REHABILITATION AFTER SURGERY

How to get back your strength, flexibility & fitness after surgery

Have you ever had some sort of surgery, whether elective or emergency? Are you contemplating having surgery in the near or not so near future? If yes, then the term ‘post-surgical rehab’ will make sense to you. Even if you’ve never had surgery, it’s still good to know what rehabilitation is and how it can help if you ever need to have surgery in your life.

Post-surgical rehabilitation, or rehab, as it’s commonly called, is the process of restoring a person to their pre-surgery function.

How quickly this process takes place depends on many factors, such as:

• The type of surgery the person had.

• The person’s age and general health.

• Whether the person closely follows their surgeon’s orders when it comes to rehab.

• How diligent the person is with the rebab process.

Let’s expand on these above points:

1. There are many types of surgeries; some are complex while others are quite straightforward. The general rule is that rehab will be quicker and easier for less complicated surgeries. While this is true if we look at extreme examples, such as the removal of a

2. A person’s age and their general health before the surgery are also important factors. Sometimes a person who is older and already has a number of serious health conditions might not do as well when it comes to rehab after a relatively easy procedure than a younger and healthier person who has to have more complicated surgery. fatty deposit (lipoma) versus open heart surgery, it won’t necessarily always be the case.

3. How well the patient follows their surgeon’s orders, is also very worth considering. While most of us would want to get back to our ‘old self’ as quickly as possible after surgery, it’s extremely important to realise that the surgeon is the one who knows better than anyone what we should be doing and when it’s safe to commence a certain activity. If we take it on ourselves to ‘speed up’ the process we can actually end up going backwards and the result will be that the recovery will be longer, not shorter.

While rehab will be different after each surgery one basic principle remains the same. Rehab can start as soon as possible after the surgery, generally on day one. Even though the patient might still have many restrictions, there will

always be gentle exercises which can be commenced almost immediately. Physiotherapy is an integral part of this process.

Physiotherapists liaise closely with the surgeon and doctors in establishing the rehab protocol. We make sure that the patient is doing the exercises safely. There are three phases to consider: 1. Phase 1. particularly for complicated surgeries, will include doing breathing exercises to prevent fluid accumulating in the lungs (which can lead to postoperative pneumonia, a serious complication) as well as helping the patient to sit up in bed/transfer from the bed to the chair. This can help prevent blood clots which can lead to a pulmonary embolism, another serious complication.

2. Phase 2. As the person gets a bit stronger, the rehab focus shifts more towards getting the person back to their ‘pre-surgical’ function. Depending on the type of surgery the patient had, more emphasis might be placed on certain muscles/ joints. After a hip joint replacement, for example, more attention will be focused on strengthening the muscles around the hip and improving the hip range of motion. The basic principles, however, will still be the same. They include improving muscle strength, range of spine and joint motion, fitness etc.

3. Phase 3. Once the patient is discharged from hospital. It’s important to continue with the rehab. Often patients will be referred on to an outpatient physiotherapist. Even if this does not happen you can continue seeing your regular physiotherapist, who will look after you as you get better and stronger and will make sure that the program reflects your needs and goals at each stage of your recovery.

As mentioned above, it’s paramount that rehab is commenced as soon as possible.

Pre-surgery rehabilitation is a term which is being used more and more now called ‘pre-habilitation’ or pre-surgery rehabilitation. This refers to getting your strength, flexibility and fitness to the best possible level before you go in for surgery. This will significantly increase your chances of having an easier and faster recovery after surgery. Once your physiotherapist knows exactly what type of surgery you are going to have, he/she will be able to develop a specific presurgery rehabilitation program to make sure that you have the best post-surgical recovery.

Margarita Gurevich is Senior Physiotherapist and uses Clinical Pilates, SCENAR Therapy & other evidence-based techniques, including Real Time Ultrasound and McKenzie Treatment. Margarita specialises in sports injuries, women’s health (including incontinence) and gastrointestinal issues. Margarita may be contacted via her website.