How Physical Therapy Can Help Before and After Surgery

Almost everyone understands that physical therapy is a common component of recovery from a surgical procedure, but it is less well known that physical therapy is also used to help prepare patients for surgery as well.

Working with a physical therapist to promote strength and flexibility in muscles and joints is almost universally recommended by the medical community in post-operative settings. New research also reveals that physical therapy before surgery can reduce the amount of aftercare needed and improve outcomes.

What Is Physical Therapy?

Most of us have a general understanding of physical therapy in that it’s an array of exercises that help us recover functionality following surgery. We generally equate it with easing pain symptoms, strengthening weakened muscles and improving joint mobility.

While these are true, achieving these outcomes involves many detailed steps. There is an initial evaluation of the patient’s current physical and mental state, followed by a more granular assessment of key physiological factors like joint mobility and limb strength.

Once the patient has been evaluated, the physical therapist must dialogue with the patient and doctor to determine what outcome is desirable. Then a plan is formulated that caters to the specific needs of the patient.

Implementation of the treatment plan may involve a variety of therapeutic techniques, including

  • Heat
  • Ice
  • Strength building
  • Stretches
  • Ultrasound
  • Manual therapy
  • Electrical stimulation
  • Education

While some of these therapies must be performed in a clinical setting, others can be performed independently at home.

Most people readily recognize the role of physical therapy following surgery in which it helps restore strength and functionality, but it is less readily associated with other health conditions like chronic pain, limb loss, acute care, and respiratory rehabilitation.

An often-forgotten component of physical therapy is preventive care. While this may include exercises that build strength, flexibility, and mobility, it also includes a strong educational component that involves dialogue and personalized instruction.

Physical Therapy Techniques

Physical therapists employ a wide range of therapeutic techniques to achieve intended outcomes, including                                        

  • Strength training– physical therapy is perhaps most associated with these strength-building exercises that reinvigorate atrophied muscles. In recent years, however, there is an increasing emphasis on improving muscle strength throughout the body to provide more functionality.
  • Light therapy—the application of red or infrared light to affected areas has been linked to increased production of DNA, ATP, and collagen, all necessary components for healing. This methodology has been used to treat arthritis, carpal tunnel syndrome, and other pain conditions.
  • Robotics—one of the most advanced techniques that have entered physical therapy is robotics. With robotic treadmills and exoskeletons, physical therapists no longer need to manually move the limbs of patients. This technology can also detect minute changes in the patient’s movement and adjust accordingly.
  • Cupping—by decompressing the soft tissue just beneath the skin, physical therapists can activate blood flow and promote healing. This is an ages old technique that has gained support among health care professionals in recent years.
  • Ultrasound—this method has long been a staple of physical therapy. An emitter of high frequency sound waves is placed on a problem area like a healing fracture or plantar fasciitis.  The high energy sound waves heat up the tissue which induces blood flow and speeds healing.
  • Traction—unlike the popular misconception of patients with elevated casts, traction is merely relieving pressure on the spine to treat conditions like sciatica, herniated discs, and pinched nerves. Over several sessions, traction can alleviate pain, straighten the spine, and promote healing without surgery.

How Effective Is Physical Therapy?

It is widely accepted in the medical community that physical therapy is an effective treatment for post-operative pain. Traditionally, post-op pain has been treated with pain medications, most notably opioids. However, in recent years, more pain specialists are recommending a multi-modal pain management approach that includes physical therapy.

More physicians are recommending that physical therapy become a priority following a surgical procedure because it speeds recovery, reduces costs, and limits use of valuable medical resources.

It is also becoming clearer that pre-operative physical therapy has benefits as well. In one meta-study of 451 patients with an anterior cruciate ligament who underwent surgery found that those who had pre-operative physical therapy generally had better outcomes. These benefits are derived from the following features of pre-operative physical therapy

  • Mental preparation for surgery
  • Reduction in swelling and pain
  • Improved range of motion
  • Stronger musculature surrounding affected joints
  • Normalized movement patterns prior to surgery
  • Greater stamina
  • Enhanced overall health and wellbeing
  • Strong introduction to exercises to be used post-operatively

Physical therapy is also commonly recommended for many other pain conditions like arthritis and lower back pain. In one study in the New England Journal of Medicine, it was reported that arthroscopic debridement plus physical and medical therapies for patients with osteoarthritis in their knees was no more effective than physical and medical therapies alone.

This and similar studies suggest that physical therapy is quite effective at maintaining and, even, restoring joint function. Physical therapy plays a key role in building strength, tissue flexibility and range of motion.

How Physical Therapy Can Help You

If you are planning to have surgery soon, you should discuss with your surgeon what kinds of physical therapy you should be undergoing both prior to and after the procedure. You should expect to start physical therapy about a month prior to the procedure, but the amount of rehabilitation you must complete post-operatively will depend on the kind of procedure and how quickly your body recovers.

Even if you are not preparing for or recovering from surgery, you can still benefit from physical therapy if you have certain health conditions like arthritis, knee pain or plantar fasciitis. If you have a chronic condition, you may obtain the greatest benefit from ongoing therapy, but, in many cases, it may be necessary to only attend a few sessions with a physical therapist before performing a PT plan independently at your home.

Article written by: Dr. Robert Moghim – CEO/Founder Colorado Pain Care

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