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   McDonald Physical Therapy News 


September 2014  

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Dear Friends,


I recently saw a patient who was worried whether she should cancel her first physical therapy visit as she thought she might need surgery on her knee. She was sent from her primary care physician and was waiting to get in to her orthopedic surgeon. Her orthopedic surgeon visit wasn't for 2 weeks and she was concerned that we might make her knee worse.

We were lucky because this patient did decide to come in for her physical therapy while she waited for her visit to her orthopedist. During those two weeks she worked hard to regain her motion, and began walking with less of a limp. Her strength improved and her pain started to decrease. Long story short, when she went to her appointment the surgeon looked at her X-rays and MRI and after examining this patient decided she should continue her physical therapy and that surgery was not necessary. What a surprise! This patient ended up bringing us a great treat (homemade brownies!) and thanking us for educating her on coming in for her physical therapy.

I do not want you to think we only do this for the brownies! A common misconception by patients, especially in regards to a knee or shoulder pain, is thinking it's best to wait on their physical therapy until they see their surgeon. Even if this woman ended up needing the surgery, she would still have been better off going in to physical therapy before seeing the surgeon. Why? Because studies have shown if a person has better motion and strength going into their surgery, they return to their normal activities of daily living faster. If an athlete regains their motion and strength before surgery, he/she return to their sport much more quickly than without it.

So, enjoy your health, and remember to choose physical therapy directed exercise, even when you have knee or shoulder pain and are waiting for a few weeks to see your surgeon.


Prehab: Creating A Strong Foundation


If you or someone you know is preparing for an upcoming surgery, the information you are about to read will be very useful. Most individuals are familiar with the thought of rehabilitation after surgery, but the idea of

pre-surgical rehabilitation is gaining recognition.


Often, there is a period of waiting involved prior to any surgery. This time is valuable, and it can be utilized to prepare the body for surgery and facilitate a better outcome after the surgical intervention. When muscles, bones and joints are in optimum condition before the procedure, the impact of the inevitable muscle loss and joint stiffness is minimized post operatively. Essentially, the stronger a person is going into surgery, the better the chances of an easier and faster recovery after the surgery.


Individuals who participate in a pre-surgical rehabilitation program tend to regain function and return to their daily lives faster than individuals who do not participate in pre-surgical rehabilitation. Traditionally, a physical therapist helps with post-surgical rehabilitation, but you may be surprised to learn that the therapist can also be your biggest ally during the 'prehab' process.


Pre-Surgical Rehabilitation 101

It is common for the region that is about to be operated on to be inflamed and weak. With a carefully planned exercise routine, a physical therapist can help reduce inflammation and improve blood circulation to the affected area. This improves mobility and helps with pain relief. This also helps promote correct movement patterns and minimize compensatory movements like leaning and uneven weight bearing.


Improving health and fitness, and being in optimal physical health can go a long way towards the facilitation of post-operative recovery.


These are some simple guidelines to follow with a pre-surgical rehabilitation program:

  • Start the program at least six weeks prior to the surgery.
  • Start slowly. This is not the time to aggravate an existing issue or trigger a new one.
  • If you are physically fit, consider increasing your intensity, frequency, or duration as long as it doesn't interfere with your current injury.
  • Yoga is an excellent way to prepare both the mind and body for surgery. The combination of relaxation and soothing movements can be beneficial before and after surgery.

One of the requirements for post-surgical discharge is that a patient is able to complete certain activities. Your physical therapist will collaborate with the surgeon to design your goals and establish benchmarks for recovery. For example, you may be expected to walk a certain number of steps or climb stairs before you are allowed to go home. Once this pre-requisite is met, you can start a home exercise program. Patients who are physically prepared for surgery can leave the hospital sooner and are likely to suffer fewer complications.


Physical Therapy and Prehab

A consultation with your physical therapist will involve an evaluation to determine:

  • Muscle and joint strength
  • Ability to move and perform day-to-day tasks (climbing stairs, getting in and out of bed)
  • Degree of assistance required from friends and family members

By working with a physical therapist prior to surgery and creating a pre-surgery rehabilitation plan, you will create a strong foundation for rapid recovery. Similar to the post-surgical collaboration, you can expect your physical therapist to work closely with your doctors to facilitate recovery even before you have surgery.


The physical therapist will help you familiarize yourself with walking aides and other supportive devices like crutches, walkers, or canes should they be needed. You will discover the importance of breathing, proper techniques and range of motion of important exercises that you'll be doing after the surgery. This will reduce the stress and apprehension associated with discharge and facilitate independence. As your physical therapists, we are committed to keeping you as healthy as possible. If you or someone you know is considering surgery, schedule a consultation with us. 'Prehab' is a great way to speed up rehab-call MPT @ 574-233-5754.


*article courtesy of Doug White, White's Physical Therapy




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