Healthy Focus October 2022

Physical Therapy: Get Back to What Matters Most

Physical therapy (PT) is an effective, non-invasive way to reduce pain, improve mobility, and increase your range of motion following a hospital stay. Physical therapy can also prepare you to withstand the rigors of surgery and set you up for a successful recovery afterward.

Prehabilitation Goals

  • Improve fitness level
  • Build muscle strength
  • Reduce pain, stiffness, and disability
  • Learn how to use a post-surgery assistive device

Rehabilitation Goals

  • Help regain range of motion
  • Rebuild strength
  • Help incision heal
  • Learn how to move safely
  • Retrain for specific activities

What does a physical therapist do?

  • Manual therapy, such as massage and manipulation
  • Hot/cold therapies
  • Education and training for injury prevention
  • Training in how to use an assistive device
  • Ultrasound
  • Electrical stimulation
  • Therapeutic exercise
  • Biofeedback

When to See a Doctor
Ask your primary care doctor or surgeon if your hospital center offers prehab as part of a free pre-surgery education program.

Physical Therapy Steps

Before surgery (prehab)

A pre-surgery physical therapy program begins about six weeks before your surgery date and may include some combination of land and water-based strength and aerobic training to increase your fitness level, reduce pain, and improve your overall health. According to the Arthritis Foundation, individuals who are more fit before surgery may have shorter hospital stays and may go directly into an outpatient rehabilitation program—skipping inpatient rehab all together. And, they may need significantly less medical care following surgery.

Undergoing prehab may even delay surgery, or prevent it all together, by improving the strength and flexibility of the muscles around your ailing joint, says the American Physical Therapy Association.

Even if you still need surgery, prehab will prepare you for your post-surgery rehabilitation. You’ll learn how to safely perform rehabilitation exercises and, if you’ll need an assistive device, such as a walker or cane, you’ll learn how to use it.

After surgery (rehabilitation)

Rehabilitation will likely begin the same day as surgery. In the past, orthopedic patients were encouraged to rest following surgery. Now we know that moving (in safe ways) as soon as possible after surgery facilitates healing and recovery. Your physical therapist will teach you how to get in and out of your bed and chair and get you started with a walking assistive device if you need it.

In the days and weeks following surgery, physical therapy will improve your flexibility and range of motion and build strength in the muscle around the joint. Your physical therapist may use manual manipulation to reduce muscle tightness, electrical stimulation, or ultrasound to help your incision heal or recommend supportive devices, such as a brace or splint. You’ll learn how to safely perform exercises at home to reinforce what happens in your PT sessions. As you recover, you may engage in activity-specific training so you can resume your favorite recreational activities.

Take your post-surgical physical therapy seriously and do your home exercises. According to the Arthritis Foundation, 50% of surgical outcome success has to do with a patient’s commitment to recovery, which includes adherence to physical therapy.

Next Steps
Not all insurance companies cover prehab or they limit the total number of qualified physical therapy sessions. Stick with your rehab program and follow your physical therapist’s recommendations. Remember: it’s YOUR recovery.

HCMC Center for Wellness and Rehabilitation
HCMC is fortunate to have an offsite outpatient facility offering physical, occupational and speech therapy for our community and the surrounding areas, for individuals ages birth to unlimited. We have a dedicated, knowledgeable staff determined to provide every patient with the most effective, evidence-based practice treatments, to allow for excellent outcomes. Get more info here.

Learn Not to Return

There’s no place like home! After spending time in the hospital, the last thing you want to do is go back. Unfortunately, one in five patients is readmitted within 30 days of being discharged. Despite being so common, readmission is usually avoidable, so it is important for you to take charge of your health by being an active participant in your own recovery. Follow these steps to help you on your personal path to wellness.

Speak Up and Repeat!
Never hesitate to ask your doctor, nurse, or pharmacist if you have a question about your care. When you are given instructions for your care outside of the hospital, try repeating the instructions back to the hospital caregivers to ensure you understand them and to help you remember what you need to do.

Have a Plan
Before you leave the hospital, make sure that you have a written plan for staying well after discharge. This plan should include a list of any suggested follow-up appointments your doctor recommends, a list of your medical conditions, any equipment or accommodations you will need at home, and an explanation of all of your medications, including when you need to take them and for how long.

Prevent Medication Mishaps
One of the most common reasons for rehospitalization is problems with medication compliance. Your job is to take your medication at the dosage and frequency that has been prescribed. It is helpful to have a friend or family member help you write down everything you already take as well as any medication instructions your doctor may give you so that your medication can help you recover rather than set you back. It is also crucial that all of your healthcare providers know all of the medications you are taking, including any over-the-counter medications, vitamins, or supplements, so that there is no danger of bad medicine combinations or doubling up on similar or the same medication.

Make and Keep Appointments
A healthcare professional can help you make a list of all recommended follow-up appointments you will need after being discharged from the hospital. Ask if you need to make the appointment yourself, and ask for any names, phone numbers, or other information you will need when making the appointment. Don’t skip these appointments even if you are feeling better. Follow-up appointments can help to measure your recovery and can help to catch any problems before they become bad enough to warrant readmission.

Know Who to Call
Having a strong support network is one of the most important steps you can take to get well. Having friends, family, and care workers to help you remember aftercare instructions and follow-up appointments, and watch for any symptoms, is invaluable. Make sure that you know who to contact during the day, at night, and on the weekends, and how to reach them in case of any problems.

HCMC Home Health

Home Health is designed to provide the smoothest transition from hospital to home. Patients must be referred to Home Health and must be homebound, need skilled care in the home and be under the care of a physician. The staff provides valuable physical assessment, evaluation, and instruction for the patient and family, while closely monitoring the patient’s condition with regular reports to his or her physician. Learn more.