Post Fracture and Surgical Rehabilitation

We see a large number of patients who have had surgery for a number of different reasons. Our excellent facilities and expert knowledge enable our team to provide first class physiotherapy post-surgery, ensuring that each patient regains their function as soon as possible.

At Total Physiotherapy we have links with expert regional consultants:

  • Mr Steve Bollen
  • Mr Chris Wray
  • Mr Daniel Tang
  • Mr Christopher Mann
  • Mr Nick London

Each consultant surgeon has their own speciality covering sports medicine, upper and lower limb as well as spinal problems. Our physiotherapists can work alongside the surgeon to ensure the patient has the correct rehabilitation program post surgery.

After surgery or a fracture it is extremely important to undergo rehabilitation in order to gain full function. Depending on the surgery, certain parts of the body are compromised in order to treat a specific problem. This can involve cutting through muscle tissue at the hip in order to repair a fractured hip, or cutting through the abdominal muscles in order to complete bowel surgery. Either way the muscles are damaged as a consequence and it is important to regain the muscles function in order to regain joint stability and complete movements in a natural and correct manor. If the muscle strength is not improved post surgery then there is a high risk that the specific area will be susceptible to future damage and pain.

How can Physiotherapy help post upper limb surgery?

Physiotherapy post upper and lower limb as well as spinal surgery is extremely important in order to regain full range of movement, muscle strength and a fully functioning limb. A large number of patients come to see our physiotherapists post shoulder, elbow, wrist, hand, foot, ankle, knee, hip and spinal surgery. Patients who have had C-sections or abdominal surgery also benefit from physiotherapy input to improve core stability and regain control around the abdominal/pelvis area. The type of surgery will purely depend on the patient’s symptoms/injury, ranging from ORIF (Open Reduction Internal Fixation), nerve decompressions, joint decompressions, replacements. Due to advancing technologies, arthroscopy surgery (key hole) is more commonly used as they less invasive.

The types of surgery that patients have commonly received include:

  • Achilles Tendon repair
  • ORIF (Open Reduction Internal Fixation)/Repair to the tibia, fibula, femur, radius, ulna, humerus.
  • Shoulder arthroscopy and sub-acromial decompression
  • Knee arthroscopy and meniscectomy
  • Achilles Tendon repair
  • Carpal tunnel release/decompression
  • C-Section
  • Laparotomy
  • Hernia repair
  • Ulnar nerve decompression
  • Removal of support implant
  • Knee arthroscopy and anterior cruciate ligament (ACL) reconstruction
  • Knee replacement
  • Repair of femoral neck fracture
  • Repair of trochanteric fracture
  • Hip replacement
  • Rotator cuff tendon repair
  • Spinal Laminectomy

When providing treatment and rehabilitation, the physiotherapist will always work closely with the surgeon to ensure the correct rehabilitation is adhered to and the tissue is not loaded too soon. This allows the physiotherapist to guide the patients through a structured rehabilitation program to ensure optimal recovery.

As well as seeing patients post surgery, at Total Physiotherapy we see a large number of patients who may have fractured a bone which required a period of immobilisation. We regularly see patients who have suffered from the following fractures

  • Colles Fracture
  • Ankle fracture
  • Lateral or medial malleolus
  • Bimalleolar (lateral and medial malleolus)
  • Trimalleolar (lateral and medial malleolus, and distal posterior aspect of tibia.)
  • Patella fracture
  • Tibia/Fibula fracture
  • Femur fracture
  • Lisfranc fracture
  • Calcaneal fracture
  • Rib fracture
  • Clavicle fracture
  • Humerus fracture
  • Ulnar fracture
  • Scaphoid fracture

After both surgery and experiencing a fracture, in the first instance it is important to regain full, natural range of move movement to the joint, in a pain free manner. Once this is gained, the patient can begin to work on strength and stability work, focusing on keeping the exercises functional and specific to their daily routine/occupation. This also applies to surgery of any joints in the upper limbs. The patient may have had carpal tunnel surgery or fixation of the wrist after a fracture. Further surgical procedures include ulnar nerve decompression, radial head replacement, shoulder joint replacement, sub-acromial decompression (SAD), rotator cuff repair, fixation of a fracture through pins and plates, to name a few!

The techniques used by the physiotherapists will purely depend on the severity and type of the fracture/surgical procedure. After a joint or limb has been immobilised for a length of time there will be a large amount of muscle wastage and joint stiffness present. 

It is important that the physiotherapist uses the appropriate manual therapy techniques to enhance the repair and recovery of the limb/joint, in order to regain full function. This may initially involve managing pain levels through acupuncture, TENS, soft tissue massage, ice, gentle exercise and stretching. Once the pain levels are controlled, if it is the lower limb that has been injured, then it is important to focus on introducing weight bearing activities as advised by the Orthopaedic doctor/surgeon. This will involve training the body to walk again (gait re-education) in the correct/natural pattern.

It is also extremely important to gain full range of movement to the injured area to prevent compensation mechanisms at different joints/tissues. This can be achieved through specific/functional exercises, stretching, joint mobilisations, joint manipulations, trigger point release therapy and massage to name a few. The physiotherapist can then look at improving the strength of the injured limb/joint through providing a rehabilitation program specific to their treatment goals and their previous functional status (returning to a specific job role or returning to sport).

If you would like to discuss your problem before booking an appointment please give our physiotherapy team a call, we will do our best to help.