post operative physiotherapy

Different injuries respond to different treatments. Some injuries will require surgery immediately whereas some injuries may require surgery after all other treatments have been tried. If this is the case, physiotherapy can be very effective before and after treatment.

post-operative CONDITIONS

ULNAR NERVE DECOMPRESSION

INTRODUCTION
 Elbow region is opened to visualise the passage of ulnar nerve through a surgical procedure.

CAUSE
 Accident and trauma
 Arthritis
 Broken bones
 Diabetes
 Elbow dislocation
 Surgical complications

SYMPTOMS
 Weakness or tenderness in hand
 Tingling in the palm and last two fingers of hand.
 Can’t able to tolerate cold .
 Touch on the elbow joint will be painful..

POST OPERATIVE PHYSIOTHERAPY
 Strengthening exercises
 Elbow Range of motion exercises.
 Scar tissue mobilization.
 Splinting.

TOTAL KNEE REPLACEMENT

INTRODUCTION

Total knee replacement (TKR), the most common treatment, includes removing the knee's damaged bone and cartilage and replacing it with implants to restore the knee to its normal functionality and range of motion.

PATIENT EDUCATION IN REHABILITATION
- Achieve knee mobility both actively and passively.
- Strive for minimum discomfort and edema
- Obtain full weight bearing - Strive for independence in movement and everyday activities - Take pain medication
– Cryotherapy
- Ankle movement
Lower limb functional exercises - strengthening exercises for the knee and hip -bridging.

Aim for autonomous exercise in a communal context. Train your balance and proprioception. Include behavior-changing techniques to boost your overall physical activity-related objectives such as ambulation activity.

LIGAMENT RECONSTRUCTION

Surgery to restore or replace a damaged ligament is known as ligamentomy. Ligaments are resilient connective tissues that help to support and maintain joints. An injury or rupture to a ligament results in discomfort, decreased mobility, and joint instability.

Symptoms
 A loud pop or popping sensation in the knee;
 Excruciating pain that prevents movement;
 Rapid swelling;
 A loss of range of motion; and a sense of instability or giving way when bearing weight.

 Causes
 Cutting is when you suddenly slow down and change direction while pivoting with a foot firmly planted.
• Sudden stops;
• A direct impact to the knee; or
• A collision, such as a tackle in football

Physiotherapy
• Electrotherapy, soft tissue massage, and joint mobility techniques to relieve pain;
• Individually suggested exercises and procedures to loosen or strengthen the affected area. Exercises that improve range of motion, strength, and flexibility are therapeutic exercises.
• Re educating the neuromuscular system.
• Balance and proprioception exercises

AC JOINT / CLAVICLE EXCISION

INTRODUCTION
Surgical technique where in 5 mm of bone are removed in addition to clearing out deteriorated tissue in the joint next to the shoulder.

CAUSES:
Trauma and arthritic changes

SYMPTOMS:
Pain
Stiffness
Decreased range of motion
Swelling

MANAGEMENT:
Following surgery, the objectives include:
-improving strength
-improving function
Following are three categories into which the postoperative phase and its management can be divided:

1. 1-2 weeks following surgery
- Use of ice in treatment
- Activating the locals
- Physical activities that widen the range of motion
- Using devices to relieve pain
- Improving joint steadiness

2. Functional tasks are introduced into the treatment plan 4-6 weeks after surgery (task specific)
– Proprioceptive instruction

3. After six weeks of recovery from surgery, perform exercises to regain normal range of motion,
shoulder strengthening exercises, and sports-specific workouts.

CARDIAC SURGERY

Myocardial insufficiency is typically treated with cardiac surgery or coronary artery bypass grafting.

CAUSES:
-High grade blockages in any significant heart-supplying artery
-If percutaneous coronary intervention has not been successful

MANAGEMENT:
1. Physical treatment before surgery:
Incentive spirometer and ACBT
Early mobilisation exercises, endurance training, and respiratory muscle training
Relaxation training
2. Physical rehabilitation following surgery:
Phase 1:
Exercises to increase mobility, bed mobility, and sternal protection
Phase 2:
Cycle ergometers, stationary exercises, general mobility exercises, general gymnastics, and breathing
exercises with TriFlo for three weeks.
Phase 3:
Continuing the activities you learnt in prior phases and reducing your cardiovascular risk even further.

ROTATOR CUFF SURGERY (REPAIR & DEBRIDEMENT)

1. A brief description of the condition.
Rotator cuff muscles are the group of muscles present around shoulder. Which helps to stabilize and maintain position of upper limb and also helps shoulder to perform various activities. Damage or injury to this rotator cuff muscles leads to instability or impingement of shoulder. If it is repeated or in chronic stages. Needs surgical correction. physiotherapy plays important role after surgery. To restore shoulder functions.

