So, you finally took the plunge and got a knee replacement after years of limping around in pain. The surgery went well, and you were sent home the same day. But the very next morning, there’s a knock at the door. Your physical therapist has arrived to start your recovery – and that’s when the real work begins.
Physical therapy (PT) is prescribed after surgery to help patients regain mobility, manage pain and return to their normal routines. Whether you’ve had a joint replacement, spinal procedure, abdominal surgery or even heart surgery, PT plays a critical role in rehabilitation.
“The primary goal of post-surgical physical therapy is to support healing while restoring function,” said Dr. Marcus Malone, of Vero Elite Rehab and Orthopedic Surgery. “PT typically involves exercises designed to prevent stiffness and scar tissue, improve mobility, and reduce the risk of complications like blood clots.
“Our therapists also give patients the confidence and education to perform their exercises properly at home. I’ve seen patients who didn’t follow through – or did the exercises incorrectly – develop stiffness and scarring that required surgical manipulation, and in some cases, a second surgery.”
Physical therapy typically includes a mix of hands-on techniques, where the therapist moves parts of your body, and active exercises that the patient performs under supervision. It can involve stretching, strength training, massage, and the use of heat or cold therapy.
“A trained physical therapist watches how a patient moves and helps correct their form,” said Michelle Guancione, DPT, a licensed physical therapist with Elite Rehab Therapy. “For example, a patient might walk with a limp and avoid putting weight on their healing leg. While that might feel safer to them, it can slow down recovery. We’re also there to monitor for issues like dizziness or faintness – and we’re trained to intervene if needed.”
Dr. Malone knows firsthand how valuable supervised PT can be. Despite being a daily exerciser and an avid athlete, he did PT after hip surgery – and it may have saved his life.
“During one of my first sessions, I suddenly lost my breath after just a couple minutes on the exercise bike. That was highly unusual for me,” he recalled. “The therapists recognized that something was wrong and got medical help immediately. It turned out to be a pulmonary embolism. Had I been alone at home, I might have brushed it off – and I wouldn’t be here today.”
Monitoring wounds is another crucial part of a therapist’s job.
“Sometimes the Steri-Strips come off early and the wound opens slightly, which can lead to infection,” Guancione said. “We’re trained to spot those issues and consult the surgeon if needed.”
Although everyone heals at a different pace, research shows that starting PT early typically leads to better outcomes. A study published in the Journal of Orthopedic and Sports Physical Therapy found that patients who began therapy within 24 hours after total hip or knee replacement had improved recovery and were less likely to need extended inpatient rehabilitation.
Key benefits of post-surgical physical therapy:
1. Faster recovery and return to daily activities: PT prevents the loss of strength and flexibility that comes from extended bed rest, helping patients resume walking, working or enjoying hobbies more quickly.
2. Pain management without drugs: Manual therapy, targeted exercises, and tools like heat, ice or electrical stimulation can reduce the need for opioids and other pain medications.
3. Lower risk of complications: Moving early and safely helps prevent complications such as blood clots, pneumonia and muscle wasting. A 2013 study in Chest found that early mobilization significantly reduces post-surgical pulmonary issues.
4. Prevention of scar tissue and stiffness: Gentle stretching and guided movement can help reduce the formation of scar tissue and adhesions that limit mobility.
5. Psychological benefits: Regaining independence through physical activity can lift mood and reduce the risk of post-surgical depression.
Types of physical therapy:
PT may be provided on an inpatient or outpatient basis, depending on the surgery’s complexity and the patient’s overall condition.
“There are two main types of physical therapy rehab,” explained Dr. Malone. “Acute inpatient rehab is done in a hospital or long-term facility. It’s for patients who live alone or aren’t strong enough to get around safely at home – even with help. They typically receive three hours of therapy a day, five days a week.
“Outpatient rehab is for those who are well enough to go home. They’ll visit a rehab center a few times a week for hour-long sessions and learn how to safely continue exercises at home.”
The length of time someone needs PT varies. Some recover in just a few weeks; others may need several months. Each program is personalized to help patients reach specific mobility goals.
Therapists use outcome measurement tools to assess patient function, assign a score or risk level, and tailor treatment accordingly. These assessments are repeated throughout recovery to track progress and adjust therapy as needed.
While PT offers many benefits, it’s not without risks – especially if exercises are done incorrectly or too aggressively. Improper technique or pushing too hard too soon can lead to setbacks, delayed healing or even injury.
“Some patients are so motivated that they overdo it,” said Guancione. “We might start with two sets of 10 exercises, and they decide to do five sets on their own. They come in the next day swollen and sore. They think they’re helping their recovery, but they’re actually setting it back.
Just because you feel mentally ready doesn’t mean the tissue under the incision is healed.”
Physical therapy is a powerful tool in post-surgical recovery – supporting faster healing, greater mobility, and a lower risk of complications. But it’s not a passive or risk-free process. Successful outcomes depend on starting at the right time, following a personalized plan, and working closely with a skilled physical therapist.
Dr. Marcus Malone is a board-certified physical medicine and rehabilitation specialist. He earned his medical degree at Saint Matthew’s University School of Medicine in Grand Cayman, Cayman Islands, and completed his internship in family medicine at the University of Virginia in Charlottesville. His residency in physical medicine and rehabilitation was completed at Marianjoy Rehabilitation Hospital in Wheaton, Illinois. His office is located at Vero Elite Rehab & Orthopedic Surgery, 787 37th St. Suite 200, Vero Beach. Call 772-798-7808 for an appointment.
