Physical therapy, both before and after knee or hip replacement surgery, can help improve your recovery.

In 2017, nearly 700,000 people chose joint replacement surgery. Nearly half had complications. Difficulty climbing stairs, constant pain and even traumatic falls are real problems. Physical therapy, both before and after surgery, can help improve your odds for a better recovery.

Physical therapy before surgery

Undergoing physical therapy before surgery helps your body handle the trauma and the physical changes it’s about to face. For instance, look at hip surgery. Gait disturbance, where you no longer walk with normal strides, can happen in nearly half of patients who report problems after surgery. This is often caused by weak muscles (36% percent of affected patients) or tight muscles (over 40% of affected patients). This is often known as “hip drop” and it can debilitate you.

Weak areas in the body before surgery become like dominoes that trigger new problems. For instance, post-surgical pain and edema (fluid retention) can keep you from working your quadriceps and stretching your hamstrings. This then affects the very muscles needed to stabilize the hip joint, causing further weakness and more problems in the joint itself.

Looking at knee surgery, many patients see problems triggered by tight muscles in the groin. Those patients lack flexibility in their hip because of a tight psoas muscle and shortened quadratus lumborum muscle. A tight psoas muscle then results in piriformis syndrome, trochanteric bursitis, iliotibial band syndrome, and lateral knee pain, all dominos that fall because the body was trying to overcompensate for weak areas. The result is often re-injuring your joint.

You can fix the “post surgery” problem by improving your range of motion before surgery. There is good evidence that starting physical therapy before the surgery results in very positive results after surgery. Ensuring that your body is properly conditioned before surgery improves the odds that you’ll return to activities like playing tennis, golf, bowling, speed walking, dancing, bicycle and so forth.

Want the best chance of success? Exercise and start now, before surgery. A 2003 study has shown that both home exercise and physical therapy have an equal chance at preparing patients for surgery. Both will help, and most insurance companies consider both routes in their reimbursement decisions. However, we believe that home exercise alone cheats patients of quality care. Many people do their exercises wrong.

Teaming with a therapist towards the goal of recovery is your best chance at getting your life back after joint surgery.

By Raj Issuree, MPT



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