Pre-Operative Physical Therapy in New York City, NY

What is Pre-Operative Physical Therapy Program?

Many of us think that a physical therapy recovery program is only needed after having surgery, or part of what is commonly considered, post-surgical rehabilitation. It makes sense because your body does lose an amount of strength and coordination when undergoing a surgical procedure, and post operative physical therapy is needed to fully recuperate and regain your function.  However the very best postoperative rehabilitation strategy includes a comprehensive physical therapy consultation and treatment before your surgical procedure – and ideally at your home and or place of work. 

Receiving physical therapy prior to your surgery is recognized as  preoperative physical therapy and prepares your whole body for the surgery ahead and not just an isolated part of your body.  Preoperative physical therapy can also give you peace of mind and a sense of confidence going into your surgery knowing you’ve done everything to ensure your surgery is free of complications and  ‘smooth sailing’.

From cardio-thoracic surgery or rotator cuff repair to joint replacement, a preoperative physical therapy program including low intensity exercise will improve circulation which in turn accelerates the body’s healing response. This is supported with research where patients reported better control of post-surgical pain after having only 1 or 2 preoperative physical therapy sessions prior to their surgery.  

Additionally, building muscle in your core, legs, arms,  and back reduces the likelihood of experiencing large amounts of atrophy (progressive degeneration or shrinkage of nerve tissue or muscle) while recovering from your surgery.  Atrophy is one of the leading post surgery rehabilitation issues that delays a patient’s ability to resume back to their full life.

Could Pre-Operative Physical Therapy At Home Benefit You?

Our physical therapists provide solutions to those trying to avoid surgery or planning to have surgery: 

• Rotator Cuff Repair
• Spinal (Microdiscectomy, Fusion)
• Joint Replacement (Shoulder, Hip, Knee, Ankle)
• Knee (Meniscus, ACL, PCL)
• Hernia Repair
• Other

A preoperative physical therapy program can focus on several different areas, depending on the nature of your scheduled surgery, including:

Strengthening – Generally focused on a specific area associated with your operation; however, as your in-home physical therapist we also consider your entire body and home living environment and may propose exercises designed on strengthening your core (the group of muscles in your mid section attached to your pelvis and spine) or extremities that may be stressed post surgery and upon your return home.  Your core muscles anchor your center of gravity, enabling you to balance yourself.   

Endurance –   As your in-home physical therapist, we will develop custom tailored programs to your needs, abilities and living environment, without the risk of tearing any sutures or reinjuring yourself.  Endurance activity keeps your circulatory system, heart, and lungs healthy and improves overall fitness. Building your endurance makes it easier to carry out many of your everyday activities over the course of a full day, which may involve stairs, sliding glass doors, general household functioning, etc.   Upon understanding your daily routine and the layout and foreseeable challenges of your home residence, we will know specifically what endurance building activities serve you best.  

Balance – Generally any surgical operation will leave us all feeling unsteady. Balance training is important to help prevent falls and can improve your personal safety when negotiating steps, bathing, and or in managing through a moment of feeling lightheaded.  Balance training also helps strengthen your core and legs, improving stabilizer muscles, joint stability along with internal focus. 

Flexibility – If your tendons and muscles are flexible before surgery, you will improve the chances of your body adjusting swiftly as needed after surgery.  Having flexibility:

• Reduces injury risk
• Lessens the risk of falls
• Prevents and corrects muscle imbalances
• Improves posture
• Enhances joint range of motion
• Improves athletic performance
• Counters the effects of long periods of sitting 
• Reduces joint pain and strain

Strengthening Your Mind – While the purpose of physical therapy is to improve physical health and well being, pre-operative physical therapy also gives patients peace of mind in not only understanding what to anticipate after their operation, but in having the recovery protocol or steps mapped out in their mind.  Being educated and having the knowledge of the path to recovery comforts in offering certainty, driving confidence, and  facilitating a stress free and speedy recovery.  

Home Preparation – Having your home ready for your post surgery life goes a long way to ensuring a speedy recovery. It’s possible your home may need some modifications that enable you to go about things in a safe manner.  As your in-home preoperative physical therapist, we will assess your home through the lens of points of risk mindful of the nature of your surgery and:

• assess all of your living and walking spaces, from bathrooms to bedrooms to the kitchen, to stairs as well as spaces for footing, are there any slick surfaces, are rails needed anywhere?
• assess any stress points in your daily functioning; are you attempting to lift heavy objects like a gallon of milk or laundry detergent; how are you reaching for kitchenware, toiletries, etc.

