Physio & Post Surgical Rehabilitation

There are some injuries where conservative (non-surgical) management just won’t cut it (pun intended). On the operating table the surgeon will execute their skill-set and put you back together. The reality is that this is the easy part. The hard part is just about to start. Rehabilitation… which for many musculoskeletal or orthopaedic surgeries can last for many months.

Rehabilitation post-surgery is one of the most important parts of your recovery and not engaging in some form of it will more than likely have a longer term impact. Surgery is a traumatic event for your body. Depending on your surgery the trauma extends from the incision through skin, layers of fascia and soft tissues, to cutting & stitching or in some cases the use of screws, metal plates and bone drills. Sure it’s a controlled process with a planned outcome but that doesn’t make it any easier on the body. You are left with pain, swelling and reduced functional capacity BUT that’s where post surgery rehabiltation comes in, the process of restoring you back to your strongest self.

Why is the rehabilitation process so important?

1. Restore Range of Motion

Surgery will often result in a loss of range of motion for the directly affected joint but also the indirectly affected joints (for example if you have knee surgery sometimes the ankle can become stiff because you are limping or less mobile than normal). You need to restore this range of motion to make sure you don’t put undue stress onto the surgical site and surrounding muscles and joints which might have to work a little bit harder. Trigger ball exercises, stretches, mobility exercises and etc. will be vital in restoring this.

2. Regain Strength

Working to regain strength in the muscles affected by surgery will form an integral part of your recovery. While surgery may ‘fix what’s broken’ it will be your responsibility (with the guidance of your physio) to re-build strength and resilience. Strengthening should be planned out and will often have be progressive  gradually return you to your pre-operative strength or beyond.

3. Teach & re-establish good Motor Patterns

Often injuries can be a result of poor motor patterns that over time stress a structure in your body. Fixing this pattern post-surgery is extremely important to make sure these injuries don’t redevelop over time. Acute injuries will also often need motor re-patterning as well as surgery often requires some period of rest. Re-teaching the body how to move in the most efficient and effective manner will result in greater outcomes post-surgery.

4. Prevent Re-Occurrence

The last thing you want to happen after you’ve spent your time & money having surgery is have the same injury rear its ugly head. As mentioned a couple of times, surgery aims to (hopefully) fix the anatomical deficiency but the rehab process is ultimately where most of the hard work.

CASE STUDY

Gus – 10 months post ACL surgery

Gus injured his knee playing rugby in June 2017. He underwent a knee reconstruction to repair a torn ACL, medial ligament & torn medial meniscus. He has been coming to physio for 11 months. Gus is the perfect example of someone who saw the detrimental impacts that losing focus on post surgical rehabilitation can have. He worked really hard in the first 3 months after surgery and was progressing really well, he had regained close to full range of movement and was getting stronger. Then he slacked off for 3 months, didn’t go his rehab diligently and as a result his strength & stability went backwards and his return to running was delayed. He is now back to most activities and is working to regain the confidence to get back to playing touch football. His sessions consist of a variety of hopping & jumping agility drills, squats, leg press, box jumps. He is also running 2-3 x per week. It’s a long process but it’s absolutely imperative to do that hard work for the longer term outcomes.