2005-02-25 / Columnists

Eye On Physical Therapy

By Dr. Tim Rohrs


While patients are implored to be an active participant in their own health care, it is imperative for them to understand the consequences of their actions. Post surgical patients often come for physical therapy after surgery to relieve pain and swelling, improve their range of motion and strength and ultimately, to return to their prior level of function. I am amazed and perplexed at their lack of respect for their physician’s instructions.

Instructions to wear a sling after rotator cuff repair surgery or wearing a knee brace after ACL reconstruction is serious business. These repaired tissues are vulnerable to stresses placed upon them. Trying to use the joint that had surgery is like trying to build a house on a concrete foundation that is still wet. While muscles may be stitched together, and tendons fastened into bones with screws, it is still no where as strong as it will be in 6 to 8 weeks. Scar tissue formation helps stabilize and reinforce a repaired muscle and tendon. New bone growth and remodeling of the bone must take place to stabilize the screw or plug that was placed in the bone.

Physical therapists are educated to rehabilitate that shoulder or knee to strengthen the muscles and improve motion while AVOIDING placing stress upon the repaired tissue. When the patient decides to return to the gym without clearance, or stop using the sling, or discontinue using the knee brace, they are increasing the chance that the tissue that was repaired will be damaged. When they start doing exercises prescribed by their cousin, “who had the same surgery”, they are playing a game of Russian roulette.

Whether you have been instructed to take an antibiotic for the full ten days or instructed to wear an Air Cast on your ankle, there is a good reason for it.

If you do not understand the reason, please ask. It is better to ask now then to pay the price later.

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