I Had Surgery. Why Do I Need Separate Rehabilitation?

Key points in 30 seconds

1. Surgery repairs; rehabilitation makes it usable again.
2. Range of motion shrinks before strength does.
3. While you're protecting it, the way your whole body walks and holds itself changes.
4. When to start is decided by the clinic that did the surgery.
5. If it's swollen, warm, or oozing, the clinic that did the surgery comes first.

What we often hear

• "They say the surgery went well, but it's not like it used to be."
• "No one tells me when I can start moving it."
• "I'm afraid it'll hurt again, so I can't really move it."

I had surgery. Why do I need separate rehabilitation?

Surgery repairs the damaged area; rehabilitation makes that area usable again. Even after repair, if you don't use it, it stiffens, and once it stiffens, it hurts again.

Many people think everything is done once surgery is over. But for a few weeks after surgery, pain makes you move less, and moving less means muscle loss and stiff joints. Once that state sets in, the result is a surgery that went well and a daily life that's still uncomfortable.

What shrinks first?

Range of motion shrinks before strength does. As you stop using the painful side, the far end of the range the joint can reach disappears first.

It's not just the surgical site. If you favor one leg when walking, more weight goes onto the other side, the pelvis tilts, and the lower back tries to make up for it. After just a few weeks, the way your whole body moves has changed.

When do I start?

When to start is decided by the clinic that did the surgery. When it's safe to move depends on the area and the method, and that judgment belongs to the surgeon.

Once the time is approved, we look at three things: regaining the range that has stiffened, building back the muscle that was lost, and undoing the changes to walking and posture that came from protecting the area.

Is it the same for places like the ankle or wrist?

It's the same. In fact, smaller joints stiffen faster. After an ankle injury is immobilized for a few weeks, it's common for the ankle not to bend up and down well afterward.

When the ankle bends less, the knee and pelvis take over that much when you walk. One ankle ends up changing how the whole body walks. That's why we don't look only at the injured spot.

What are the limits of this judgment?

When and how rehabilitation is best done differs by type of surgery, and we don't have the evidence for that.

One more thing. If the surgical site is swollen or warm, the pain suddenly gets worse, or the wound is oozing, the clinic that did the surgery comes first. That check needs to be done before talking about rehabilitation.

We start by sorting out what changed before and after surgery. Only by separating what the surgery fixed from what's still left can we set goals for rehabilitation.

If they say your surgery went well but things aren't like they used to be, come see us. We start by checking what's still left.

How quickly function comes back differs from person to person, depending on the surgical site and how much time has passed.