How Physical Therapy Improves Outcomes After Surgery
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Whether you’re having a knee replaced or are undergoing an intense heart procedure, the road to recovery can be long and arduous. Physical therapy is one of the most common ways to both speed up healing and regain the strength needed to return to your everyday life.
In this blog, we talk to Sarah Becker, PT, DPT, a rehab therapy supervisor at INTEGRIS Health Jim Thorpe Outpatient Rehabilitation, about the benefits of physical therapy after surgery. "Physical therapy following surgery for an injury is so important,” Becker declares. “When you are recovering, it can be difficult to discern whether your pain is a normal part of the healing process or if it is something to be concerned with. PTs can help you in your recovery and help to monitor that your healing process occurs as it should without complications.”
Why is physical therapy important?
Physical therapy after surgery offers many advantages. Not only does it aid in recovery and pain relief, but it also helps restore functionality to pre-surgery levels. Without physical therapy, you’re more prone to reinjury, surgical complications and prolonged recovery times.
Here are several examples of how rehab after surgery can help you.
What post-surgery rehabilitation can help with
Improves mobility, balance and strength: Surgery takes a toll on the body, causing both physical and mental stress. Your body can become weak, lose mobility or have trouble with coordination. Whether it’s a loss of range of motion or strength, physical therapy helps restore any issues with functionality. Usually, this begins with performing routine tasks. For example, after knee surgery, physical therapy may initially focus on ensuring you have enough mobility to walk.
Reduces scar tissue: Scar tissue is a normal part of the healing process, which occurs when collagen fibers form to repair damaged tissue. For some people, the body produces too much scar tissue that can cause pain and limit movement. The earlier you start physical therapy after surgery, the less likely excess scar tissue will form.
Reduces pain and inflammation: Surgery, while beneficial, is a traumatic experience to your body. Between the cutting of tissue or inflammation from nerves, surgery leaves you with pain and swelling. Many people turn to medications, such as opioids and non-steroidal anti-inflammatory drugs (NSAIDs), to ease discomfort. However, gentle stretching and a strengthening routine can also provide pain relief. In general, any type of movement is beneficial to swelling after surgery.
Reduces complication risk: All types of surgery come with risks and complications, many of which are related to blood clots or infections. Using physical therapy to improve and increase blood flow to tissues around the surgical site can help improve healing and reduce complications. Plus, being sedentary after surgery can cause blood clots, so involving movement counteracts any health problems inactivity may cause.
Rebuilds stamina: Inactivity from surgery can quickly cause your body to lose muscle mass and functionality due to atrophy. This tires out your muscles and joints, even during the most routine movements. Physical therapy ensures you can slowly progress to your pre-surgery stamina.
Types of physical therapy for post-operative patients
Physical therapists use several modalities to treat patients after surgery. Ultimately, there isn’t a one-size-fits-all approach. Instead, your physical therapist will create a plan that best suits your recovery.
Manual therapy
This hands-on therapy involves manipulating various parts of the body to reduce pain and increase range of motion. There are several techniques used in manual therapy, including joint mobilization, soft tissue mobilization, myofascial release and trigger point therapy.
Therapeutic exercises
This type of therapy involves the use of exercises to increase movement, build strength and increase flexibility.
To increase flexibility, a physical therapist will come up with stretches to perform. There are several types of stretching your physical therapist may suggest, including active stretching and passive stretching. Passive stretching uses another person or a device, such as a strap, to assist with the stretch. On the other hand, active stretching uses your own muscles as the resistance. Arm circles are a good example of this.
Your physical therapist will also implement exercises, such as yoga, for balance and coordination. Eventually, you will build up to strength training, which includes the use of your own body weight, resistance bands or weight training.
Gait training
Your gait describes the pattern in which you walk. Gait training therapy helps you relearn how to walk after surgery or an injury. By working on strength, flexibility and coordination, you will be able to walk with the proper stability and alignment. A physical therapist typically focuses on walking posture and how to use your core to distribute your weight and provide balance.
Hydrotherapy
Hydrotherapy is conducted in the water to reduce the stress placed on joints. By using the buoyancy of water, the upward pressure helps bring your body to the water’s surface to make it easier to perform movements. Hydrotherapy is an alternative option for patients who may be non-weight bearing after surgery.
