It is critical that you prepare yourself BEFORE, trust me you do not want to have to troubleshoot scenarios or not have the assistance you need when you are in pain, on medications and physically compromised.
PRE-HAB is like putting physical deposits in your body bank, so you have more to drawn on after surgery when the reserves are already low and not optimally functioning.
Additionally, it allows your Physical Therapist to manually address your needs by working on the muscle, joint, fascia and nerve restriction or deficits that present. It gives your Physical Therapist a chance to get acquainted with your pain patterns and problem areas. Knowing this before surgery helps in how you are treated after surgery. It paints a more precise picture of how your individual body responds and recovers from manual physical therapy, mobility exercises, and rother necessary interventions. In the ideal case I appreciate the opportunity to observe the surgical procedure in order to identify; the level of the injury, inflammation, how the procedure went- easy or difficult , if there were any surprises(good or not so good) that were not initially detected by MRI or X-ray, and importantly allows me to work closely with your surgeon and discuss your; tests, scans, protocol, limitations, outcome expectations, timeline and foster communication and accountability that will continue throughout your recovery.
PRE-HAB & ACUTE INJURIES:
Acute trauma and injuries that require surgery can be the result of trauma, an accident or poor body mechanics. Either way Physical Therapy can help treat the pain, inflammation and educate you on the necessary course of care. It is especially important to resolve the acute inflammation before going under the knife, which only adds even more trauma to an already injured body. After sustaining an injury compensatory patterns develop and can lead to more pain, limitation and discomfort. Physical therapy BEFORE surgery is an EXCELLENT way to assess WHY you were susceptible to injury in the first place, what needs and CAN be fixed before surgery. If left untreated these inefficiencies often become amplified after surgery, immobilization and decreased activity.
I have observed this countless times especial in cases of ACL, shoulder injuries and other surgeries that require prolonged immobilization, assistive devices and involve protocols that are especially restrictive.
After an ACL injury there are specific compensatory patterns that develop, typically observed in the hip flexors, hamstrings, quads and IT Bands. Due to walking with a bent knee, pain, swelling and the instability of the knee the WHOLE BODY compensates. If a patient does not achieve a certain knee range of motion, address muscle restriction or weakness, the level of pain, atrophy, restriction exponentially increases after surgery. Post surgery certain gains knee to be made at specific times, carrying poor patterns into surgery puts a patient post surgery at great risk for; dependency on pain medications, sleepless nights, back, hip and knee pain, scar tissue formation, and requiring another procedure- overall a more miserable process(which can be avoidable!). Compared to my pre-hab ACL patients who we get to the point pre surgery where the even question if the even need the surgery, they feel so good.
It is extremely important to address poor posture, tight muscles, limited range of motion or muscle atrophy BEFORE going into a shoulder surgery and especially one that requires extended immobilization(sling time). Rotator cuff and shoulder labral procedures and require anywhere between 6-12 weeks of sling time. There are some key exercises and steps you can take to enter into these surgeries with confidence. Shoulder surgeries can be tough because of the associated and increased neck pain and general discomfort, which why it is so important to address any issues you may have before- you will be so happy you did.
Patients that participate with physical therapy BEFORE surgery may expect to:
PRE-HAB & CHRONIC INJURIES & LIMITATIONS:
When pain, limitation, functional decline and overall health become compromised an elective surgery becomes necessary. Due to an extended period of functioning with pain, instability and movement limitations you have likely developed significant compensatory patterns. It is CRITICAL to identify and address these before surgery. Improving strength, flexibility and neuromuscular control NOW creates less of an uphill climb after surgery. Additionally, it may help decrease possibly experiencing; headaches, numbness and tingling, muscle cramps, spasms and risk of depression.
PROTOCOLS & IMMOBILIZATION:
These WILL vary upon procedure, surgeon and each individual. This is NOT the time to compare yourself against others or rely on the internet. Protocols, immobilization and limitations serve a purpose and are ultimately for your SUCCESS. They are to be followed if you want to make your surgical investment worth it. It is beneficial to communicate with your surgeon and Physical Therapist to educate and prepare yourself for what you can expect to follow post operatively. (I hope they are communicating with each other-we do!)
Additionally, before surgery it may be beneficial to acquire the assistive equipment you may need and make other lifestyle changes.
You probably still have many questions. My hope is that you will give serious thought and take action to prepare, or motivate someone you know that has an upcoming surgery to take the steps to make their surgery successful.
Please contact one of our Specialist Physical Therapist for a FREE phone consultation, (805) 941-0125. You can click below to schedule a time that is convenient for us to call you if that is easier.
And check out our FREE Tips: "Top 3 Tips To Avoid, Prepare & Recovery From Surgery: Return to Workouts & Sports Quicker & Without Risk" to help you succeed with the least amount of pain, frustration and disruption to your life.
At Perseverance Physical Therapy & Pilates we help people aged 40+ stay fit, active and overcome mobility loss to be able to live the life they love without fear, limitation and depending on painkillers or procedures.
Yvonne A. Castillo, MSPT, DPT, CPT