Physiotherapy after Orthopaedic Surgery

With elective surgery starting up again at places like Fortius Clinic and Schoen Clinic after the Covid-19 pandemic, I thought it would be useful to outline what to expect from physiotherapy during your post operative recovery. Whilst there will be some differences depending on the joint you have had operated on and the specific procedure that has been performed, the stages I have outlined below are applicable to most. Of course, always follow the advice of your surgeon and physiotherapist as this does not replace professional advice!

Immediate post-op phase

The focus initially is on reducing any swelling and being able to look after yourself at home. Don’t be scared to take your prescribed pain relief to help with this process and follow the instructions of your surgeon with regards to how much you are allowed to do. If you have had surgery on your lower half you may be on crutches and moving around with these can take a bit of practice. If you have had shoulder or elbow surgery you may be in a sling or brace which may restrict your ability to wash yourself and do the household chores.

In almost all cases you will have some ‘homework’ from your physio. This will normally comprise of gentle movement exercises and some gentle muscle activation work. Although these might be the last thing you want to do in this stage, they are really helpful in laying the foundations for the stages to come.

Regaining range of movement and muscle function

Some procedures mean that you are only allowed to move the operated joint a certain amount. This will be detailed in the post-operative instructions. But a lot has changed in recent years and now most of the time we are actively encouraged to move as much as possible. Aside from the obvious, movement is great at helping to reduce swelling and inflammation, and normalising muscle function. Pain and swelling have an inhibitory effect on muscles meaning that it can be hard to activate and get them going again after surgery. The longer this goes on, the longer the process to regain their strength and function.

Regaining everyday function

As range of movement and muscle function improves, you should find it much easier to do the things you need to across the day. This might mean getting rid of your crutches if you have had lower limb surgery, or being able to dress yourself easily if you’ve had shoulder surgery. As well as being great for your operated joint, it obviously makes life a whole lot easier.

Building strength and co-ordination

As pain decreases and function improves it is time to hit the gym! Don’t worry if you have not been to a gym much before, your physiotherapist should help guide you through the process of progressively loading the operated joint in a safe but challenging way. We have to challenge the muscles in order to regain strength so there will be some hard work involved but this will be really rewarding as you see your muscle bulk returning and gain confidence from feeling stronger. Co-ordination should improve as you become more practised at the exercises and over time the complexity of these will likely be progressed as well as the load you are working against. This is the stage where your physiotherapist can liaise with your personal trainer (if you have one) or may recommend the services of a strength and conditioning coach alongside physiotherapy sessions.

Return to sport

Obviously not everyone will be aiming to get back to sport on a regular basis but it is important when setting your goals with your physiotherapist to consider some of the things you do occasionally so that you can progress your rehabilitation program to an appropriate level to be able to complete these activities confidently and safely. Even if you only have the occasional kick around you will need to be able to change direction quickly, kick a ball and have the endurance to run for 30 mins plus. If you enjoy playing tennis on your summer holidays, we need to make sure that you are able to a swing a racquet, reach for those trickier shots and perfect those overhead smashes again.

Keep it Up!

This last stage does not necessarily need to involve a physiotherapist but it certainly can do. In order to maintain the improvements made during your rehabilitation and to minimise the risk of re-injury it is important to keep things ticking over. This doesn’t mean you have to be doing your physio exercises all day everyday, but it will involve keeping fit and active with some general exercise most days and continuing with some resistance training a couple of times a week.

If you are waiting for your surgery I hope this gives you a bit of insight into what to expect in your recovery but please get in touch if you have any specific questions or concerns about your rehabilitation.