Physical / Occupational therapy plays an important role in helping patients return to everyday activities following joint surgery to replace hips, knees, shoulders, fingers or ankles. Making a full recovery takes a considerable amount of time and significant effort on the part of the patient, but is often possible with the help of a physical therapist.
Therapy following joint replacement surgery usually begins with a thorough assessment of your condition and the development of a treatment plan. During a quick screening, the physical therapist will check your heart rate, blood pressure, breathing, skin integrity, and range of motion and functional strength of other areas of the body. An evaluation of your overall ability to move may be done and you may be asked to complete a questionnaire to describe problems you could encounter with day-to-day activities, such as getting dressed. Finally, the therapist will make a recommendation of how many visits and for how long you will need physical therapy.
Your physical therapist will recommend certain exercises as part of your rehabilitation program. Exercise can help improve flexibility, decrease swelling, increase strength, enhance endurance, improve balance and coordination, and lessen difficulties in performing daily activities. The type and intensity of exercises you do will take into account the surgery that was performed, type of replacement joint and condition of the joint before surgery.
If you had a shoulder replacement, for example, your occupational therapy program would typically begin with isometric strengthening exercises. This would focus on muscles that lift and push the arm forward and backward, raise the arm, and turn the shoulder. As your therapy progresses, elastic bands would be introduced to further strengthen shoulder muscles. Approximately 12 weeks after surgery light weights can be used, beginning with one-pound weights and gradually progressing up to five-pound weights. Aquatic exercises also may be included in your physical therapy program.
As you go through therapy it is important not to overdo the exercises. If you notice any swelling, you may be doing too much, too fast. A small amount of muscle discomfort during therapy is to be expected, but if you experience pain, you may be irritating or straining the joint too much. Check with your therapist if you experience any problems with your exercises.
Physical therapy may feel uncomfortable at first, but exercises will help speed your recovery and reduce pain after surgery. If you had a total hip replacement, you will be asked to begin walking to increase circulation in your legs and feet, and to prevent blood clots. It may take months to make a full recovery. During that time your physical therapist will work with you to build endurance so your muscles will work effectively for longer periods of time. You also may be asked to start weight-bearing and postural exercises, as well as balance and coordination exercises.
Your physical therapist will recommend more advanced exercises as your condition continues to improve. During follow-up visits your therapist can make sure you are performing the exercises routinely and safely. Eventually you will be released to full activity, but keep in touch with your therapist to ensure that you achieve your optimal range of motion and make a complete recovery.