Pre and Post Operation Rehabilitation

 

 

 

In order to ensure that you or a loved one achieve the best possible outcome after surgery it has been recognised that counteracting the effects that any length of stay in hospital as quickly and safely as possible with targeted rehabilitation programmes leads to the best outcomes.

 

Post surgery this entails closely following your surgeon's advice and engaging as soon as possible with a Physiotherapist and/or an Occupational Therapist if required. There is also now growing support for individuals to engage in pre-operative  muscle strengthening and conditioning programmes (prehabilitation) for 2-6 weeks prior to surgery to counteract the loss of muscle size, strength and function thats occurs after surgery and bed rest in hospital. 

 

The good news is that Fit For Life can provide all the support and expertise you or a loved one needs to maxmise your recovery back to your optimum health and physical fitness.

 

Some of the more common surgeries that Fit For Life can provide full pre-and post operative services are listed below. 

Where does this service take place?

We can deliver this service at a location of your choice whether that is in your own home, a respite facility, Nursing home or at our Clinic in Sandyford Dublin 18 or one of our regional centres. 

 

Confirm Appointment & Cost

Once you have made an enquiry to book a home/residential visit you will be contacted by a member of our team to confirm your preferred time and day of your appointment and the exact cost of the service and the therapist who will be carrying out the assessment.

 

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Hip Operations


Hip Arthroscopy

What is a hip arthroscopy?

Hip arthroscopy is a minimally invasive surgical technique that allows doctors to view the inside of the hip joint. This is performed with a fibre optic telescope which allows the doctor to perform some surgical procedures. For example:

  • Repair or trimming of cartilage
  • Removing loose bodies such as cartilage or bone fragments from the joint
  • Removal of the synovium (the membrane lining the hip joint).

How do I recover from my hip arthroscopy surgery?

Physiotherapy plays a very important role in your hip arthroscopy rehabilitation and there are specific exercises you need to do after surgery to restore your strength, control and mobility (movement). Your physiotherapist will discuss these with you and make sure you can do them safely and effectively.

Your physiotherapist will give you elbow crutches and teach you how to walk with them. Some people are instructed to partially weight bear (walking with only half of your weight on your operated side) and others can fully weight bear straight away. Your physiotherapist will tell you what your consultant has requested.

Total Hip Replacement

What is a total Hip Replacement?

In a total hip replacement (also called total hip arthroplasty), the damaged bone and cartilage is removed and replaced with prosthetic components. The damaged femoral head is removed and replaced with a metal stem that is placed into the hollow center of the femur. The femoral stem may be either cemented or "press fit" into the bone. A metal or ceramic ball is placed on the upper part of the stem. This ball replaces the damaged femoral head that was removed. The damaged cartilage surface of the socket (acetabulum) is removed and replaced with a metal socket. Screws or cement are sometimes used to hold the socket in place. A plastic, ceramic, or metal spacer is inserted between the new ball and the socket to allow for a smooth gliding surface.

How do I recover from my total Hip Replacement?

The aim of surgery is for you to be able to resume your normal everyday activities (90% success rate) without pain including climbing stairs and walking. It is also possible to participate in recreational walking, swimming, golf, driving, light hiking, cycling and ballroom dancing.

First of all you will be given some general precautions Including; • 'Weight bear as tolerated' (WBAT), with use of assistive device (AD) as needed (crutches, walker) • No crossing legs (crossing ankles OK) • Use good bending/lifting mechanics (keep back straight and bend at knees) • Keep hips above knees when sitting, avoid sitting in deep chairs Then with the assistance of a physiotherapist you will enter a 2 phase programme of rehabilitation or 3 phases if you wish to return to recreational sport. * it should be noted that every individual is different and full rehabilitation post operation may vary! Phase I (0-6 weeks) : Day 1 Post-Operation programme of rehabilitation which will be completed once your physiotherapist is satisfied that; • You no longer require an Assistive Device to walk short distances • You have a normal gait (walking) pattern • You are experiencing little or no pain and swelling carrying out your home exercise programme or activiities of daily living (ADL's). Phase 2 (6-12 weeks) : This phase will be continued until you can carry out ADL's completely pain free and are no longer experiencing swelling. Phase 3 (12 -20 weeks) : To be completed if you wish to return to recreational sports safely

What is a Hip Hemiarthroplasty​ The hip joint is a ball and socket joint. The ball is formed by the head of the thigh bone (femur) and fits snugly into the socket (acetabulum).​ The hip hemiarthroplasty is similar to a total hip replacement, but it involves only half of the hip. ("Hemi" means half, and "arthroplasty" means joint replacement.) ​ A hip hemiarthroplasty is used most commonly to treat a fractured hip.​ The hemiarthroplasty replaces only the ball portion of the hip joint - not the socket portion. In a total hip replacement, the ball and socket are both replaced.​

How do I recover from my Hip Hemiarthroplasty surgery?

Your medical team will provide you with a list of do and don't listed below. Then your physiotherapist will assist you with a gradual phased rehabiliation programme.

1. Do not cross your legs.​ 2. Do not bend the operated hip​ excessively. a) Bending the knee of the operated leg​ too high towards the chest.​ b) Leaning too far forward​ 3. Do not twist the operated leg in or out.​ Likewise do not twist your body on ​ our leg, i.e. by reaching too far across​ your body. When walking or turning​ you should always keep your toes and ​knee-caps pointing straight ​ ahead​ 4. Do not roll or lie on your side.