2. Symptoms
 Pain
 Swelling
 Hypersensitivity around skin incisions
 Postoperative stiffness (Reduced shoulder movement)
 muscle weakness

3. Causes
 Repeated overhead movements
 Trauma
 Impingement syndrome

4. Physiotherapy Treatment
 Cryotherapy
 Taping
 Strengthening protocol
 Pain management
 Proprioceptive exercises
 Manual therapy
 Sport specific exercises (return to sporting activities)
 Home exercise program

THORACIC FRACTURE FIXATION

INTRODUCTION
Thoracic fracture fixation is a surgical procedure that restores spinal alignment and stabilizes the thoracic spine. Thoracic fractures can occur when the spine is subjected to forces that exceed its strength and stability. Common causes of thoracic spine fractures are traumatic injuries such as car accidents, falls from height, and sports injuries. Chest fractures may also occur because of weakening of the bones due to osteoporosis.

AIMS
The goals of breast fracture surgery are proper reduction (bone fusion), spinal and nerve relief, and early treatment with exercise and therapy. If the fracture is unstable, internal fixation is often needed, and metal screws, rods, or cages can be used to stabilize the spine.

ROLE OF PHYSIOTHERAPY
Essential after thoracic surgery to relieve and restore mobility. Please return to the original level as soon as possible.

TREATMENT
Ice and ultrasound to relieve pain and swelling.
- Advice on lying, sitting and standing postures to increase comfort and confidence while exercising. It also offers an ergonomic assessment to help you find your way at work and at home.
- Soft tissue massage to promote healing and pain relief
- Stretching exercises to improve neck flexibility and pain relief
- Stretching flexible tissues, range of motion, rotation and other active and passive
Spinal flexion and extension to improve range of motion exercises Strengthening isometric muscles Chest and abdominal muscles Running program Easy way.

Good exercise.
– A structured exercise program tailored to the activities you enjoy most, with short-term and long-term therapeutic goals

LUMBAR STABILISATION

Introduction
Lumbar stabilization is a surgical procedure done to limit movement of the spine due to extreme instability.

Physiotherapy management (Post operative)

Phase1 – (1-6 weeks)
- Begin with toe and ankle movements
- Mild isometric contractions of the abdominal, pelvic floor and back muscles
- Sitting with back support

Phase 2 – (6-10 weeks)
- Strengthening and reconditioning of abdominal and back muscles
- Do not lift more than 10kg or perform overhead activities
- Continue normal activities under the guidance of a physical therapist
- Walk for 30min every day
- Achieve good ADL
- Control pain and inflammation with ice
- Reduce soft tissue scar with scar mobilization
- Bed mobility
- Push and pull technique
- Lift and carry not more than 10kg weight

Phase 3 – ( 11-19 weeks )
- Return to work
- Exercise continuation
- Practice specific skills
- Begin resistance training program
- More intense stabilization
- Half, full front and back plank
- Be aware of overhead activities

Phase 4 (20weeks – 1 year )
- Injury recovery
- Regular aerobic exercise
- High resistance exercises

LABRAL REPAIR

Introduction

Labral repair surgery is a procedure used to reverse damage to the labrum, cartilage, in the shoulder.
 It requires about 6 – 8 weeks to heal to the bone
 During this time , less stress we put across the shoulder, more likely it is for the labrum to heal.

Clinical Features

 Pain in the hip or groin, often made worse by long periods of standing, sitting or walking or athletic activity.
 A locking, clicking or catching sensation in the hip joint.
 Stiffness or limited range of motion in the hip joint.

Physiotherapy Management

 1 to 2 weeks- Rest.
2 to 6 weeks
 Passive Assisted Movements and exercises to
Restore Range of motion.
 Promote normal walking pattern.
 Progressive Muscle strengthening using resistance.
 Activities to improve Balance reactions.

WHAT ARE THE BENEFITS OF POST OPERATIVE PHYSIOTHERAPY ?

Post-Operative Physiotherapy aims to help people to restore optimal mobility and overall functions in the body. It also helps in. 1) Building muscle strength, improving posture and balance of the body. 2) Reducing pain with various manual therapy that is crucial for strengthening weakened and disused muscles.

The primary goal of physiotherapy is to facilitate recovery from surgery by preventing or treating postoperative complications and providing physical rehabilitation to aid in returning to premorbid physical function.

Bethany Navajeevan Physiotherapy Clinic
& Rehabilitation Centre

'Learn to Heal' with Care & Compassion