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Preoperative Physical Therapy

Josh Krueger • August 31, 2021


Preoperative physical therapy visits have evidence to suggest improved functional outcomes after surgery and improved patient satisfaction.

 

These physical therapy visits may include:  

  • Assistance with pain relief and decreasing inflammation
  • Increasing range of motion and strength
  • Safe transfer techniques in the home and community
  • Instruction in use of walker, cane, crutches, brace, sling, etc.
  • How to bathe, sleep, care for proper healing
  • Fall prevention
  • Expectation during hospitalization and education regarding factors influencing discharge 
  • Ease anxiety about the unknown and help to understand the process.

 

Often not only does the affected leg or arm weaken due to pain and swelling but also our core and our motor control/coordination diminishes so it is of true benefit to get your core and motor control working at its best prior to surgery.

 

Our therapists can also assist you in getting set up with a personal trainer in the gym or even BASE camp (see Collins Aerospace Rec Center for details) would be an excellent option as the instructors will modify your workout around your personal limitations. In this way you are able to continue to get your body in its best shape and ready for a successful surgery.

 

A few examples of patients that have come in for PT preoperatively include:

 

  1. ACL Reconstruction


  • Address swelling, lack of motion and strength
  • Instruct in use of crutches and brace
  • Educate on elevation, icing, and compression stockings to control swelling
  • Transfers, walking, stairs and safety
  • Fall prevention
  • Answer questions regarding surgery or after care and return to school/work
  • Issue contact information if questions arise


Oftentimes after an ACL tear a significant amount of swelling ensues and this will often prevent full motion in the knee. Therapy before surgery to help reduce swelling and regain motion helps to prevent scar tissue formation within the knee. The swelling also creates muscle “shut down” and atrophy. Starting strengthening in an appropriate manner before surgery will also help improve the recovery.


    2.   Rotator Cuff Repair


  • Address pain, lack of motion and assist with passive motion
  • Instruct in use of sling and how to get it on/off safely
  • Educate on icing
  • Answer questions regarding after care including how to change dressing, bathe/shower, and sleep.


Whether a rotator cuff tear is chronic or acute, motion typically is a problem prior to surgery and scarring may develop. Improving this motion prior to surgery helps to prevent any issues after surgery. Raising your arm prior to a rotator cuff repair surgery is often very difficult and painful and not only will working on the motion help but improving the activation of the surrounding musculature that stabilizes the shoulder will also help. Many patients fall into the habit of hiking their shoulder when raising their arm which lends to further problems and oftentimes can cause neck pain and headaches.

 

 

    3.    Knee Replacement


  • Address pain, lack of motion and strength
  • Instruct in use of walker or crutches
  • Educate on elevation, ice pack, compression stockings or wrap to control swelling
  • Educate on wound care and dressing
  • Transfers, walking, stairs and safety
  • Fall prevention
  • Answer questions regarding surgery or after care
  • Issue contact information if questions arise

 

The typical patient that is ready to have a knee replacement has lost the ability to straighten their knee. This not only makes it harder to attain after surgery but also causes problems up the chain and into the low back because of how the gait is changed. Not only is the patient unable to straighten their knee when walking but because of this their glute (buttocks) muscle is unable to activate like it should, lending to even further problems. Proper exercises to assist with knee straightening and glute strengthening will help improve recovery.


If you have a future surgery planned it may be of benefit to schedule a PT appointment and discuss your concerns and goals and see if therapy visits would benefit you and help you achieve your wanted outcome with ease. Call the Rec Center Physical Therapy clinic at 319-295-8899, to schedule your preoperative physical therapy appointment today.


Ashlee Fandel, MPT, MTC, has been practicing for over 20 years in outpatient physical therapy. She received her Manual Therapy Certification in 2006 improving her skills in joint manipulation and soft tissue mobilization. Although she believes the “hands on approach” is highly beneficial, it is the education of how the body works and how to treat it appropriately that carries through for life long health. Our joints and muscles work effectively when they have good range of motion and strength to coordinate well together. This is the specialty of an outpatient physical therapist; to determine the weaknesses and imbalances from an orthopedic standpoint. It cannot be ignored however that having a total body that works with good nutrition, sleep, appropriate physical activity and stress management allows for a good working environment. This well rounded, whole body approach is how Ashlee prefers to address each patient.


Ashlee enjoys weight lifting, running, sports activities, and walking her dog Sulli. All these are even better with family and friends. 

Ashlee feels that being a physical therapist has blessed her with the ability to meet many different people and come to understand them on a deeper level as they heal. She feels fortunate to have an occupation that allows her to have an impact on an individual’s life. New Paragraph

A Physical Therapy Holiday Survival Guide

08 Dec, 2022
Keeping up with physical therapy during the holidays is tough. There are so many other things to do - cooking, parties, shopping, travel, and visiting with family and friends. But if you're in physical therapy over the holidays, there's a reason. You're having pain, or not moving as well as you want to. These issues place limitations on your life, which are going to affect your ability to do things - like cooking, partying, shopping, traveling, or enjoying time with friends and family. So even though keeping up with your PT this time of year is tough, it's important. That's why we're going to give you our best tips to help you through the holidays. Plan Some of what makes the holidays challenging is the crazy schedule. To survive this, you're going to have to plan ahead. We're not just talking about appointments on your calendar, either (although those are important). Here are some things to think about planning ahead: Your PT appointments Your schedule is busy during the holidays. So is your PT's. Plan and schedule your appointments in advance. You'll get the times and days that work best for you, and you'll already have your PT appointments in your calendar to plan other things around. Your exercise Hopefully you have a regular time to exercise. With the holiday mania about to shake up your routine, that time may no longer work. Think about when you're going to exercise ahead of time and you'll stay consistent. Your diet Healthy eating often gets derailed during the holidays. Putting low quality fuel into your body won't help you feel better. Think about planning what you're going to eat ahead of time. We're not saying to skip every holiday treat offered to you, but maybe think about which ones you really need to have, and which ones you can skip in advance. It makes saying "no thanks" to that third slice of fruitcake easier. Modify We're realistic. We understand that life isn't the same during the holidays as it is during the rest of the year. That's part of what makes this time of year special! With that in mind, our next set of tips focuses on making modifications to help you get through the holidays successfully. Your PT Plan When you planned your PT appointments out well in advance, you might have run into some challenges. Talk to your therapist about how you might be able to modify your plan of care through the holidays to make it all work. Maybe you're going to PT three times a week and you can only come twice a week for a week or two. Plan this sort of thing in advance with your PT and you can work together to come up with the best plan. Your exercise Exercise is so important, it made our list twice. Now that you know when you'll exercise, you might have to modify your routine to make it fit. Again, we recommend talking with your PT to see what you can do. Maybe your home exercise program can be modified so you can do everything in the kitchen during downtime when you're cooking up your holiday feast. Maybe you can reduce the number of exercises to focus on maintaining the gains you've made until things settle down. Your schedule In your planning in advance (see how important it is?) you might have found that your normal routine wasn't going to work. If your PT appointments or exercise time is usually right after work and you've now got commitments during that time, maybe you can move them to the morning before work. If you've been exercising outside, the shortened days may move you into the gym. Be flexible and consider temporarily modifying your schedule and your routine to make it work better during the holiday season. You can always go back to your previous routine after. The holidays are a special time of year. Keeping up with your health and your physical therapy can be challenging during this time. But you don't have to fall behind. With some planning and flexibility, you can stay healthy, survive the holidays and head into next year with good momentum!

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