Physiotherapy and rehabilitation- A necessary adjunct to orthopedic surgery

What is physiotherapy?

Physiotherapy is a category of healthcare services which are focused on restoring the body movements which may get impairment due to illness, surgery or accidents and may lead to disability. Physiotherapists are healthcare professionals specialized in the delivery of physiotherapy services. They can boost up mobility, functional ability and improve quality of life through detailed examination, evaluation,and physical intervention.

 

Figure 1: NANDE HOSPITAL PHYSIOTHERAPY EXPERTS

 

Physiotherapy includes rehabilitative and preventive services for a range of conditions and symptoms some of which include:

  • Neck and back pain due to muscle and skeletal problems
  • Movement problems in bones, joints, muscles,and ligaments due to arthritis
  • Respiratory problems such as asthma
  • Cardiovascular problems
  • Neurological problems such as multiple sclerosis, Parkinson’s disease, stroke etc.

Why is physiotherapy required after orthopedic surgeries?

For patients who undergoorthopedic surgery, post-operative physiotherapy planning and adherence to the plan is critical to the end outcome. Physiotherapy helps to restore the movements and strengthens the muscles surrounding the area of surgery. Muscle strengthening is necessary to facilitate ease of movement and to provide protection against future injury. The main goal of physiotherapy after orthopedic surgeries is to help patients in gaining enough mobility and range of function so that they can perform their daily tasks independently. Physiotherapy is required for some of the following conditions:

  • Total joint replacement of knee or hip
  • Spinal surgery
  • Total shoulder replacement
  • Ankle, elbow or knee replacements
  • Laminectomies
  • Meniscectomies

In some kind of surgeries, proper movement of the joint cannot be restored and thus new ways are tried by physiotherapists to avoid putting excessive strain on joints. In some cases, it takes time for a person to rehabilitate and it is a painful process in the beginning as the affected area is severely weakened by injury and surgery. However, the affected area can come back to normal with specific strength building exercises.

Physiotherapists often use a variety of modalities for the treatment which include

  • Exercises for flexibility, stability, balance, strength, coordination
  • Massage
  • Electrical stimulation, Transcutaneous Electrical Nerve Stimulation (TENS)
  • Ultrasound
  • Heat, moist heat
  • Cold
  • Iontophoresis
  • Light therapy etc

What kind of orthopedic surgeries require post-operative physiotherapy?

Some of the surgeries that require post-operative physiotherapy rehabilitation are:

  • Hip surgeries like hip replacement/resurfacing, hip labral repairs, hip arthroscopy
  • Knee surgeries: These are the most common surgeries which require post-operative physiotherapy rehabilitation. These surgeries include knee replacement, ligament reconstruction, arthroscopy, chondroplasty, cartilage or tendon repair
  • Shoulder surgeries like fracture management, shoulder reconstruction and stabilization, rotator cuff repair, capsulotomy etc
  • Spine surgeries (neck and back) are very difficult to recover from due to the complex anatomy and proximity with vital nerves. Patients with spine surgery require physiotherapy for fast recovery.Some of these surgeries include stabilization, discectomy, laminectomy, and spinal fusions.
  • Foot and ankle surgeries like joint replacement, arthroscopy, ligament repair, fracture management, and bunion and toe surgery.
  • Elbow surgeries that often require post-operative physiotherapy include tennis elbow and golfers elbow release and fracture management.

Can physiotherapy be a treatment option for certain orthopedic conditions?

An individual’s fitness to undergo a surgery gets affected by a variety of factors like age, underlying medical condition etc. As a result, surgery may not be recommended for some people. Similarly, in some cases, surgery may not be required at all. In such cases, physiotherapy can be considered as a treatment option for certain orthopedic conditions because it relieves pain, increases the range of motion, and improves the strength & function of the joint.

Some of the orthopedic conditions where physiotherapy can be used as a primary line of treatment include:

  • Sprain or tear
  • Rheumatoid arthritis
  • Osteoarthritis
  • Osteoporosis
  • Spondylolysis
  • Fracture management
  • Spondylolisthesis
  • Ankylosing spondylitis
  • Muscular aches

Physiotherapy treatments which are generally performed for orthopedic conditions are:

  • Manual therapy includes mobilization, manipulation and other related techniques to reduce the pain and increase the mobility of joints.
  • Massage: It varies from light pressure massage to deep friction massage which helps in breaking down scar tissue in muscles or tissue.
  • Ultrasound therapy: In this therapy, conducting gel is applied on to the affected area and ultrasound waves are passed on to the injured area through the electrical It alleviates pain, promotes circulation and relaxes muscles. Ultrasound therapy is mainly used for soft tissue injuries.
  • Electrotherapy: Nerve activity is increased by giving a low dosage of controlled electric shocks which alleviates muscular pain and helps in muscular regeneration.
  • Acupuncture: A traditional Chinese medical therapy which is used to reduce pain and normalize the movement.
  • Dry needling: Fine needles are inserted into dysfunctional muscles and healing process is initiated due to electrical and biochemical changes. It changes the way the body feels pain.
  • Inflammation of swollen joints can be reduced by ice packs and heat packs tend to release tense joints

How long does physiotherapy last?

The number of sessions of physiotherapy needed for an individual depends on the complexity of the problem, type of injury to the area and the speed of the recovery.

Physiotherapists usually take more time in the first session as more time is consumed in knowing a patient’s medical history, assessing the type of injury and therapy planning. After the first session of physiotherapy, follow up sessions are usually performed for 30 minutes to one hour. Many sessions are usually required as treatment must be gradual to prevent future injury.

What are different types of rehabilitation exercises after orthopedic surgery?

Orthopedic surgeries can help the patient go back to their normal lifestyle by improving the quality of life, increases the range of motion, and reducing pain. Rehabilitation after orthopedic surgery becomes mandatory because healing takes time and the benefits you will get from surgery will depend on rehabilitation exercises after orthopedic surgery. Orthopedic surgeries which respond better after rehabilitation exercises include knee and hip surgeries, spine surgeries rotator or meniscal tear repairs.

Various benefits of rehabilitation exercises include restoration of normal movement of the body part like knees, muscle strengthening, reduction in pain and swelling and improve circulation after surgery.

Some of the exercises which are generally performed after orthopedic surgery like knee surgeries include:

  • Quadriceps sets
  • Straight leg exercises
  • Ankle pumps
  • A bed supported knee bends
  • Sitting supported and unsupported knee bends
  • Walking
  • Stair climbing and descending

 

Figure 2: http://www.rehabcaribbean.com/service/physiotherapy/

 

Disclaimer: The shared article is only for awareness and education purpose. Readers are advised to consult their doctor for proper evaluation of the condition and more information. Do not self-medicate.

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