Step by step, you can rebuild muscle after major surgery
A reader contacted me this past week with a question she was hoping I could help her with. She was born with a hip defect and has had repeat surgeries to the same area of her hip and thigh to correct the problem. She has also spent several months in a cast, post surgery, which resulted in muscle wasting. Her question was in three parts:
1. Is it possible to rebuild the muscles that were cut and immobilized? 2. How much work would be involved? 3. Why do muscles shrink to begin with? All great questions! I’ll do my best to answer them.
I thought I would start with the last question and work my way back to the beginning. When muscles “shrink,” it is due to a phenomenon call muscle atrophy. Atrophy is the opposite of hypertrophy, which refers to the muscle growth that occurs from lifting weights or doing other resistance exercise. The main reason muscles shrink is from a lack of activity, although diseases such as ALS, MS, Muscular Dystrophy and peripheral neuropathy can also cause muscles to waste away as moving the limbs becomes more challenging. In the case of this reader, it is evident that her muscle wasting is a result of the surgeries and the bracing that made it impossible to move her leg.
In very simple terms, the way that one gets more fit is by adapting to new stresses placed upon the body. Muscles get stronger (and bigger) when you ask them to do just a little bit more than they are used to. In the gym, this is called “progressive resistance training,” a fancy way of describing weight lifting. Simply going through the motions of lifting weights (or machines or pulling resistance bands) isn’t enough to rebuild muscle if the challenge isn’t great enough. Typically, the weight that works best for maximizing muscle growth is one you can lift only 8 to 12 times before having to rest. Repeat this for three sets.
As you get stronger and the lifting gets easier, it is essential that you increase the load being used for the muscle to continue to grow. The short answer to that part of the question is that muscles shrink when they aren’t challenged and they get bigger and stronger when they have to adapt to a new stimulus.
The amount of work necessary to notice positive changes depends on many factors. Medical exercise training begins about 12 weeks post-op for a total hip replacement and only if the client has no open wounds, they are fully weight bearing, have minimal pain, and have received a discharge from physiotherapy and have medical clearance. When these conditions are met, one can begin with a strengthening program designed to help restore functional strength and endurance for activities such as stair climbing, walking and getting in and out of chairs.
The focus of training should be on building strength and endurance in the hip rotators, the gluteal muscles (the butt) and the quadriceps (thighs). Age, overall health status, consistency and nutrition all will play a role in how long it will take to rebuild the muscles you are working on.
In regards to rebuilding muscles that have been cut and immobilized, I spoke with physiotherapist, Mackenzie Buttineau of Performance Physiotherapy in Hamilton for an expert opinion. She related that muscles can, indeed, be rebuilt after being cut during an operation. The process would begin with scar mobilization techniques such as friction massage or ultrasound treatments to restore proper movement patterns and range of motion in the affected area. The strength training, as noted above, would bring about functional improvements in about six weeks, while muscle hypertrophy would be noticeable in about eight weeks.
The good news is that the frustration of going through repeat surgeries and recoveries does not mean that no further improvements can be made to an affected area. With planning and consistent follow through, the body can continue to experience strength, endurance and functional improvements over time.
Medical Exercise Specialist Ernie Schramayr helps his clients manage medical conditions with exercise. You can follow him at erniesfitnessworld.com; 905-741-7532 or erniesfitnessworld@gmail.com.