Our aim at St Kilda Physiotherapy is to restore pain free movement, function and strength when at home, work and playing sport.
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Post Surgical Rehabilitation

Post – Surgical Rehabilitation

Surgery repairs tears in tendons and ligaments, replaces ruptured ligaments and stabilises broken bones. High velocity impact sports and falls can produce enough force to cause such injuries. This article will discuss common surgeries and why you may have physiotherapy afterwards.

Reconstructive surgery of the knee, ankle and shoulder joints involve replacing completely torn or very weak ligaments with tendon harvested from nearby. It may also involve tightening stretched ligaments that are still intact. Healthy ligaments stabilise a joint so repeated dislocations (joint pops out) or instability (very loose joint) may require this type of surgery following injury.

Anterior Cruciate Ligament (ACL) reconstruction involves using either the hamstring or patellar tendon to replace the ruptured ACL. .A crack or a pop in the knee is often felt and heard at the time of injury. Physiotherapy is important to regain strength, balance and flexibility of the knee .A knee brace and crutches are often needed initially with some period of weight bearing restriction. Patients can usually start bike riding 6 weeks following surgery and start running at the 3-4 month mark when the ACL graft is strong enough. It may take 9-12 months before returning to your chosen sport.

Lateral Ligament reconstruction of the ankle may involve tightening of stretched ligaments if they are intact. Otherwise tendon is harvested if lateral ligaments are ruptured. Similarly rehab involves regaining strength, flexibility and balance of the ankle and leg. If ankle taping or an ankle brace can stabilise the ankle joint for sport, surgery may not be necessary.

Shoulder reconstruction involves repairing torn or stretched ligaments and usually repairing part of the shoulder socket (labrum) as well. This is done to stabilise the shoulder joint and prevent dislocations. A sling may need to be worn for 4-6 weeks following surgery but the shoulder needs to be mobilised (stretched) and strengthened during that period and afterwards to enable a good recovery.

Menisci (cartilage) knee injuries often occur as a twisting injury of the knee. The medial (inner) menisci and lateral (outer) menisci are shock absorbers that protect the knee. They also help stabilise the knee. A small tear will heal with physiotherapy treatment. A larger tear may need surgery for repair. Return to sport is the goal and it is important to build up strong knee muscles, full range of knee movement and balance.

Tendons can be torn during heavy lifting (shoulder rotator cuff tendons) or in running and jumping sports (Achilles tendon rupture). Surgery involves stitching the ends together to enable continuity of the tendon. Tendons are very strong so it takes a lot of force and repeated trauma before there is a rupture.

In the shoulder, rotator cuff tendon tears are common and in young people these tears if severe enough are surgically repaired to give a good result. The supraspinatus tendon is the most common   of the four tendons injured that make up the rotator cuff. The shoulder is immobilised in a sling following surgery, but physiotherapy is started straight away to prevent shoulder joint stiffness and to strengthen the shoulder.

Achilles tendon ruptures are usually surgically repaired and the leg is placed in a boot initially. Physiotherapy rehabilitation is lengthy and involves regaining foot and ankle movement and gradually strengthening the lower leg/calf to prepare for a return to sports. At approximately 6 weeks following surgery the scar surrounding the Achilles tendon repair will be stable and soft tissue stretching and massage will speed up ankle movement. Light calf strengthening also begins at this stage and the patient can walk without heel lifts soon after. Light jogging begins at around 4 months post surgery.

Falls or sporting accidents can result in fractures (broken bones) commonly of the ankle, foot and knee requiring surgery to stabilise the fractures. Pins and plates may be needed to do this and patients often present on crutches with a boot on. Weight bearing on the leg may not be possible for a number of weeks depending on the fracture. Regaining full leg strength, movement and balance is the aim.

Lower back surgeries are still common. Lifting a heavy object incorrectly is the usual cause. Lumbar spine disc damage with nerve irritation can cause leg and back pain, leg weakness and numbness and tingling. Lumbar discs may be removed (discectomy) or removal of spinal bone (laminectomy). This takes pressure off nerves. If there is degenerative disc disease a section of the lower back may be fused (back fusion). Physiotherapy is important following back surgery to regain full strength and movement of the spine.

No one wants to have surgery but physiotherapy rehabilitation will help you get back on track- quickly and safely.

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