Checklist for Successful Surgery Rehab
Welcome back to the Total Performance Newsletter! If you are a new subscriber and did not receive previous editions, check out the "Newsletter" tab on my website (www.totalperformance-pt.com) and they are all posted there. If you have trouble accessing this link, please let me know! This month, we will continue to take a look at some specific movement and injury-related issues that commonly arise and how to deal with them.
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Getting back to today’s newsletter, we are going to go through a checklist of things to do to optimize the rehab process after surgery.
Before we get into the checklist, it's important to note that surgery should be the last option. I'm a firm believer that you should do everything you can to avoid surgery, but there are times where it's just necessary. Once that decision is made to get surgery, then it's time to get to work on this checklist.
Pre-Surgery
The path to successful surgical rehab begins before the surgery occurs. Here are some essential steps to take into account:
Pick a surgeon and PT you trust
The most important factor in a successful surgical outcome is if you trust your surgeon. You should absolutely get multiple opinions, take into account any referrals/recommendations you're given, and weigh all your options before deciding who to go with. They all have the skills, knowledge, and experience, but you have to make sure you connect with the surgeon you choose. Some people want a soft bedside manner, some don't care at all. Some want the guy whose been doing it for 40 years, others want the young hotshot with the latest technology. Whatever matters to you, make sure you feel 100% comfortable with the surgeon you choose.
Same goes with your physical therapist. You're going to be spending a lot of time with them after surgery, so make sure you are completely on the same page. It's totally worth it to meet with your PT a few times before surgery to make sure you hit the ground running.
Be extremely clear on post-surgical expectations and protocols
The time immediately following surgery is crucial for a successful recovery. What you do during the initial days/weeks sets up the foundation for the rest of the rehab process. There are often range of motion and strength milestones that must be achieved early on and are otherwise very difficult to get back later on. So, make sure you are 100% clear on the expectations regarding any medications, braces/slings, ice/motion machines, movement and weight bearing guidelines, and anything else the surgeon and/or PT advises. The few days after surgery can be a bit chaotic and you'll need your rest, so having all this sorted out prior to surgery is key.
Get in the best shape possible
The better you go into the surgery, the better you'll come out. This goes for all aspects of health-building muscle, maintaining aerobic endurance, improving mobility, getting nutrition and hydration in order-all of it. These things will be essential post-surgery, so you might as well start building the habits pre-surgery.
Even on a more technical level, if you are able to exercise the joint/body part that is about to undergo surgery, you should focus on getting it as strong as possible. This will decrease the amount of strength lost post-surgery and expedite the process of regaining it. If you can't exercise that particular area, then getting the rest of the body as strong as possible still has a carryover effect. There is a whole body of research backing this up, where exercising only one limb still got the other limb stronger due to the neural pathways (brain to muscle connections) being essentially the same. Pretty cool stuff and highlights the idea of strengthening whatever you can pre-surgery.
Post-Surgery
Here is where the real work begins. Keep these in mind throughout your road to recovery!
Follow all immediate post-op instructions carefully
Pre-surgery, it was essential to get your braces, meds, and movement instructions in order-now it's time to execute.
Be sure to stay on schedule with your pain meds. I'm all for getting off them as soon as possible, but in the early phases after surgery it is essential to stay ahead of the pain. This isn't just for comfort's sake, but it's also important for facilitating whatever early movement that is allowed. If you're in pain, you'll be less likely to move. Less movement = more swelling = stiffer joints = harder to get range of motion and strength back. There should be a plan for weaning off, but let the meds help you in these early phases.
In the same context, be sure to follow all instructions regarding your movement constraints-this goes for braces, slings, crutches, walkers, and range of motion/weight bearing limitations. Some surgeries will require you to significantly limit motion at first, while others need you to get things moving right away. Whatever the instructions, they are there to facilitate healing. Getting these things correct right off the bat will set you up for a smoother and more successful rehab process.
Do your home exercises
No one is giving you home exercises (or at least they shouldn't be) just to waste your time. The purpose of a home exercise program is to bridge the gap between sessions or to work on easier and more basic things so that you can set yourself up to progress during your actual PT sessions. This is especially important during the early phases of post-surgery rehab, where a high volume of repetition is needed to control swelling and pain and get back baseline levels of range of motion and strength.
Be patient
Rehab in general, especially post-surgery rehab, is not always a linear process. There will be ups and downs, good days and not so good days. You'll make big jumps one day, and then feel like you're stuck for a week. It's all a normal (and yes, frustrating) part of the process. Beyond normal words of encouragement about "trusting the process", I like to highlight two main things anytime we seem to hit a plateau.
First is a reiteration of what a surgery really is. Reminding ourselves that even a "minor" surgery is not so minor, but rather it's a massive trauma to the body and our body is just doing the best it can to balance protecting and healing itself. Instead of thinking of a plateau as a negative, it's more accurate to consider it as a way our body is communicating about what it needs. It's important we listen to it and adjust accordingly.
Second is to look at the rehab process on a bigger timeline as opposed to just a few days or a week. Yes, maybe the past few days have been rough, but think about where you were a week ago? A month ago? As long as your making progress over the long haul, you're moving in the right direction. Keep chugging a long.
Open communication with PT
This one relates to all the points made above, with the main idea being to make sure you have an open and honest line of communication with your PT. Be honest with how you're feeling, what feels helpful, what doesn't feel helpful, which things are progressing well, which things do you feel are lacking. Ask questions about how and why you're doing the things you are. Whatever comes to mind, put it all out there. Similarly, your PT should be doing the same with you. The more cohesive the PT/patient relationship is, the better the outcome.
Nutrition, Stress, Sleep
I've touched on these in several other newsletters, and the theme remains the same. Getting your nutrition, stress, and sleep under control provides your body with the ultimate healing environment. Surgery is stressful enough from both a physical and psychological standpoint, so by getting these other factors in order basically eliminates any other "distractions" and allows our body to devote its resources to healing from the surgery.
As I said above, nobody wants to get surgery and it should always be reserved as the last option. But, if surgery becomes the necessary solution, keep these things in mind to ensure your recovery goes as smoothly and successfully as possible!
Stay tuned for next month’s newsletter, where will we continue to look into some common issues that arise and practical solutions to deal with them! Also, if you have any topics that you want to see covered in a future newsletter, please let me know!
