Exercising after orthopaedic surgery
Posted on 10 August 2017
Orthopaedic surgeons can repair broken bones and replace worn-out joints, but it’s up to us to walk the road to recovery.
Dr Faf Weyers, an orthopaedic surgeon at Mediclinic Bloemfontein has seen his fair share of trauma to ankles, forearms, wrists, hips, knees and clavicles. And while every repair job and procedure is different, there are some simple guidelines to consider when exercising post-op.
Get up: the sooner the better
The days of prescribed immobility and long rest periods after surgery are over. ‘We want our patients to move safely and as much as possible after surgery,’ says Dr Weyers. ‘If I perform surgery for a fracture on a Monday, I want my patients out of bed with the help of a physiotherapist and orthotics, such as walking frames, by Tuesday.’
Remember the power of five
‘For every one day that a patient is bedridden after surgery, it takes five days to regain lost power,’ says Dr Weyers. Gentle exercise reduces swelling to the surgical site and boosts self-confidence.
Take a shorter splint stint
Splints are needed to repair damaged joints and bones, especially in the hand, finger or arm, but some movement is essential to avoid stiffness. The longer a bone is splinted, the harder rehab becomes. ‘I prefer to switch my patients to removable splints where possible as gentle movement aids fixation,’ says Dr Weyers.
Train your brain
‘The brain is lazy,’ says Dr Weyers. ‘If an ankle fracture is kept still and bears no weight for six weeks, the brain will forget about it. The joint will then need retraining.’ In medical terms this is called proprioception – the brain’s awareness of a joint and it’s position in relation to the rest of the body.
Strengthen your bones
Another advocate for early post-operative mobilisation is that the longer a joint or limb is still, the softer the bones become. In the past fractures were rested strictly while waiting for bones to knit, but this has been shown to lead to a decline in bone density called disuse osteopenia. ‘It’s best to do gentle weight-bearing exercise with professional assistance,’ says Dr Weyers.
Stick to the programme
Early mobility is essential, but you can’t go it alone. Exercise and movement after orthopaedic surgery must be tackled with a trained therapist who will focus on restoring functional movements like walking or holding a pen. This is done using aides initially, such as therabands, or balls. ‘Expect to receive a lot of physio in hospital and after discharge,’ says Dr Weyers.
Take a long-term view
Depending on the injury and surgery, it will take about 30 days to get real, functional strength back. ‘With all this talk about moving about, don’t bring your shoes to the hospital and expect to walk home unaided after a hip replacement,’ says Dr Weyers.