Hot and cold therapy
The use of ice and heat can help promote healing after surgery. When something cold (such as ice) is placed on the body, blood flow and circulation both decrease to reduce swelling and inflammation. Cryotherapy, which uses extreme cold temperatures to promote healing, is a form of cold therapy. Heat therapy, on the other hand, improves blood flow and circulation to soothe discomfort and increase flexibility. For example, a heat pad on your lumbar spine can help increase mobility to treat tight lower back muscles after surgery.
Electrotherapy
This therapy uses electrical currents to stimulate muscles and nerves. Electrotherapy can provide pain relief, improve circulation, promote muscle strengthening and decrease inflammation. Transcutaneous electrical nerve stimulation (TENS) is a popular form of electrotherapy that improves blood flow, which is especially useful in areas that have poor circulation such as areas of your feet.
Functional training
As the name suggests, functional training mimics movements that you use in real life performing everyday tasks such as pushing, pulling and twisting. The movements helps both improve strength and coordination. Examples include lifting kettlebells, throwing a medicine ball or pushing resistance bands.
Balance training
Balance training uses exercises to improve posture and strength after surgery. Examples include standing on one leg or performing exercises on a balance ball. Many balance training exercises target the core (abdomen and back), the legs and the ankles – three areas that play a key role in stability. Balance training is frequently used to mitigate the post-surgical instability that increases the likelihood of falls.
Who should consider physical therapy after surgery?
Physical therapy after surgery is usually associated with orthopedic injuries and ailments, including knee surgery or hip replacements, but any patient who undergoes surgery can benefit from physical therapy.
- Knee: Surgery to repair the anterior cruciate ligament (ACL) is the most common knee surgery, although any type of knee surgery can benefit from physical therapy. Exercises and stretches help regain motion and reduce inflammation and swelling. It’s also important to rehab muscles around the knee, such as the hamstrings and quadriceps, as those play an important role in supporting the knee.
- Hip: The hips play a crucial role in moving your legs, as well as balance and stability, so rehab is important to regain strength and range of motion in this area.
- Back: Any type of surgery to the lumbar spine (discectomy, laminectomy, spinal fusion) can benefit from rehab. Physical therapy addresses issues with mobility and can also loosen muscles in the back, hips and core that are prone to weakness and tightness.
- Heart bypass surgery/valve replacement: The heart is a large muscle, and it needs rehabilitation after any type of surgery, especially heart surgery. Physical therapy improves conditioning and the heart’s ability to process oxygen.
- Joint replacement: Joint replacement is a major surgery, and it can take time for you to adapt. Physical therapy helps bridge this gap by helping to reduce blood loss and swelling in the short term. In the long term, it helps improve range of motion and reduces the chance of scar tissue building up.
- Shoulder: The shoulder plays a key role in lifting objects and moving your arms, so physical therapy helps restore your range of motion and builds strength to promote a faster recovery.
- Brain surgery: Physical therapy helps regain mobility and balance after any type of neurosurgery.
- Abdominal surgeries: When you have a hernia repair or a gastrointestinal (GI) procedure, physical therapy works to strengthen the core and hips to prevent reinjury. You will also learn the proper mechanics of lifting and how to practice good posture.
- Surgery for fractures (arm, legs, arms, feet, etc.): Range of motion and flexibility can decrease after a broken bone, and physical therapy helps address these issues, along with preventing weakness from occurring due to inactivity.
- Surgeries for cancer: Cancer alone can drain your strength and stamina, so any type of surgery to treat cancer can compound these effects. Physical therapy works to regain strength and improve healing – healing is slower in patients with compromised immune systems, such as those affected by cancer.
- Thoracic surgeries: After an intensive procedure such as lung surgery, physical therapy can help regain strength, improve circulation and boost stamina in your lungs.
- Vascular surgeries: Patients can benefit from an exercise program that can improve recovery and reduce complications for any type of artery or vein surgery.
In conclusion, Becker reemphasizes that using a physical therapist after surgery can significantly enhance your recovery process. “Our therapists at Jim Thorpe Rehab perform an evaluation on your first visit to create an individualized plan that will help you meet your specific goals, and hopefully get you there as quickly and easily as possible!"
Contact Jim Thorpe Rehabilitation to learn more about our in-patient and outpatient services.
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