Before and after surgery, your PT will look at not only the joint involved, but at whole body alignment and movement. The core muscles of the trunk form the foundation for healthy breathing as well as movement of the arms, legs, head and neck. Multiple joints often need strengthening and movement training in addition to those joints involved in surgery.
Consider the shoulder
In addition to regaining shoulder range of motion after a surgery, rib cage position, breathing and pelvic stability need to be addressed. The cervical spine (neck) is often overused and irritated due to trying to cope, move, reach and throw with a shoulder that is not functioning well, restricted in motion, or painful. Rehabilitation before and after surgery, will not only be about decreasing pain, regaining shoulder motion and strength, but also to enhance strength and stability of the core muscles of the trunk that control rib cage position, breathing and posture. Faulty trunk and rib cage positioning can often lead to impingement problems in the shoulder joint and are often part of the original problem. Scapular (shoulder blade) stability and position must be retrained as the shoulder is rehabilitated, ideally restoring well aligned posture and therefore long term restoration of the health of the shoulder joint.
For spine, hips, knees and ankles
The same principles apply. Joints in the spine and legs can be injured all at once, but more often become injured related to unhealthy stress during walking, running and fitness activities due to an asymmetrical position of the pelvis and spine. Both before, and after surgery, we help patients to recognize unhealthy posture and movement habits to relieve stress from overused, injured and repaired joints for long term success and return to healthy walking, running, sport and hobbies.
A complete, thorough home exercise program after a surgical joint procedure is critical to patient success. This is achieved by time spent training patients and rechecking from visit to visit. Patients are sometimes handed quick home programs that can be performed inadequately. This can be caused by rushing the performance, inadequate hold times, or compensations occurring to the intended movement and thereby missing the potential effectiveness of the exercise. Home programs need to be assessed and trained carefully initially and on a regular basis.
