Rehabilitation is the post-surgical program of re-establishing joint motion, muscle strength around the joint and finally joint function. It is very important to understand that rehabilitation is a long process. While the surgery is performed within hours, the rehabilitation needs many months, potentially up to a year. The difference between the length of the surgery and the time needed for rehabilitation is huge, and patients should have that clearly in mind.
When the patient undergoes surgery of the knee, ankle or shoulder, for example, by whatever method, they should be aware that they need a long recovery period. It is therefore very important that the patient is committed to the whole process.
Rehabilitation is a progressive activity. In this context, ‘progression’ means safely increasing workloads and stimuli on the repaired joint during the recovery process.
It is important to properly stimulate the affected tissues after surgery. This is, biologically, a very complex process, because we need to let the tissue mature. You must wait for some time to help the biological process, and that process needs stimulation. The right stimulation is protected range of motion and exercise.
Consequently, the core of rehabilitation is doing the right exercises at the right time, with the right balance between not enough and too much exercise. So, neither complete rest nor sporting activities is advisable in this phase of rehabilitation. Something in the middle is required. That balance changes during the weeks and months after surgery. What this means in practice is that the intensity of the stimulation increases progressively. That’s why you need an experienced physiotherapist who can guide you through this complex process.
- Knee joint: ACL/PCL-reconstruction, MCL repair, meniscectomy, total knee replacement (TKR)
- Shoulder joint: Arthroscopy for rotator cuff repairs, frozen shoulder, shoulder replacement, SLAP repair or dislocation.
- Ankle joint: ligament repairs, fusions and joint replacements.
- Bone fractures: Any bone! Surgically inserted metal rods or plates. (unfortunately very common in Bali, due to lots of motorbike accidents)
- Spinal: Laminectomy, discectomy and fusions.