Ortho and Physical Therapy

We’ve all been there, especially those of us over 50. That moment when you start to think you may need surgery to repair a worn-out knee or an aching hip.

But surgery isn’t a cure-all for sore joints, torn ligaments or fractured bones. It’s just the first step. For many patients who undergo orthopaedic surgery, physical therapy will be an important part of their journey to recovery.

What is orthopaedic surgery?

Orthopaedics is the medical specialty that focuses on injuries and diseases of the body’s musculoskeletal system – namely your bones, joints, ligaments, tendons, muscles and nerves – which allow you to move and be active.

Orthopaedic surgery is one option for treating conditions such as a torn ligament, broken ankle or injured shoulder. Procedures can include soft tissue repair to fix a damaged ACL in your knee, joint replacement such as a hip, or even spinal fusion to address back pain or internal fixation.

The prevalence of orthopaedic surgery, particularly joint replacement, has grown significantly since the year 2000. In 2011, the most recent year for which data was available, 1.8 million joint replacements were performed in the United States, with jut over 645,000 knee replacements accounting for around one-third of all procedures. Spinal fusion was the second most performed orthopaedic surgery with 465,070 operations done that same year. And those numbers are up 66 percent from 2000 when orthopedists performed 1.08 million joint replacements, including 282,350 knee replacements and 210,682 spinal fusions.

Why do you need physical therapy after orthopaedic surgery?

The minute patients wake up after orthopaedic surgery, their recovery begins. And that usually means physical therapy as soon as possible, with the patient encouraged to sit up and even try walking the same day as their surgery. That’s because it’s important to get the joints moving again quickly to avoid stiffness or muscle weakness, which could slow recovery.

A physical therapist with Tidewater Physical Therapy can offer both pre-surgical and post-surgical support to help get patients back on their feet faster. Pre-surgical support can include exercises and therapies that promote strength and flexibility to reduce time spent in the hospital.

But of course the real work is after surgery, when patients are faced with having to get moving even when they’re in pain. For patients who have had knee or hip surgery, a physical therapist will help you learn how to walk using an aid such as a walker, cane or crutches. That will ensure you’re stable on your feet and reduce the chance of injury while you’re healing. And you’ll learn mobility techniques to help strengthen the muscles that will support your new joint.

Exercises may include ankle pumps and rotations, bed-supported knee bends, straight leg raises, knee straightening exercises, sitting knee bends and standing knee raises. Your orthopaedic surgeon and physical therapist may recommend exercising 20 to 30 minutes two or three times a day during your early recovery and then several times a week to maintain your mobility.

In the case of a shoulder replacement, you’ll most likely need to wear a sling for the first several weeks following surgery. Exercises will start off basic and might include pendulum swings where you’ll support your weight with your good arm on a counter or table while you hang your arm that had surgery in front of you and slowly move it in circles. After four to six weeks, your physical therapist will show you other exercises to stretch your shoulder and improve movement.

It might seem like a lot of work, but stick with it. You’ll get better faster, which means getting back to the things you love to do.

Sources:

http://www.aaos.org/research/stats/CommonProceduresTreatments-March2014.pdf
http://orthoinfo.aaos.org
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3037119/
http://www.mayoclinic.org/tests-procedures/hip-replacement-surgery/basics/what-you-can-expect/prc-20019151
http://www.niams.nih.gov/health_info/joint_replacement/
https://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000176.htm