Corbin Hedt, PT, DPT, SCS, CSCS, Houston Methodist
Modern surgical techniques have produced innumerable improvements to the quality of life for millions of individuals. Since the advent of the automated pneumatic tourniquet in the 1980’s to today’s robotic procedures in orthopedics and cardiac care, many have benefited from the medical advancements in surgery and the minimally-invasive procedures. The number of outpatient surgeries in the United States is expected to reach upwards of 144 million procedures in 2023 and continues to increase as the population ages. Thus, a significant need for post-operative care has evolved, especially as a means of mitigating the deleterious effects of surgical trauma, optimizing functional capacity and preventing the need for recurrent treatment or surgeries. In most cases, physical therapy is prescribed following even minor procedures to ensure a complete recovery.
Physical therapy is a dynamic field that specializes in improving the quality of life through prescribed exercise, hands-on care, and patient education. Each of these components are just as vital as the other in maximizing an individuals’ success following surgical procedures. Physical therapists (PT) are licensed professionals, commonly with a doctorate-level of education (DPT), and specifically trained in the evaluation and treatment of both non-operative and post-surgical conditions. Some PTs even undergo further training through residency or fellowship programs to specialize in more defined areas of practice such as sports, orthopedics, neurological care, pediatrics, and others. Generally, a PT is tasked with understanding the continuum of healing, following and injury or surgery, and must incorporate and apply meaningful treatment strategies to improve function relating to the goals set by the therapist and the patient during their initial evaluation or ongoing assessments.
“Exercise can be a difficult and scary endeavor to engage in, following any sort of injury or operation, but a skilled PT knows how to progressively guide individuals through safe activities with appropriate resistances.”
When receiving treatment from a PT, a myriad of potential treatment approaches can be employed based on the needs of the patient. Most individuals will likely receive some element of therapeutic exercise in an effort to improve strength, range of motion, flexibility, function, and ultimately reduce pain. Impairments in these areas are common barriers, following surgical procedures, and must be addressed carefully. Understandably, exercise can be a difficult and scary endeavor to engage in, following any sort of injury or operation, but a skilled PT knows how to progressively guide individuals through safe activities with appropriate resistances. Furthermore, manual therapy is a form of therapeutic intervention, utilizing a hands-on approach to restoring joint motion, muscle extensibility, or soft-tissue quality, with a very direct affect to the region of focus. Often times, after surgery, patients struggle with edema/swelling of the area, which can be very counterproductive to movement and muscle activity. By applying specific manual techniques, a PT can not only improve the amount and duration of swelling, but also help prevent the cyclical return of excessive fluid, reducing the time needed to get back to unencumbered movement. Additional treatment modalities are also available, such as: electrical stimulation to reduce pain or improve muscle activation; ultrasound to provide a localized tissue-heating response; taping, bracing, or orthotic fitting to reduce unwanted movement and instability. While not an all-encompassing list, it is important to note that patients have a lot of options when it comes to post-operative care. Generally, the selection of treatment approach will be based on the triad of best available peer-reviewed evidence, therapist expertise and clinical judgement, and patient values/goals.