What Is Pre-Surgical Therapy?
While most people understand the importance of undergoing physical therapy, a lot of folks don’t know about pre-surgical therapy and its importance. Pre-surgical therapy is a treatment program by a physical therapist designed to help you achieve greater outcomes after surgery. Also known as “pre-hab therapy,” pre-surgical therapy is recommended by healthcare professionals approximately one month prior to surgery.
No one really wants to have surgery, but living with a loss of function or pain leads many to undergo surgery every year. As people are now living longer, their joints are undergoing more wear and tear. Pre-surgical therapy is often done for those undergoing surgery for rotator cuff, hip, shoulder and ACL reconstructions. It’s critical for patients with these types of injuries to have surgery so they can resume daily activities.
The Goals of Pre-Surgical Therapy
The goals for pre-surgical therapy include:
- Mental and psychological preparation for surgery
- Reduce inflammation and pain after surgery
- Normalize movement patterns prior to surgery
- Increase range and motion
- Improve muscular control of the injured body part
- Improve overall fitness and well-being
- Gain a thorough understanding of exercises that are required following surgery
There will always be a loss of movement and mobility after having surgery. For a better outcome after surgery, pre-surgical therapy by a physical therapist has been shown to be effective for patients. Those who have had pre-surgical therapy wind up having increased stamina and strength after surgery. Daily function and mobility are also greater with pre-surgical therapy.
Pre-Surgical Therapy and Physical Therapy
It is important to note that the body will not regain normal motion without specific retraining. After a comprehensive assessment, a physical therapist will work together with the patient to establish goals and specific guidelines in order to resume normal activities after surgery. A pre-surgical therapy program is structured and tailored to the patient’s needs and type of injury. Both pre-surgical therapy and post-surgical therapy are critical to a successful outcome after surgery.
Studies have been done to support the importance of pre-surgical therapy. “Forty-five patients admitted to the Department of Orthopedics and Traumatology of Locomotor System for elective total hip replacement surgery, were recruited for a study. The assessment consisted of a detailed interview using various questionnaires: the Harris Hip Score (HHS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the 36-Item Short Form Health Survey (SF-36), and the Hip disability and Osteoarthritis Outcome Score (HOOS), as well as physical examination. Patients were assigned to groups based on their attendance of preoperative therapy. The patients who received pre-surgical therapy had a significant improvement in pain, daily functioning, vitality, psychological health and social life.”
What Is the Importance of Rehab After Surgery?
No matter what type of surgery you’re recovering from—from joint replacements to a heart valve replacement—undergoing rehab after surgery with a physical therapist is essential to maximize your physical potential, accelerate your recovery, and help you get the most out of the highly skilled interventions provided by your surgical team.
No matter how minimally invasive a surgical procedure is, it still causes trauma to your body. While your body is healing, you’ll likely experience challenges like pain, inflammation, and swelling. You may also have newfound difficulty with daily tasks like dressing, standing, and walking. You may even have specific instructions from your surgeon on things to do or things not to do in order to protect your healing surgical site and prevent complications.
For example, if you’ve had surgery to correct a broken bone in your leg, your doctor may tell you to be “non-weight bearing” or “partial weight bearing” for several weeks. If you’ve had a hip replacement, your doctor may require you to follow “posterior hip precautions.” If you’ve undergone surgical repair of a torn rotator cuff, your doctor may want you to restrict movement at your shoulder.
What do these precautions and restrictions mean? How can you learn to function in your daily life while complying with such restrictions? How might these restrictions affect your body (e.g., weakening of muscles due to disuse), and how can you minimize, prevent, or reverse these effects?
These are important questions and further show why working with a physical therapist for rehab after surgery is so critical.
Above all, post-surgical rehabilitation is an evidence-based, drug-free, and non-invasive way to regain your strength, balance, flexibility, and function following any type of surgery. Research even shows that physical therapy can reduce the amount of pain medication a person needs to use!
What to Expect From Post-Surgical Rehabilitation With a Physical Therapist
Physical therapists are experts of the human body who diagnose and treat a wide number of conditions. In post-surgical rehabilitation, physical therapists are key team members who can implement plans of care with the goal to:
- Reduce pain, swelling, and inflammation
- Accelerate wound healing and minimize scarring
- Improve circulation, range of motion, and strength
- Restore your functional mobility (your ability to move around in your environment and participate in activities, such as climbing stairs, and getting in and out of a car)
Depending on your unique needs, a physical therapist may also help you adapt to new changes in your body or learn how to use certain tools and adaptive equipment (such as crutches, incentive spirometers, or braces).
At your first post-surgical evaluation, your physical therapist will review your medical history and any relevant documentation from your surgeon. He or she will examine your surgical site, as well as other aspects of your health including strength, balance, blood pressure, heart rate, pain level, range of motion, and cognition. Finally, you and your physical therapist will go over your goals.
Based on all this information, your physical therapist will design and implement a customized plan of care and employ a variety of exercises and techniques to help you achieve your goals:
- Manual therapy such as soft tissue massage, joint mobilizations/manipulations, and muscle stretching
- Therapeutic exercises
- Gait and balance training
- Neuromuscular re-education
- Dry needling
- Patient education
Your physical therapist will periodically make reports on your progress and adjust your plan of care as necessary to ensure you’re progressing well. When your rehabilitation program is complete, your therapist will write a summary of your care and give you instructions and recommendations about things which will help you continue to progress (e.g., nutrition, stress management, sleep, exercise program, etc.).
How Long Does Physical Therapy Rehabilitation Take?
The amount of time you’ll spend in physical therapy rehabilitation depends on many complex factors, including age, overall health, type of surgery, and whether you experienced any complications.
In many cases, a person goes from the operating room to the rehab room within a matter of days or even hours. Common protocols range from two to seven times per week and for two weeks to three months or more. You may need physical therapy more frequently early on in the recovery period and less frequently as you go on. Therapy can happen in a hospital, an inpatient rehab facility, an outpatient clinic, or even in your own home.
No matter what your unique protocol looks like, patience and consistency is the key while you allow your body to heal.
A Physical Therapist Can Help You Before and After Your Surgery
Strong evidence shows that consulting with a physical therapist both before and after surgery can reduce your risk of complications and drastically improve your overall outcome. Even just a few pre-operative sessions can be effective for helping you prepare your body for the operation.
Do you have surgery ahead of you? Find a location near you today to set up an appointment and learn more about how we can help you get the most out of your procedure.
