Due to have orthopaedic surgery?

Having physiotherapy before your procedure can improve your recovery and overall outcomes.

Annie Head Senior Physiotherapist

Annie Head
Senior Physiotherapist

We asked our Senior Physiotherapist, Annie Head to put together some commonly asked questions about pre-operative physiotherapy, and some ‘Top Tips’ for those preparing for orthopaedic surgery.

Annie has a wealth of experience preparing patients for orthopaedic surgery (what we call pre-operative physiotherapy), including total hip, knee and shoulder replacements, shoulder surgery including subacromial decompressions, rotator cuff repairs, and back surgery. She is confident in providing advice, reassurance and treatment pre-operatively, and from day one following surgery, right through to discharge.

How can pre-operative Physiotherapy help me?

Studies have shown that there can be improvements in function and strength, as well as reduced pain and length of stay in hospital, if a patient is physically and mentally prepared for their orthopaedic surgery. Seeing a physiotherapist before your operation can help you to prepare by providing you with specific exercises to help strengthen the muscles, tendons and ligaments that need to be strong for your successful rehabilitation. It will also help when you come to exercise after your operation as the muscles will ‘remember’ what they need to do.

Talking through what to expect after your surgery with a physiotherapist experienced in post-operative rehabilitation, will help to prepare you mentally for the procedure, aftercare and recovery.

What types of problems can benefit from pre-operative Physiotherapy?

Physiotherapy can be beneficial before lots of different types of orthopaedic surgery. It may be that you have injured the ligaments and cartilage in your knee, or the tendons in your shoulder which could need repairing. Very commonly we see joint replacement surgery due to osteoarthritis (knee, hip or shoulder). Any surgery affecting the body’s joints and soft tissues (muscle, tendon, ligament) will benefit from pre-operative physiotherapy.

Surely if I need surgery, Physiotherapy before my operation is unlikely to help me?

Physiotherapy won’t change the fact that you have damage to the soft tissues or arthritis in the joint, but having strong muscles and as much range of movement as possible is really important for your successful recovery. Improving the strength of the muscles around the joint can also help with reducing pain.

What would pre-operative Physiotherapy involve?

You would attend an initial assessment with your physiotherapist where a thorough history would be taken, as well as talking through any problems you are experiencing now and what your goals might be for after your surgery. For some it may be getting back to their favourite sport, for others it may just be as simple as being able to go for a walk without pain.

Your physiotherapist would then do a physical assessment looking at how you move currently and assess the affected joint and muscles for stiffness and muscle weakness. They would then be able to provide you with specific exercises that they feel will help you leading up to your surgery, and answer any questions or concerns to help you mentally prepare for what’s ahead.

Depending on how far away your surgery is, you may only want to attend once, or if you have a while to wait you may benefit from coming every few weeks to monitor how things are going and if any of your exercises need changing. In some cases, your physiotherapist may also suggest some ‘hands-on’ treatment or modalities such as acupuncture, to help if you are in a lot of pain.

How long before surgery should I have pre-operative Physiotherapy?

There isn’t a set timeframe for starting physiotherapy before your operation. Even seeing someone a couple of weeks before your surgery can help to alleviate any fears about what to expect, understand the time frames for recovery, and practice the exercises that you will likely be given immediately after your surgery. Of course, if you see a physiotherapist a few months prior to your procedure, you’ll have more time to improve your strength, but it isn’t essential and even a little physiotherapy beforehand can help with your overall outcome.

Will pre-operative Physiotherapy make my symptoms worse?

Your physiotherapist will not ask you to do things that will make you feel worse, as the aim of coming to see them is to give you more confidence and help prepare you for your upcoming surgery. Seeing a physiotherapist in person means that they can tailor the exercises to your needs; so if an exercise doesn’t work for you because it causes more pain, they can look at alternatives.

Annie’s Top Tips ahead of orthopaedic surgery

Do as much as you can to prepare your muscles for surgery beforehand. Strengthening and mobilising exercises will help to give you the best possible outcome. The right exercises can be provided by a physiotherapist, and will be specifically for you.

Do as much as you can to mentally prepare ahead of your surgery. Ask as many questions of your Physiotherapist and Consultant or Surgeon as you need to, so that you know how you will feel after your surgery and what your rehabilitation will involve. This will help you make temporary adaptations to your lifestyle and prepare mentally for what is ahead.

Be realistic about how long it may take to get to where you want to be. The first phase of tissue healing takes 6-8 weeks. This is when your pain and swelling will be at its worse. Your body needs time to recover so you need to listen to it and recognise when you may have overdone things. Full recovery takes at least 12 weeks and many people say it can take up to 6 months to get back to full function. A Physiotherapist can support you throughout this journey.

Annie Head qualified with a BSc (Hons) degree in Physiotherapy in 2000 and has over 20 years of clinical experience. She has spent 14 years in a busy private hospital in Sussex, treating both outpatients and inpatients, with a range of acute and chronic musculoskeletal conditions, as well as orthopaedic pre and post-operative rehabilitation. She is a member of the Health Care Professions Council and The Chartered Society of Physiotherapy.

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