• David Simmons, PT, DPT

Tips for surgery (before and after)

Do Physical Therapists get injured?

The short answer is yes. Despite having as much knowledge of the human body as we do, we can still suffer injuries just like everyone else. With that being said, I recently went through a knee surgery to fix a torn meniscus and wanted to share my journey through the process along with some things that came up during my rehab that may be helpful for you.


After I started having some knee pain, I knew that something was off. I tried to rest it for a couple of weeks, do some exercises, icing, and soft tissue work with no long-term success. I had a bad feeling that it was my meniscus in the way the pain was presenting and other symptoms I was experiencing. Luckily, I work at a pretty awesome outpatient PT (Physical Therapy) clinic so I was able to have a PT I work with to check out my knee. After she did a quick evaluation, she agreed with me and felt like it was also my meniscus. From there, we both agreed that an MRI was the next step. She was able to write me a script to get an MRI that I scheduled for the next week. Many people think that in order to get imaging done they have to see their primary doctor or an ortho. Here in Colorado Physical Therapists are allowed to order imaging. So if a pain arises and the wait at your doctor is a couple of weeks then Physical Therapy might be the place to start.


Pre-surgery process

After getting the MRI it was confirmed that I had a tear in my meniscus. Next steps were to find an orthopeadic surgeon to discuss my options. Luckily, our office had connections to many surgeons (for all different body parts) so I knew the surgeon I wanted to see. It is very important to do your research before meeting with a surgeon. The beauty of the internet these days is that most people have reviews on them that can be very helpful in picking who you go see. Also, reaching out to local PT clinics or doctors offices to see who they recommend is a great idea. Do not be scared to get a second opinion. If a surgery is required, that is a major decision, and if time is not an issue, making sure opinions match is a great way to ensure you are getting the best quality care. It is also important that you fully understand and have knowledge on what exactly the issue is and how the surgery will fix it. A lot of times, surgery verbiage can sound foreign to those that do not work in medicine. So make sure you take the time to research the issue and go to the surgery appointment with questions that may come up.


Once the surgeon is selected and the surgery is set up, it is important to make sure your plans for after surgery are all in place a week or two before. Luckily, my surgery was an outpatient procedure so I got to go home that day. Some surgeries you may have to spend a night or two in the hospital and it just makes things easier if you have a plan in place. Other helpful things to note include: should I get/borrow an ice machine, will I need assistive equipment (i.e: raised toilet seat, walker, crutches, etc), should I plan to spend time on one floor so I do not have to go up and down stairs, will I need time off from work, etc. For people that live alone with minimal-to-no assistance from family/friends, I cannot recommend enough to try and make some meals ahead of time that you can freeze to just heat-up post surgery.


Surgery

Your surgeon is selected, your plan is in place, now comes the easy part: surgery. This is pretty self explanatory and out of your hands. For me, the exact surgery was undetermined until the surgeon got in there to check it out so I was unsure exactly how things would end up. Luckily, I was able to keep my whole meniscus which was great for the long-term but for the short-term meant I was on crutches and non-weight bearing for 6 weeks. With a one year old at home, this was going to be the most challenging for my wife.


Post-surgery rehab process

It is always key to make sure you find out from the surgeon when they want you to start therapy. Every surgery is different and has different healing times. This is something good to do pre-surgery so that you can schedule a couple appointments for after surgery to not miss any time. The most important thing you can do in the first couple days after surgery is rest, ice, and elevate. No matter the surgery there is going to be swelling and it is essential to decrease that swelling as quickly as we can. It is very important to stay on top of pain control. Many people these days are fearful of pain meds and want to get off them as quickly as possible. This is great and while I totally understand this, they were prescribed for a reason. Surgery is painful and if you try to get off the meds too soon this can impact your mobility, range of motion, and/or cause lots of delayed soreness. As always, follow

doctor/medication guidance, but they are very helpful in the early post-op process.


Seeing your physical therapist

The time has come and it is time to see your physical therapist. In my opinion, this is the best part; however, going through it as a patient for the first time, it is more difficult than I would have expected. First and foremost, make sure that your PT gives a general outline of what to expect. This is huge for you to understand day one so that you have realistic goals outlined and a general sense of timing when it comes to the rehab process. Next, finding time to do your exercises at home is hard (I just learned how hard with this surgery). We get it and that is why we try our best to narrow it down to the most important exercises to focus on. With that being said, some hints I have found helpful in doing my home therapy:

  • Leave your exercise sheet or equipment you will use in a place you will see it every day

  • Develop a routine when it comes to your exercises (get up 5 minutes early, schedule a break in your work day, etc)

Remember a home exercise program is essential to your recovery. I used to get very frustrated when patients came in and said they did not do their exercises. Now after going through the process as a patient, I totally get it. Life is busy and sometimes finding extra time in our day is just not possible. Do not get frustrated with those days and do your best to find the time tomorrow. Also make sure you are honest with your physical therapist. If you feel overwhelmed by the number of exercises let them know, if you do not understand something ask them a question. Lastly, and most importantly, BE PATIENT! Again any surgery is a big deal and the body takes time to recover/heal. The last thing you want to do is overdo something before the body is ready and suffer another injury or re-injure the same body part. For most surgeries you will get back to your prior level of function and goals but it takes time. Trust the process!


Below is a review of some of the tips that I discussed in detail above:

  1. When pain arises, try and get in with a medical professional as soon as possible: here in CO you can start with a Physical Therapist.

  2. Do your research on surgeons and do not be afraid to get a second opinion.

  3. Make arrangements for after surgery a week or 2 before the surgery takes place.

  4. Schedule physical therapy appointments before your surgery.

  5. It is never a bad idea to see a physical therapist before surgery so you get comfortable and understand what to expect after surgery.

  6. Stay on top of the pain.

  7. Leave your exercise equipment/sheet in a place where you spend a lot of time.

  8. Adjust your schedule to make sure you develop a routine to get your physical therapy done.

  9. Be honest with yourself and your therapist throughout the process.

  10. Make sure your therapist and surgeon are in contact with each other if needed.

  11. BE PATIENT!

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