Millions of Americans undergo surgery each year. Physical therapy is one of the best healthcare decisions you can make before and after surgery to ensure you heal properly. This blog will discuss tips to help you prepare for a surgical procedure as well as what to expect after the procedure.
When you undergo surgery, there is a disruption to the tissue layers within the body. The first layer is called the epidermis. It acts as a water barrier, and there are highly sensitive nerve endings that allow you to feel touch, pressure, and temperature. The second layer is the dermal layer which houses blood vessels, oil glands, and more nerves. The next layer is the hypodermis layer, and it contains fat cells to keep you warm. Fascia layers are tightly bound but flexible web-like substances that separate tissues from one another. For example, there is fascia that covers your nerves, muscles, and other structures. These layers are disrupted when you have surgery, and the body will initiate an immune response to heal the area. This immune response will cause white blood cells and tissues to migrate to the site. During this time, you will notice significant swelling.
During the acute phase, resting, icing, compressing, and elevating is key in creating an environment for the tissues to heal. These are essential steps; however, physical therapy can often be initiated during this time, depending on the type of surgery performed. Physical therapy can help manage swelling and initiate a gentle range of motion to pump the excess fluid out of the joint/surgical site and back to the heart. Sometimes the passive range of motion is inappropriate because the injury site needs more time to rest before movement is initiated. Be sure to speak with your surgeon before surgery and adhere to the surgeon’s protocol. Some surgeries like a total knee replacement will require physical therapy the next day after surgery.
After a week or two of the acute phase, physical therapy is usually needed to help manage swelling, perform passive range of motion techniques to improve joint mobility, and ensure surrounding tissues do not adapt by shortening. Passive range of motion means that you are not activating your muscles and tendons to assist with movement; your therapist will perform all the motions for you. Gentle passive range of motion helps to decrease scar tissue formation at the surgical site. Scar tissue is very fibrous and tough and is important to help glue the tissues together. However, if it is not stressed appropriately with movement, it will cause joint restrictions to form. These restrictions become a source of pain in the future.
In this phase, the patient will start to move the affected area with the help of a therapist to stress the ligaments, tendons, and muscles. These structures need to be stressed appropriately to continue to prevent adhesion and joint contractures. Some people avoid movement during this phase and subsequently suffer from chronic pain, swelling, and could become a surgical candidate to remove the scar tissue formation later.
When you decide to move the affected structure, your brain sends a message to the area. Your pain should be minimal as the pain experienced will cause the muscle not to turn on and activate well. It is now time to focus on gaining the strength to do the activities you want to do like standing, walking, squatting, and eventually jumping if that’s your goal.
If you have questions about physical therapy before your upcoming surgery, schedule a Free Assessment with one of our experts. Free Assessments are available in-clinic and virtually through our Telehealth platform.
The Athletico blog is an educational resource written by Athletico employees. Athletico bloggers are licensed professionals who abide by the code of ethics outlined by their respective professional associations. The content published in blog posts represents the opinion of the individual author based on their expertise and experience. The content provided in this blog is for informational purposes only, does not constitute medical advice and should not be relied on for making personal health decisions.
1. Yousef H, Alhajj M, Sharma S. Anatomy, Skin (Integument), Epidermis. National Institute of Health, 2020, https://www.ncbi.nlm.nih.gov/books/NBK470464/. Accessed 13, November 2021.