While most surgical procedures are becoming less invasive, more advanced in technological precision and increasingly common, it is still a major event for any person. Apart from the surgery itself, how you prepare before and after an operation has a direct impact on the outcome of your recovery.

We understand that having an operation is a significant decision; and therefore our goal as health professionals is to make sure you are always informed, prepared and taken care of every step of the way. 

Before your surgery (Pre-operative phase) 

Pre-operative physiotherapy – commonly referred to as “Prehab” – lays the foundation of the entire recovery process and can help prevent complications that may arise without proper monitoring and care. Your prehab often includes: 

• An overview of the surgical procedure itself 

• A broad idea on common recovery timelines* for your particular surgery 

• Mental preparation for what will happen after your surgery 

• Discharge advice, such as any necessary equipment you may require at home after the surgery 

• An exercise program to follow prior to your surgery, in order to maintain as much strength and range of movement as possible  

*Post-operative recovery timelines vary amongst individuals based on their biopsychosocial factors, and is often provided as a general guideline only. 

Common types of surgery that often require physiotherapy

Physiotherapy is commonly needed for most orthopaedic surgeries, such as:

• Arthroscopies: considered a minimally-invasive method and sometimes referred to as “key-hole surgery”. This is a very common technique for most body joint conditions, including the shoulder, wrist, hand, hip, knee, ankle and foot. 

• Tendon & ligament reconstructions: such as ACL reconstruction, rotator cuff repair, Achilles and other tendon repairs.

• Joint replacement: including shoulder, ankle, knee and hip replacements. 

• Bone surgery: including fixation and stabilisation of fractures, bunionectomy, osteotomies and realignments.

In addition to orthopaedic surgeries, a physiotherapist can also assist in the rehabilitation from other types of operations, such as spinal surgery (discectomy, laminectomy, spinal fusions), and other procedures like hernia repairs.

After your surgery (Post-operative rehabilitation) 

Acute recovery phase 

The first stage of your post-op rehab begins once you are discharged from surgery and it continues until your wound has healed and the swelling has resolved. This is because the key priorities in this phase is to allow maximal time for wound recovery and keeping any risk of infection to the minimum.

Whilst you are recovering from orthopaedic surgery, we focus heavily on: 

• Pain relief as much as possible 

• Reducing swelling as much as possible 

• Wound care and hygiene

• Providing advice on modifying your day-to-day tasks e.g. alternatives to having a shower (to prevent the wound from getting wet), how to get in and out of bed etc.

• Gentle manual therapy and exercises to restore joint range of movement 

• Basic exercises to begin to regain muscle strength without disrupting healing, stitches and sutures.  

Strength and range of motion phase 

After the first few weeks of your surgery and the initial wound recovery, your program will focus on restoring range of motion, muscle strengthening and improving your general functional ability. Your post-op rehabilitation program at this stage will likely include: 

• Strength and conditioning exercises designed to stress and stimulate your muscle tissues appropriately

• Endurance exercises to maintain or improve cardiovascular fitness 

• Soft tissue treatment and mobilisation techniques to address scar tissue formation 

• Manual therapy to facilitate joint range of motion

• Introduction of some elements of core strength and balance retraining 

In this particular phase of your rehabilitation, we often remind people that some degree of pain and discomfort during the exercises are to be expected. However, you will always be given clear guidance on when to progress further with your exercises and when you need to stop. Generally speaking, our objective at this stage is to restore and improve your overall CAPACITY – strength, flexibility, endurance, body awareness. You will be given clear targets for each of those attributes to reach, so that your body is ready for the next phase of your rehabilitation. 

Functional training & return to activity phase 

So you’ve done the work so far - you’ve put up with weeks of repetitive exercises and stretches, and now you have reached our recommended level of exercise capacity. This is where the fun (or the toughest part of your rehab) really begins! 

By now, you should be able to: 

• Comfortably manage most basic movements involving the body part 

• Confidently perform most gym-based strength exercises in a controlled manner 

• Demonstrate reasonable symmetry or evenness on both sides of the body, in terms of strength, range of movement and flexibility  

• Begin to regain some of your overall core strength and balance 

Your exercise plan will now focus on the specific tasks involved in your daily lifestyle/training routine, and the body movements required: 

• Strength & conditioning exercises that involve multiple body parts 

• Practicing body movements that are directly relevant to your training discipline/sport 

• Sport-specific exercises that target flexibility and cardiovascular fitness 

• Advanced balance and body awareness exercises 

• Ongoing discussion and evaluation with your physiotherapist regarding your readiness to return to sport/work 

As an example of what a typical physiotherapy session may look like in this phase, a tennis player who had undergone ankle surgery would likely be asked to perform running drills in different directions on the court, serving and gradually increasing the amount of serves per training session, balance drills that are designed to distract and challenge their core stability, and so on. This phase is a very dynamic, collaborative effort between you and your physiotherapist, and good communication between you and your therapist is key to ensure you are making as much progress as possible. 

What can I expect at Sterling Physiotherapy? 

Sterling Physiotherapy has extensive experience in working with patients throughout their pre and post operative phases and can provide you with the knowledge and guidance throughout your rehabilitation.

We work closely with your surgeon throughout the entire process. Each individual surgeon may differ slightly in their recovery protocols in the early stages of your recovery, and we will always consult with your surgeon about their instructions prior to your post-op sessions.

Throughout your rehabilitation, we are constantly re-assessing and checking in with you to make sure you are given the right amount of exercises at the right time and giving you the support you need at all times. 

With your consent, we will also provide your surgeon with updates on your progress. This ensures all clinicians are up-to-date with your recovery milestones and you receive advice that is consistent, no matter who you have an appointment with. 

If you are looking for a physiotherapist to help you with your post-surgery rehabilitation or if you already have an operation scheduled, get in touch with our team today or use the contact form below and let us help you with planning your recovery. 

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