Learning How to Use Assistive Devices – Needing assistive devices is common while healing and I’m helpful in identifying the most appropriate for you as well as how to use them.  Assistive devices can extend far beyond the familiar crutches, canes, and walkers, to include alternative computer keyboards, mouse input devices, magnifiers, and phones with large tactile buttons. 

If you have a scheduled surgery, call us and we will be happy to share with you other insights and advice on how to ensure a smooth operation and swift, safe recovery.   The research is clear that preoperative physical therapy can result in you enduring less pain and having a faster recovery.  The research also notes how participating in a single preoperative physical therapy session can produce a better overall outcome for yourself in undergoing your scheduled surgery.   Everyone wants to recover in the comfort of their own home and that’s what Palmer Concierge (in-home) Physical Therapy can offer you. You deserve the best of all recovery outcomes after your surgery and we can help make it happen for you in your home.  Preoperative physical therapy  can make a world of difference in how you recover and we’re here to help.

3 Reasons to Choose Pre-operative Physical Therapy?

• Structuring an exercise program that strengthens joints and muscles affected by the surgery, which usually facilitates a speedy recovery. 
• Preparing you for traveling in a car, getting around your home, or your eventual return to your professional life and activities you enjoy.
• Recommend assistive devices that will be helpful, such as a cane or perhaps assistive technology such as an alternative keyboard or mouse input devices to make working on a computer more comfortable for you. 
• Setting up a “recovery zone” in your home as a second floor bedroom could be challenging thus setting up a resting area on the first floor might be sensible to avoid frequent use of stairs post surgery. 
• Repositioning household items in rooms such as the kitchen that might need to be placed on lower shelves and within easy reach. 

At the end of the day anyone scheduled for surgery should consider 3 key points, supported by research linked below, and include preoperative physical therapy in their overall surgical plans.

1. Preoperative physical therapy reduces post surgical pain
2. Preoperative physical therapy reduce rehabilitation time & makes for a faster recovery
3. A single preoperative physical therapy session improves key outcomes, both clinically and financially

“Tuning up” your body and going into a scheduled surgery as strongly as possible reduces the risk of unforeseen surgical complications.  Also, practically speaking, a few preoperative physical therapy sessions enable you to rehearse or practice the exercises designed in the rehabilitation program you will be expected to perform after your surgery.   Being able to ‘walk through’ your postoperative rehab program will make you a better educated and more informed patient and give you a sense of how to function and get around your home, mindful of any  new mobility restrictions or weight-bearing precautions you are coping with.   As your in-home physical therapist, before your surgery we can help you prepare for needed adjustments that will surface in the immediate aftermath upon returning home after surgery such as:

Pre-Operative Physical Therapy Case Studies

Case Study 1. Prehabilitation May Minimize Post-Surgical Pain.

It was determined that a 3-week preoperative exercise program reduced knee pain and helped maintain physical activity after surgery in patients with severe osteoarthritis who underwent total knee arthroplasty (knee replacement).  For many people in the weeks following their surgery, pain can be a big concern. Pain can restrict their work, decrease their ability to handle postoperative physical therapy, disrupt their sleep, and even make it difficult for them to manage their environment safely. It can also put a lot of pressure on them to heal faster so they can get back to their normal routines, which does nothing but delay wound healing and cause psychological stress.   This study highlights a key benefit of preoperative physical therapy.

Case Study 2. Pre-operative physical therapy can reduce the amount of care you’ll need after your operation.

Research shows that “preoperative physical therapy” for your surgery with a physical therapist before undergoing a hip or knee replacement can significantly reduce the amount of professional care you’ll need after your surgery.  The American Physical Therapy Association references a 2014 study from the Journal of Bone and Joint Surgery which showed that just 1 or 2 sessions of preoperative physical therapy reduced the use of post-acute care services by nearly 30%.  This study highlights a key benefit of preoperative physical therapy.

Case Study 3.  A single preoperative physical therapy visit improves key outcomes, both clinically and financially, following total knee replacement.

Results: Preoperative physical therapy resulted in a marked decrease in length of stay, with 37.1% of preoperative physical therapy patients leaving inpatient care on post-operative day 1 compared to 27.0% of the no preoperative physical therapy controls. Preoperative physical therapy also improved discharge disposition, with 41.6% of preoperative physical therapy patients returning home and utilizing outpatient services compared to 23.2% of controls. This study highlights a key benefit of preoperative physical therapy.