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Physical Medicine and Rehabilitation

Surgery And Physiotherapy, by ReLiva’s Dr Swapnaja Joshi

Surgery And Physiotherapy, by ReLiva’s Dr Swapnaja Joshi


Hi, I’m dr. Sapna Joshi. I am a senior physiotherapist and Masters in Physiotherapy in Musculoskeletal condition, I practice at ReLiva Physiotherapy and today I’m here to discuss about post-operative Physiotherapy management so when it comes to surgery, Surgery and physical pain always go hand in hand. Most of the people think that physiotherapy is only required after major surgeries like a replacement of your knee or your hip or like bypass surgeries but even after smaller surgeries like appendix removal which is appendicectomy or uterus removal which is hysterectomy, physiotherapy is equally important. It starts right at the moment you are out from the OT. The physiotherapist focuses on reducing the pain improving the muscle strength. joint mobility, reducing the swelling. Physiotherapy treatment starts right in the hospital and for certain cases it is prolonged even after the patient is discharged. Yes! the scope of physiotherapy in Ortho surgeries is way larger. It involves long-term treatment of Physiotherapy for weeks or months. Let me tell you something that’s very surprising! Have you ever heard of Pre-operative Rehabilitation Yes, it does exist. Pre- op rehabilitation is nothing but teaching and training the exercises to the patients before surgery. It happens in planned surgery. Procedures where the patient is taught few exercises before hand. It helps the patient’s body to get well prepared for the surgery It even helps to reduce the stress or the surgery related anxiety It also helps to maintain and improve the muscle strength and joint mobility of the patient. It helps the readuce and prevent the post-operative complications by teaching the exercises in the earlier phase. It also helps physiotherapist to understand goals of the patients and their outcomes so that we can design their post-op physiotherapy program and customize it according to the patient’s need. Success of the surgery is complete with the physiotherapy rehabilitation. What is post-op rehabilitation and why it is important? There are many complications that can happen post-op like swelling, blood clots that may occur in lower limbs because of prolonged immobility. So exercise is given to these patients to prevent these complications It also helps to improve their breathing and lung capacity. It helps to strengthen the muscles, improve their flexibility. It also helps to restore and maintain the joint mobility. Post-operative rehabilitation program depends upon the healing stage of the patient, the type of surgery, and the goals of the patient. There are three phases. First phase is the early phase, which starts in the hospital where we focus on wound healing. Reduce pain, inflammation and swelling, improve breathing capacity of lungs, improve joint mobility and muscle flexibility and in-bed mobility is also taught. Next is “the Intermediate phase” It starts once the patient is discharged from the hospital. Here, Focus is on improving muscle strength and joint mobility, reducing the residual pain and care is taken so that the patient is again functionally independent at his home or work settings. This intermediate phase can be taken in clinic / OPD or home visit can be arranged for the patient. The last and final phase depends upon the goals of the patient. For example, a patient may have a goal of running / trekking / climbing stairs to the temple. Depending upon the requirements of the patient, this phase is customized. Here, higher level activities and complex activities are taught to the patient, depending upon their goals. It is important to understand that these programs vary from patient to patient they will differ with surgical procedures and the time duration also varies Now, that you have understood all the three phases, you must have come to know that symptomatic relief reduction of pain and swelling happens mostly in the early phase. For complete rehabilitation of the patient and achieve and maintain proper muscle strength and flexibility it is very important to continue with Phase two and three!

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