By Dr. John C. Kagan, M.D.
After joint surgery, it is essential to establish an effective recovery and rehabilitation plan in order to ensure that your body remains active and healthy. An effective physical therapy program is influenced by two factors: the type of surgery and the patient’s willingness to actively participate in his or her physical therapy program. Depending on the type of procedure, it can take many months for your body to fully recover from surgery. Therefore, it is extremely important that you adhere to the guidance provided through your program and complete any home exercises, as instructed by your physical therapist.
Joint surgery options may include minimally invasive surgical diagnosis and repair, also known as arthroscopic surgery. Arthroscopic surgery is a highly valuable tool in the diagnosis and repair of joint tears and joint inflammation. Rehabilitation for knee arthroscopy may include temporary immobilization during the initial healing process. Once this occurs, an exercise program to restore full mobility and strengthen your knee is usually recommended. For those with knee arthroscopy, an orthopedic surgeon may recommend 20-30 minutes two or three times a day. At the guidance of a physical therapist, walking can slowly be incorporated into your exercise program as the healing process advances. In many cases, with the approval of a physical therapist, patients can begin walking two weeks post-operation. The American Academy of Orthopaedic Surgeons offers common exercises that could potentially be incorporated into an initial, intermediate or advanced level exercise program. These exercises should be supervised by a physical therapist, at the direction of a surgeon:
• Initial Exercise: Straight Leg Raises, Standing
Using support if needed, from a standing position, slowly lift your leg forward keeping your knee straight. Return back to standing and relax. Repeat 10 times.
• Intermediate Exercise: Terminal Knee Extension, Supine
Lie on your back with a towel rolled underneath your knee. While supported by the towel roll, straighten your knee and hold for five seconds. Slowly relax your leg, bringing your knee back to the starting position. Repeat 10 times.
• Advanced Exercise: Step-Ups, Forward
Leading with your operated knee, step forward onto a 6-inch high stool. Step down to return to starting position. Repeat 10 times. As your strength increases, you can increase the height of the stool accordingly.
Another common joint surgery is arthroplasty, which is the replacement of a joint. During this surgical procedure, the surgeon removes damaged bone and cartilage and positions prosthetic components in its place. This type of surgery typically results in a hospital stay for a few days and a longer recovery period. While hip and knee replacements are the most common types of joint replacement surgeries performed, other joint replacement surgeries may include ankle, foot, shoulder, elbows and fingers. Patients are often encouraged to use their “new” joint shortly after surgery and early postoperative exercises are essential for hip or knee replacements. Many exercises can be done while in the hospital bed, including:
• Ankle Pumps
Slowly move your foot forward and back, out towards the wall in front of you and in towards your body. Repeat several times.
• Ankle Rotations
Move your ankle inward and rotate it outwards in clockwise circles. Repeat five times in each direction.
• Bed-Supported Knee Bends
Bend one knee as you slide your heel on the bed toward your buttocks. Do not let your knee roll inward.
• Straight Leg Raises
Tighten thigh muscle and straighten leg while lifting the leg off the bed several inches. Hold for five to 10 seconds and slowly bring leg back down to bed. Repeat the exercise until your thigh feels fatigued.
For any type of surgery, recovery time will reflect on the individual and the type of surgery. In many cases, physicians will recommend that patients get in shape prior to the surgery. Cutting down or quitting smoking altogether, eating well and doing exercises to strengthen the body are customary recommendations. In all cases of joint surgery, the goal is to restore movement and strength while alleviating pain. If you are a candidate for joint surgery or are experiencing discomfort in your joints and are considering treatment options, know that you can take a proactive approach to your situation. Ensuring a successful outcome includes a commitment to finding the right treatment option for your condition, as well as committing to the healing process.
Dr. John C. Kagan and his staff are ready to answer all of your questions regarding post-surgical physical therapy. Dr. Kagan has more than 30 years of experience as an orthopedic surgeon and sports medicine specialist treating patients in Southwest Florida. He specializes in treating patients with knee, shoulder and hip pain, as well as general orthopedics and hand surgery. For more information, visit www.kaganortho.com or call 239-936-6778.