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I am having Surgery, do I need Physio?

A course of physiotherapy is usually beneficial before and, or, after a range of surgical procedures.1,2,3

Examples of orthopaedic procedures include total knee or hip replacements, a knee ACL reconstruction, a joint arthroscopy, a shoulder subacromial decompression as well as spinal procedures such as a lumbar discectomy and laminectomy. Physiotherapy may also be indicated following cardiac and pulmonary (lung) procedures as well as laparoscopies.

surgery physio rehabNow by physiotherapy, I am referring to more than just being handed a set of generic exercises and being expected to get on with them. From my experience, and according to the research, an effective course of physiotherapy should include:

  • Advice and education
  • Pain management counselling
  • Specifically prescribed exercises
  • Manual therapy
  • Electrotherapy
  • Neuromodulatory techniques, such as medical acupuncture & dry needling.

Which techniques are used will depend on your assessment findings, your preferences, and the experience and skill of your physiotherapist. The number of sessions required depends on the type of procedure and condition of the patient.

Post-surgical physiotherapy aims to:

  • Provide guidance, support and reassurance
  • Reduce pain and swelling
  • Restore movement
  • Restore and improve strength, stability and balance
  • Restore and optimise physical function
  • Ensure a return to activity, exercise and sports as required

In some instances, a course of physiotherapy before the operation, i.e. pre-surgical rehabilitation may be required to prepare the patient and the area to be operated on for surgery.

The benefits or pre-surgical physiotherapy include:

  • Establishing a therapeutic relationship
  • An opportunity to provide information and education regarding the procedure and what to expect afterwards
  • Reduce pain and swelling
  • Improve movement and strength, which will speed recovery and reduce the number of sessions required following the operation.

Many consultants recognise the value of physiotherapy and actively encourage their patients to attend for either a course or pre-surgical physiotherapy, post-surgical physiotherapy, or both. The better surgeons will communicate directly with the physiotherapist and usually have their own pre and post-operative guidelines.

I always say that our role as physiotherapists is the make the surgeons look good! A proper course of physiotherapy can significantly improve surgical outcomes, often the difference between an average result and an excellent result.

By Simon.

References:

1.Robinson A, McIntosh J, Peberdy H, Wishart D, Brown G, Pope H, Kumar S. The effectiveness of physiotherapy interventions on pain and quality of life in adults with persistent post-surgical pain compared to usual care: A systematic review. PloS one. 2019;14(12).


2.Patel BK, Hall JB. Peri-operative physiotherapy. Current opinion in anaesthesiology. 2013 Apr;26(2):152.


3.Nielsen PR, Jørgensen LD, Dahl B, Pedersen T, Tønnesen H. Prehabilitation and early rehabilitation after spinal surgery: randomised clinical trial. Clinical rehabilitation. 2010 Feb;24(2):137-48.

 

 

 

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