Rehab After Surgery

Approach

Unfortunately, financial pressures felt by the NHS, as well as independent physiotherapy providers working under insurance company restrictions, is resulting in patients being afforded less and less physiotherapy time including after surgery.  It is now becoming normal that patients are ‘treated’ over a phone or video link and being given basic, generic exercises to do with little or no face to face follow up through their recovery journey.

At the Good Physio, our approach is altogether different from the outset.  We believe that your surgery outcome is only as good as the post-op rehabilitation involving really comprehensive physiotherapy.   Patients are telling us that they want more time face to face with an expert physiotherapist in this area to feel reassured as well as guided, in person, through tailor made exercise programmes rather than being given standardised ones to work through on your own.  We help people recover optimally from, amongst other things, spinal surgery, hip and knee replacements as well after knee and ankle ligament repairs.  As well as thorough rehabilitation through strength and conditioning exercise, good physiotherapy should also aim to optimise tissue quality with ‘hands on’ manipulative therapy.  This is often vital to facilitate good quality movement patterns rather than ‘comfortable compensations’ that may end up affecting neighbouring joints in the future. Then, once you’re moving ‘well’, we generally encourage you to move lots. Pacing is important here and so is understanding pain accurately.  Pain education is vital for patients to feel confident to ‘challenge’ discomfort that is often associated with stiffness rather than avoidance of movement fearing that it might be doing harm.

Pre-Surgery Rehabilitation

Lots of patients tell us that they would actually prefer to avoid the surgery they have been offered and, in a lot of cases, surgery is often not the best solution for them.  We believe that with many patients surgery should be a last resort rather than the first treatment option offered. It is amazing how many patients are not even recommended physiotherapy as an option and are encouraged to have surgery straight away; there are many reasons for a patient feeling pain and just being shown a scan or x-ray of a joint that is described as having ‘wear and tear’ is not a good indication for surgery without having firstly completed a comprehensive programme of physiotherapy.  It is really important to remember that mild or even moderate arthritis is seen in people without pain and so having some changes in your joints by the time you are in your middle and later years is normal. Many of our patients find that once they commit to really good rehabilitation programmes they do not require the surgery after all.  There are also a proportion of patients who try this ‘non-invasive first’ approach who do end up needing surgery but they are usually happy that this has been put off for a while and that during this time they are less reliant on pain medication and more able to enjoy optimal quality of life including activity and sports.  Clearly, where there is a sudden onset to patients pain involving trauma or injury, and this has caused tissue changes that require repair, avoiding surgery is not an option. We will always refer patients for skilled orthopaedic opinion where it is needed and we work with many of Exeter’s top consultants.