Almost everyone is aware that physical therapy is a common component of recovering from a surgical procedure, but it is not well known that physical therapy is also used to help prepare patients for surgery as well.
Working with a physical therapist to enhance strength and flexibility in muscles and joints is almost universally recommended by the medical community in postoperative settings. New research also reveals that physical therapy before surgery can reduce the amount of aftercare needed and improve outcomes.
What is physical therapy?
Most of us have a general understanding of physical therapy in that it is a set of exercises that help us regain function after surgery. We generally equate it with relieving pain symptoms, strengthening weak muscles, and improving joint mobility.
While these are true, achieving these results involves many detailed steps. There is an initial assessment of the patient’s current physical and mental state, followed by a more careful assessment of key physiological factors such as joint mobility and limb strength.
Once the patient has been evaluated, the physical therapist should speak with the patient and doctor to determine the desired outcome. Then a plan is developed that meets the specific needs of the patient.
Implementation of a treatment plan may involve a variety of therapeutic approaches, including
- heat
- ice
- building strength
- stretch
- Ultrasound
- mutual therapy
- electrical stimulation
- education
While some of these treatments must be performed in a clinical setting, others can be performed independently at home.
Most people are easily aware of the role of physical therapy after surgery in helping to restore strength and function, but it is less associated with other health conditions such as chronic pain, loss of limbs, acute care, and respiratory rehabilitation.
An often overlooked component of physical therapy is preventive care. While this may include exercises that build strength, flexibility and mobility, it also has a strong learning component that includes dialogue and personal education.
Physical therapy techniques
Physical therapists use a wide range of therapeutic approaches to achieve desired results, including
- Strength training – Physiotherapy is perhaps most closely related to these strength-building exercises that activate atrophic muscles. However, in recent years, there is a growing focus on improving muscle strength throughout the body to provide more functionality.
- Phototherapy – Applying red or infrared light to affected areas has been linked to increased production of DNA, ATP, and collagen, all components necessary for healing.
- Robotics one of the most advanced technologies to have entered physical therapy is robotics. With robotic treadmills and exoskeletons, physical therapists no longer need to manually move patients’ limbs. This technology can also detect subtle changes in a patient’s movement and adjust accordingly.
- Cupping – By decompressing the soft tissues just under the skin, physiotherapists can stimulate blood flow and promote healing. This is an ancient technology that has gained support among healthcare professionals in recent years.
- Ultrasound – This method has always been a staple of physical therapy. An emitter of high-frequency sound waves is placed in a problem area such as a healing fracture or plantar fasciitis. High-energy sound waves heat tissue, stimulating blood flow and speeding healing.
- Traction – Contrary to the common misconception of patients with elevated casts, traction is merely to relieve pressure on the spine to treat conditions such as sciatica, herniated discs, and compressed nerves. Over several sessions, traction can relieve pain, strengthen the spine, and promote healing without surgery.
How effective is physical therapy?
It is widely accepted in the medical community that physical therapy is an effective treatment for postoperative pain. Traditionally, postoperative pain is treated with pain relievers, most notably opioids. However, in recent years, more and more pain specialists are recommending a multimodal approach to pain management that includes physical therapy.
More and more doctors are recommending that physical therapy become a priority after a surgical procedure because it speeds recovery, reduces costs, and reduces the use of valuable medical resources.
It is also becoming clear that physiotherapy before surgery has benefits as well. In one meta-study of 451 patients with anterior cruciate ligament who had surgery, it was found that those who underwent physiotherapy before surgery had better outcomes overall. These benefits are derived from the following features of preoperative physical therapy
- Mental preparation for surgery
- Reduce swelling and pain
- Enhanced range of motion
- The strongest muscles around the affected joints
- Normal movement patterns before surgery
- More endurance
- Improve overall health and wellness
- A powerful introduction to exercises for use after surgery
Physical therapy is also recommended for many other pain conditions such as arthritis and lower back pain. In one study published in the New England Journal of Medicine, it was reported that arthroscopic debridement in addition to physical and medical treatments for patients with osteoarthritis of their knees was no more effective than physical and medical treatments alone.
This study and similar studies indicate that physical therapy is very effective in maintaining and restoring joint function. Physical therapy plays a major role in building strength, tissue flexibility, and range of motion.
How can physical therapy help you?
If you are planning to have surgery soon, you should discuss with your surgeon the types of physical therapy you should undergo before and after the procedure. You should expect to begin physical therapy about a month before the procedure, but the amount of rehabilitation you should complete after surgery will depend on the type of procedure and how quickly your body recovers.
Even if you’re not preparing or recovering from surgery, you can still benefit from physical therapy if you have certain health conditions such as arthritis, knee pain, or plantar fasciitis. If you have a chronic condition, you may get the most benefit from ongoing treatment, but in many cases, it may only be necessary to attend a few sessions with a physical therapist before implementing a physical therapy plan independently in your home.