So you are having surgery?
Your Questions Answered
For your convenience, I’ve put together a list of some of the most common orthopedic surgeries that I treat as a physical therapist along with some things you might want to think about as you prepare for surgery. These thoughts are formed anecdotally from my own personal experiences and not meant to replace medical advice from your surgeon or therapy team!
Total Knee Replacement
This is a big one. We all have knee pain at some point, but when the pain becomes persistent and starts to interfere with walking ability or ability to navigate stairs, it's time to start considering if total knee replacement might be the answer. 20 years ago, this surgery required longer recovery times, but as surgical technology has improved, those recovery times have reduced. A typical timeline might be about 2 weeks of fairly intense pain and swelling (sorry - I don't want to lie!) and another 2 weeks of moderate pain and swelling. By about 4 weeks, most are walking without an assistive device and feeling mostly human. Although most people are functioning well by 6 months, there will be some who are still working on getting rid of a habitual "stiff knee" limp. Going down stairs is typically the hardest skill to regain after TKR. Surgeons like to ask for a full year before you demand perfection out of that brand new knee! Just know that you won't fully gain your natural knee flexion back, but that's okay - shoot for 125 degrees of knee flexion and start early. The biggest challenge is reducing the swelling in the knee as quickly as possible... so rotate out those ice packs 20 min of every hour like it's your full time job! (some people love the polar ice - I personally think a good commercial quality ice pack does the best job)
MUST HAVE TOOLS: stretching strap, ice pack, myofascial roller, bolster, analgesic pain relief cream
OPTIONAL TOOLS: knee alignment pillow, theraband
Total Hip Replacement
Total Hip Replacements are a little different than Total Knee Replacements in the sense that they are often NOT elective surgeries! Sometimes they are in fact a positive choice to have surgery to overcome osteoarthritis in the hip or hip dyplasia. However, in many cases, THR is performed to repair a broken femur. This surgery is more often seen in older adults and it seems that the recovery time tends to be longer than a TKR although the recovery does seem to be less painful in general. One reason THR seems to take longer is that someone who has fallen or otherwise traumatically fractured their hip is likely to be more frail or deconditioned to begin with and will need more time to build strength following surgery. A second reason THR recovery takes longer is that the hip is a far more complicated joint than the knee and there are more restrictions in place after surgery to avoid disrupting the work of the surgeon. The biggest expectation after surgery is to begin walking soon and often. Surgeons are picky about their post surgical protocols, but no doubt - they will let you know what their expectations are. A walker will definitely be required initially and the muscles surrounding the joint will need to be strengthened in order to support the prosthesis. Specific restrictions will be different based on whether the surgical approach was anterior or posterior. (Hint: anterior has less restrictions). Once again, reducing swelling quickly is crucial along with protecting the joint during sleep.
MUST HAVE TOOLS: hip alignment pillow, ice pack, reacher, long handled body scrubber, analgesic pain relief cream
OPTIONAL TOOLS: stretching strap, myofascial roller, bolster, theraband
Spinal Fusion or Spinal laminectomy
Spinal surgery of any kind (cervical, lumbar, thoracic) is a big decision that comes with plenty of consideration for the alternatives. Spinal Fusion is probably the "biggest" surgery and is often chosen in order to stabilize the spine to reverse or prevent the effects of a degenerative spine, often times the specific concern is to reduce central cord compression. Recovery from a spinal fusion can easily take 6 months to 1 year. The other flavors of spinal surgery (laminectomy, foraminotomy, discectomy) are usually a little less involved and take less recovery time (8-16 weeks in my experience). These less involved procedures usually aim to decompress a nerve root and relieve the nerve pain that can go down the leg or arm and cause numbness and tingling and in some cases motor loss. In most cases, you will be wearing a brace after surgery and you will have restrictions to your range of motion (no bending, lifting, twisting) for a period of time.
MUST HAVE TOOLS: ice pack, reacher, long handled body scrubber, stretching strap, Nerve pain relief cream
OPTIONAL TOOLS: large therapy ball, cervical pillow, myofascial roller
Rotator Cuff Repair or Total Shoulder Replacement (traditional or reverse)
Ah, the shoulder repair. This one is a sneaky one because the shoulder is one of the most complex joints in the body. I find that the recovery for a rotator cuff repair or total shoulder repair can vary greatly depending on how damaged the shoulder was to begin with. A total shoulder replacement might be chosen if the damage to the shoulder is severe and the painful shoulder limits a person from sleeping or performing normal daily activities. The problem could be anything from severe rotator cuff injury, avascular necrosis, osteoarthritis, fracture, or rheumatoid arthritis. A rotator cuff repair might be chosen if the damage to the rotator cuff is more isolated to 1 or 2 tendons. Surgery is likely not necessary if the damage is less than 50% thickness and the pain is manageable. The rotator cuff is made up of 4 specific muscles (The subscapularis, the teres minor, the supraspinatus, and the infraspinatus) but is functionally supported also by the deltoid, biceps, and triceps. The most commonly injured or torn muscle is the supraspinatus muscle. With a total shoulder replacement, the shoulder is typically immobilized for a period of time (around 12 weeks) and strengthening begins a few weeks after surgery. For rotator cuff repair, you may be able to move sooner, but your surgeon's protocol will be specific, letting your therapist know when to advance your program. Most protocols will begin with passive or assisted range of motion only, waiting 10-12 weeks before adding any kind of weights. Recovery from either surgery can take up to a year to regain full pain free range of motion and strength. Either way, you will want to have the tools ready to help your progress. Oh and plan to sleep in a recliner or similar set up for a period of time!
MUST HAVE TOOLS: over the door pulleys, small weights, muscle and joint pain cream
OPTIONAL TOOLS: hand strengthener, theraband, flexbar
Ankle or foot fixation
The main issue with ankle/foot surgery is regaining the range of motion that allows for comfortable walking. This includes not only the obvious ankle movement (plantar flexion and dorsiflexion), but also all the movement in the joints between the 26 bones of the foot! In some cases, when fixation occurs with a screw or plate, it is important to try to maximize range of motion at the surrounding joints. In many cases, you will be non-weight bearing (or partial weight bearing) after a foot or ankle surgery and may be in some type of immobilization boot or cast. When your doctor releases you and your therapist starts working with you though, it's time to get busy moving! Recovery times can vary greatly in this broad category of surgeries, but generally plan at least 3 to 6 months for return to normal activity.
MUST HAVE TOOLS: bolster, wobble board, ice pack, theraband, muscle and joint pain cream
OPTIONAL TOOLS: marbles, Franklin Ball®, balance disc
Hand/wrist Surgery
The most common hand and wrist surgeries I see include surgical repair for a fractured wrist (usually from a fall on outstretched arm), carpal tunnel surgery, surgical correction of Dupuytren's contracture (finger is contracted in a flexed position), or trigger finger. Our hands are so important to our ability to maneuver items and perform fine motor skills, so when we break our wrist or have another type of hand surgery, the recovery is somewhat specialized and intricate. You will likely be sent to a certified hand therapist (CHT) to facilitate your recovery. These sessions might include special braces or splints. Whichever surgery you, have, rehab will involve working on fine motor skills.
MUST HAVE TOOLS: small balls, theraputty
OPTIONAL TOOLS: therabar, hand/grip strengtheners, small weights
Not interested in specific recovery tools?
So, you want to send a recovery box, but you aren't particularly sure which box to send? Why not send one of our other boxes? These boxes aren't meant to target any specific surgery, but meant to provide some useful items that anyone would like to have when recovering from an illness or surgery. Check out our boredom buster, creature comfort, swell no more, or scar and skin care boxes!