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Spinal Surgery Hip Replacement Physiotherapy Rehab at The Sogunro Practice in St Albans

Pre and Post Surgery

“I’m scheduled for a knee replacement operation in 12 weeks time and I want to get back to an active lifestyle afterwards”

Rehab exercise after surgery is an established part of recovery that most people are familiar with.

Prehab, which is exercise therapy before surgery, is a relatively new concept that has been shown to improve and accelerate recovery after surgery.

Here at the Sogunro Practice we routinely work with clients at both stages.

Prehab: If you have been scheduled for orthopaedic surgery then the chances are that you decided to undergo surgery because your pain levels had left you unable to exercise or even unable to complete basic activities of daily living. When you decrease everyday activity to this degree then under-used muscles become weaker and the affected joint stiffens. This results in more pain, more dysfunction, and ultimately leaves you in a weakened position post surgery.

Properly targeted prehab involves a combination of condition-specific exercise and musculoskeletal treatments, designed to improve muscle strength and maintain the range of movement in joints in the period before your surgery, aiding a quicker post-operative recovery. Although some clients are able to delay or even occasionally avoid surgery due to the success of their prehab, it’s important to recognise that it isn’t intended as a replacement for surgery but to get you to the best level of fitness in preparation for your surgery. Ideally prehab starts at around 12 weeks before surgery to optimise the benefits, giving you a head start for your post-operative rehab and returning you to your active lifestyle faster.

Rehab: Immediately after your surgery, the consultant and physiotherapist teams at the hospital may provide post-op rehab exercises for the initial healing period, and usually a period of 6-12 weeks is required before you are signed-off to progress to other types of exercise. Continuing with rehab exercise after your medical sign-off is so important to get the best long-term outcome for orthopaedic surgery and to avoid potential future issues. This is because even after the operation site has healed it can take many months for the soft tissues around the site to recover functionality. So for example, 6 weeks after knee replacement surgery, your new knee joint may be secure and functioning well, but the surrounding muscles, tendons and ligaments remain compromised as a result of weakening during the painful pre-operative period and trauma during the surgery. A progressive rehab programme after medical sign-off is designed to strengthen damaged, weakened or disused muscles, restore optimum mobility and flexibility, and establish normal movement patterns and habits.

Applied Pilates – how can we help?

Prehab and rehab programmes must be tailored to fit your specific needs, taking into account the type of surgery, levels of fitness and your personal long-term objectives. It is essential that your instructor understands the nature of your issue and the surgery involved and that only clinically appropriate exercises are used, therefore it’s important to make sure you attend a form of clinical pilates, such as Applied Pilates both to avoid damage and to achieve results. Any generic pilates routine, or classical pilates, or fitness pilates is therefore inappropriate as a tool for prehab or rehab. At the Sogunro Practice we use only condition-specific Applied Pilates exercises that have been clinically tried and tested, and we have years of experience dealing with a wide range of orthopaedic surgeries.

This type of clinical pilates is predominantly found in the 1:1 physiotherapy environment, and so is generally inaccessible outside of a clinical or rehabilitation context. However our unique format, where each client follows their own personalised routine within a small group environment means that Applied Pilates is a cost effective way to achieve both your prehab and rehab goals.

Osteolates and Physiotherapy – how can we help?

When a joint becomes dysfunctional through wear and tear, or due to traumatic damage, the nervous system selectively inhibits some muscles around the joint to avoid pain. The remaining functioning muscles begin to dominate and “guard” the joint, creating more misalignment, increasing instability, pain and dysfunction. We use Osteolates and Physiotherapy soft tissue treatment techniques to redress the imbalance and specifically to increase circulation in the area to reduce pain, to relax tight and guarding muscles, and to activate inhibited muscles.

During the pre-operative prehab period, Osteolates and Physiotherapy treatment techniques additionally help prevent muscles becoming fibrotic (losing their elasticity) and formation of adhesions that can cause long-term chronic issues, months after surgery.

At the post-operative rehab stage, Osteolates and Physiotherapy treatments focus on maximising functionality during the long-term recovery process. Improving circulation around the area accelerates the healing process; scar tissue is re-aligned to prevent chronic restrictions to range of movement; muscles activated and neurological function stimulated to prepare you for full functionality.

Other advice we provide for you

We can assist you to set realistic goals, help you understand the cause of pain and/or dysfunction at each stage, and give you the confidence to keep you moving through pre- and post-operative stages.

The types of orthopaedic surgeries that we work with include:

Shoulder: arthroscopy, anaesthetic/steroid injection, ligament/tendon repair, decompression, joint replacement

Hip: arthroscopy, anaesthetic/steroid injection, labral repair, joint replacement

Knee: arthroscopy, anaesthetic/steroid injection, ligament/tendon repair, joint replacement

Spinal: anaesthetic/steroid injection, fusion, stabilisation, discectomy, disc replacement

Ankle: arthroscopy, ligament repair, joint replacement

Foot: bunion surgery, fracture management

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