Introduction
You’ve had your surgery. Now what? Many patients believe surgery alone solves the problem. The truth is: surgery removes the problem; physiotherapy restores function. Post-operative physiotherapy is not optional – it’s essential. At Medicare Hospital, our in-house physiotherapy department offers specialized post-operative rehabilitation programs.
| Key Statistics |
| Patients who participate in structured rehabilitation after orthopedic surgery have 40% faster return to daily activities, 50% fewer complications, and 30% better long-term functional outcomes. |
Why Post-Operative Physiotherapy Is Crucial
Without physiotherapy, you risk:
- Joint stiffness (arthrofibrosis) – permanent loss of motion requiring manipulation under anesthesia
- Muscle atrophy – weakness that never fully resolves
- Abnormal gait – limping becomes a habit, affecting hips and back
- Blood clots (DVT) – from immobility
- Poor surgical outcome – even perfect surgery fails without rehab
Our Diagnostics & Physiotherapy team works closely with surgical specialists across all our services to ensure seamless, coordinated care.
The Science: Phases of Physiotherapy
| Phase | Timeframe | Focus |
| Phase 1: Inflammation Control | Days 0-7 | Ice, elevation, ankle pumps, gentle range of motion, quad sets |
| Phase 2: Regaining Motion | Weeks 1-6 | Passive to active-assisted to active motion, stretching |
| Phase 3: Strengthening | Weeks 4-12 | Isometrics, closed-chain exercises, resistance bands and light weights |
| Phase 4: Functional Training | Months 3-6 | Balance, gait training, stair climbing, sport-specific drills |
Surgery-Specific Rehabilitation Protocols
1. After Total Knee Replacement (TKR)
Following your knee replacement surgery, rehabilitation begins the day after surgery:
- Week 1-2: Ankle pumps, quad sets, heel slides, walking with walker. Goal: 0-90 degrees flexion
- Week 3-6: Stationary bike, straight leg raises, mini squats, transition to cane. Goal: 100-115 degrees
- Week 7-12: Leg press, step-ups, outdoor walking, balance exercises. Goal: 115-125 degrees
- Months 4-6: Resistance training, elliptical, return to golf and doubles tennis
2. After Total Hip Replacement (THR)
Precautions vary by approach type for hip replacement. Posterior approach: no bending >90 degrees, no crossing legs.
- Week 1-2: Ankle pumps, quad sets, walking with walker, pain control
- Week 3-6: Standing hip abduction, transition to cane, normalize gait without limp
- Week 7-12: Stationary bike, leg press, balance training, return to driving and swimming
3. After ACL Reconstruction
Following arthroscopic ACL surgery:
- Phase 1 (Weeks 0-2): Brace locked, toe-touch with crutches, quad sets, ankle pumps
- Phase 2 (Weeks 2-6): Stationary bike, mini squats, wean off crutches
- Phase 3 (Weeks 6-12): Leg press, step-ups, balance exercises, begin jogging (week 10-12)
- Phase 4-5 (Months 3-9): Agility drills, plyometrics, return-to-sport testing
4. After Rotator Cuff Repair
- Phase 1 (Weeks 0-6): Sling, pendulum exercises, NO active shoulder abduction or forward flexion
- Phase 2 (Weeks 6-12): Remove sling, active-assisted motion, pulley exercises
- Phase 3 (Months 3-6): Theraband resistance, scapular strengthening, light weights
- Phase 4 (Months 6-9): Overhead activities, light sports, full return at 9-12 months for heavy lifting
Essential Post-Op Exercises
| Exercise | How to Do | Frequency |
| Ankle pumps | Point toes toward nose, then away | Every hour while awake |
| Quad sets | Tighten thigh muscle, push knee down into bed | 10 reps, hold 5 sec, 3x daily |
| Heel slides | Lying on back, slide heel toward buttocks | 10 reps, 3x daily |
| Straight leg raise | Tighten quad, lift leg 6-8 inches | 10 reps, 2x daily |
| Standing knee bends | Stand holding support, bend knee behind | 10 reps, 3x daily |
| Mini squats | Stand, bend knees 30 degrees, keep back straight | 10 reps, 2x daily |
| Step-ups | Step onto low stool (2-4 inches) | 10 reps, 2x daily |
Working with Your Physiotherapist
What a good physiotherapist does:
- Assesses your specific deficits (range of motion, strength, gait)
- Designs an individualized program (not generic handouts)
- Progresses exercises appropriately (not too fast, not too slow)
- Manages pain and swelling (ice, modalities)
- Educates you on precautions and home program
| Common Concern: Does It Hurt to Exercise? |
| Normal: Muscle soreness, stretching sensation, mild ache (2-4/10 pain). Not normal: Sharp, stabbing pain or pain that worsens after exercise. Take pain medication 30-60 minutes before therapy. Use ice after. |
Conclusion
Post-operative physiotherapy is an essential component of successful surgery. At Medicare Hospital, our Diagnostics & Physiotherapy department offers specialized post-operative rehabilitation programs working closely with our surgical team.
Frequently Asked Questions
Q: How long after surgery before I start physiotherapy?
A: Usually the day after surgery (in the hospital) or within the first week for outpatient physiotherapy.
Q: Can I do physiotherapy at home?
A: You need both clinic sessions and home exercises. Clinic sessions provide skilled assessment and manual therapy. Home exercises reinforce your progress. Minimum recommended: 2-3 clinic visits weekly for first 6 weeks, plus daily home program (20-30 minutes).
Q: How long does each physiotherapy session last?
A: 30-60 minutes, depending on the phase of recovery.
Q: Can I overdo physiotherapy?
A: Yes. If you have increased swelling, night pain, or pain lasting more than 2 hours after exercise, scale back and inform your therapist.