Do’s​ 1. Go for short walks reguarly – not ​ long walks that may tire you or involve ​ prolonged standing. Avoid uneven and ​ wet surfaces.​ 2. Keep you crutch’s until you are ​ reviewed by your surgeon, usually ​ 8-10wks after the operation.​ 3. In bed, lie on your back with a pillow between your legs. ​ Dynamic Hip Screw (DHS) What is a dynamic hip screw? DHS is used for most trochanteric fractures. The fracture is reduced by inserting a fixing to the bone. This is a special metal screw attached to a plate; it holds the broken part of the thigh bone in place whilst it heals.

How do I recover from my Hip Hemiarthroplasty surgery?

Physiotherapy should be commenced straight away after the operation. Your medical team will ensure that you have appropriate pain relief to start your rehabilitation. Your Physiotherapist will initially assist you in ensuring that you are able to transfers from your, bed, chair, toiletting assess and prescribe you an appropriate walking aid. They will be aiming to have you walking with the aid of a walking device by day 3 (providing there are no complications). An initial home exercise programme will consist of lying and seated exercises progressing to balance retraining and confidence building (most fractures are as a direct result of a fall) and gait retraining.




Knee Operations


Total Knee Replacement/Arthroplasty

What is a total knee arthroplasty ?

Knee replacement, also called knee arthroplasty or total knee replacement, is a surgical procedure to resurface a knee damaged by arthritis. Metal and plastic parts are used to cap the ends of the bones that form the knee joint, along with the kneecap. This surgery may be considered for someone who has severe arthritis or a severe knee injury.

You'll usually be in hospital for 3 to 5 days, but recovery times can vary.

How do I recover from my total knee replacement?

Phase I – Immediate Post-Surgical Phase (Day 0-3): In general, length of stay duration after TKR surgery is decreasing.

Once you're able to be discharged, your hospital will give you advice about looking after your knee at home. You'll need to use a frame or crutches at first and a physiotherapist will teach you exercises to help strengthen your knee.

Phase II – Motion Phase (Day 3 – Week 6)

Most people can stop using walking aids around 6 weeks after surgery and start driving after 6 to 8 weeks.

Phase III – Intermediate phase (week 7-12)

Return to most functional activities and begin light recreational activities (i.e. walking, pool program)

Phase IV -

Phase IV – Advanced strengthening and higher-level function stage (week 12-16): Goals: • Return to appropriate recreational sports / activities as indicated • Enhance strength, endurance and proprioception as needed for activities of daily living and recreational activities. It is usually estimated that it will take at least 4-6 months for the patient to feel as though he or she has completely returned to a pre-injury level of activity. Some cases may take as long as 9-12 months to make a full recovery. A very small amount of people will continue to have some pain up to 2 years post surgery.




Back/Lumbar Operations


LUMBAR LAMINECTOMY / DISKECTOMY / FUSION POST-SURGICAL REHABILITATION PROTOCOL

Will I have pain after my surgery?

You may have some pain after surgery. You will be given painkillers to help with this if you need them. Returning to normal activity and getting your back moving helps with your recovery and can help reduce your pain.

When can I start exercising?

You should start exercising as soon as you can, normally the day after surgery. Below are some exercises to get you started. We recommend you do each exercise 5 times, three times a day.

Alternate knees to chest, crook lying, legs side to side, sitting pelvic tilt, transversus (tummy) in standing, left and right-side bend.

When can I resume normal activities?

You should keep moving after your surgery and return to full activities as soon as possible. When you return home, as well as doing the exercises above, you should gradually increase your fitness and activity levels. At first this may be a little uncomfortable, but as you gradually increase your activities it will become easier. The surgeons say you should avoid lifting anything more than 10 kg for 4-6 weeks after your surgery.

How much can I sit?

We advise that you avoid sitting for too long at first. Get up and walk around so you change position.

Key messages

  • Remain mobile and return to activities as soon as you can after surgery. This produces better pain relief.
  • Returning to normal activities as quickly as possible is generally beneficial. It results in faster recovery and better clinical outcomes.

What Is a Lumbar Laminectomy?

A laminectomy is a procedure which involves removing bone of the vertebrae to allow for more space for the nerves. It relieves pressure on the nerves and decreases symptoms such as numbness, tingling, pain and weakness. Surgery may last approximately 2 to 3 hours. You may be in the hospital for approximately 3 days.

What Is a Lumbar Fusion?

A fusion stabilizes the vertebrae of the spine creating less chance for slippage of the discs. Bone from the iliac crest (hip), local bone from the operative site, allograft bone and other bone may be used as a bone graft. The graft is inserted between the vertebrae and then rods and screws are placed. The bone from the hip often is removed through the same incision leaving the patient with only one incision postoperatively. Surgery may last approximately 4 to 8 hours.

What is a Lumbar Discectomy?

Pain radiation down the legs may be due to a disc bulge or disc herniation. A discectomy is the removal of the piece of disc or the entire disc that is putting pressure on the nerves and causing your leg numbness, tingling, pain or weakness. Surgery may last approximately 2 to 3 hours. You may be in the hospital for as little as 1 night.