I often find myself discussing the effects of a person’s prior level of activity related to his/her current predicament. Say, for example, you have been suffering from debilitating knee pain for years and you have stopped doing your normal activities and limit the amount that you move your knee. 1 month later you have a knee replacement. How will you do in physical therapy?
Regardless of your prior level of disability, physical therapy will work wonders for your knee function; however, there will likely be a hard road ahead of you. Your level of strength and range of motion in that knee prior to your surgery can make a big difference on how quickly you will regain your strength and range. If you were a relatively active and strong individual prior to your surgery, you will likely regain your strength quicker than someone who is deconditioned and does not know the first thing about exercise.
How about range of motion? If you had years of limited movement in your knee, then your muscles have progressively shortened to the range at which they have grown accustomed. In other words, your muscles are still going to be tight after you have had your surgery, so they will take longer to stretch in order to regain full motion.
Now, we know that when you are in pain, you will naturally limit your activity level and degree of motion. This is NOT a shock to us. We just want to clarify that years of limited activity or inactivity can make recovery take longer than for someone who has remained mobile. So this advice goes out to ALL individuals, young and old, who want to avoid extra hassle with recovery from future injury or surgery: the stronger you are prior to injury and surgery, the more likely you will have a successful and speedy recovery. In other words, BE ACTIVE! Exercise, go for walks, play a sport, dance, do yoga, etc. I am not saying that you won’t get better if you did not do these things before an injury, but your recovery will go much smoother if you were active prior.
In addition to simply staying fit and active prior to injury, having PT prior to surgery can also make a difference in recovery outcomes. Research has shown that individuals who have PT prior to ACL reconstruction surgery have better overall outcomes up to 2 years following their surgery. These individuals also had PT following their surgery. This is an example of conditioning muscles prior to surgery having a positive effect on outcomes. Similar positive results were found with individuals who had PT prior to hip and knee replacements. The difference is that these individuals were seen prior to surgery only 1 or 2 visits. With these individuals, their outcomes were improved most likely due to training with walking devices, understanding a preliminary exercise program, and being given an understanding of what to expect following surgery. Either way, PT prior to and following surgery can have a very positive effect on a person’s recovery.
PTinMotion Magazine February 2015 p. 62, 63