Osteoarthritis, also known as degenerative joint disease, affects close to 21 million people in the United States. Osteoarthritis in the knee or hip is the most common cause of arthritis-related disability. As baby boomers age, orthopedic surgeons are performing more and more total joint replacement surgeries, including total knee replacements and hip replacement surgeries.
Physical therapists are trained to identify limitations of the body, and are knowledgeable about surgical procedures and treatment goals for a post-surgical patient. Most importantly, physical therapists can tailor their efforts to improve the overall well-being of a patient with a new knee or hip and ensure long-term success.
Post-surgical rehabilitation from a physical therapist offers the following long-term benefits:
- Restore normal movement to the joint
- Build up strength in the joint and surrounding muscles
- Ease pain and swelling
- Guide an individual back to normal activities
- Help with circulation, particularly right after surgery, so the patient does not have problems with blood clots
To achieve these long-term goals, physical therapists focus on the following five areas of concentration.
Stretches for Muscles and Joints. Stretching is vital in maintaining good range of motion for joints and flexibility of muscles. If the individual has stiff joints or tight muscles, normal activities, such as climbing stairs or reaching overhead, can be severely affected. With proper stretching, these functions can be preserved. After an injury or surgery, scar tissue forms and soft tissue contracts, so stretching is especially important.
Exercises to Strengthen the Body. Strengthening exercises help the patient improve the function of the muscles surrounding the replacement. The goal is to improve strength and increase the range of motion of the replaced joint over time. Recently, physical therapists have placed more emphasis on core strengthening, because the body’s core is its foundation. Strengthening muscles in the back and pelvis increases stability and improves balance, which goes hand-in-hand with a successful recovery from knee or hip replacement.
Ice and Heat Application. Ice and heat are useful in warming up and cooling off muscles. In addition, these methods can stimulate blood flow and decrease swelling, important parts of the healing process. The key to proper treatment is knowing when to ice and heat an injury.
Ultrasound. Ultrasound uses high frequency sound waves to stimulate the deep tissues within the body, which leads to warming and increased blood flow to these tissues.
Electrical Stimulation. Electrical stimulation is a therapy that passes an electrical current to an affected area. Nerve conduction within the region is altered, which can in turn alter muscle contractility. Blood flow to these tissues is also increased with electrical stimulation. Patients often experience less pain after electrical stimulation.
Depending on the surgery and the individual, specific treatments will be used. For instance, individuals who undergo knee replacement surgery may need to wear support stockings, apply cold packs, and elevate the leg for up to 3 months after surgery to relieve swelling. They would engage in range-of-motion exercises specific to the knee, strengthening exercises for the legs, and balance training. For an individual undergoing hip replacement surgery, they may have to do ankle pumps and exercises to contract and release muscles in the legs and buttocks. A physical therapist will work with a hip surgery patient, alongside an occupational therapist and discharge planner, to ensure a successful post-surgical recovery.
Physical therapists are dedicated to helping their patients gain back function, so that the patient can start enjoying life pain free again. If you or a loved one has a surgery scheduled, ask your doctor about your post-surgical care plan. NurseRegistry can accompany post-surgical care from a physical therapist by providing wound care, medication management, pain management, and more. Call us at (650) 462-1001 to learn more about how we can help you with your post-surgical recovery.
Cluett, J., “How Physical Therapy Can Help Your Recovery,” Verywell.com, July 30, 2016
Hoobchaak, Liz, “Physical Therapy after a Hip Replacement,” Athletico Physical Therapy, January 16, 2013.
“Importance of Exercise for Patients Facing Arthritis and Total Knee Replacement,” Plancher Orthopedics and Sports Medicine, 2017.
“Physical Therapist’s Guide to Total Knee Replacement,” Move Forward, 2017
“Recovering from Hip Replacement Surgery,” UCSF Medical Center, 2017.