will become focused on normalizing the range of motion, mechanics and strength of your body. During this time, your post-op physiotherapy program will likely include;
- More difficult strength exercises
- The introduction of some balance and proprioception tasks
- More aggressive manual therapy to restore full joint range of motion
- Soft tissue treatment to ensure you regain full mobility
Physiotherapy in the Functional Restoration Phase
When your surgical site is ready and your strength has returned sufficiently to do more complex exercises safely you will move into the functional restoration phase of your post-op physiotherapy program. Each person uses their body differently and has a lifestyle that has different physical demands. It is important that each patients Physiotherapy program is designed to meet their physical goals. While one patient may be looking to return to an elite level of sport, another may simply need to be able to get down on the floor to play with their grandchildren. Therefore, the program must progress toward the goals of the patient. During this period of time you may be doing some of the following;
- A progression of exercises designed to meet a complex functional goal
- More difficult and complex balance and proprioception exercises
- Manual therapy to restore full joint range of motion (if not already achieved)
Important Considerations for Post-Op Physiotherapy
There are restrictions and timelines specific to your surgery that must be respected to heal properly. For example, patients who have undergone and ACL reconstruction are usually not allowed to run until 12 weeks after surgery (assuming that they have reached the expected clinical milestones in this time) and people who have undergone a hip replacement are told to avoid bend the hip past 90 degrees for several months and are usually told they need to give up some higher risk activities such as skiing and running. These restrictions can be obtained from your surgical team or your Physiotherapist and should be respected to ensure the best possible results.