Orthopedics focuses on the musculoskeletal system. Learn about the diagnosis, treatment, and rehabilitation of bone, joint, ligament, and muscle conditions.
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Rehabilitation after minimally invasive surgery is often accelerated compared to open surgery, but “accelerated” does not mean “unrestricted.” The small incisions can be deceptive; there is still significant healing happening inside. The goal of rehab is to restore motion and strength while respecting the biological healing timelines of the repaired tissues.
Because there is less pain, patients are often tempted to do too much too soon. A specialized physical therapist guides this process, ensuring that the patient pushes the limits of motion without pulling apart the repair.
The focus is on “functional” recovery—retraining movement patterns and balance (proprioception) so the patient can return to sport or work safer and stronger than before.
Even though the incision is healed in a week, a tendon repair to bone takes 12 weeks to anchor securely. A ligament graft takes months to vascularize and mature.
Rehab phases are based on these biological milestones. Phase 1 protects the repair. Phase 2 restores motion. Phase 3 builds strength. Skipping phases because the knee “feels good” is a common cause of graft failure.
Synovial fluid nourishes the joint cartilage. Movement pumps this fluid around. Early passive motion (moving the joint without using the muscles) prevents scar tissue and feeds the cartilage.
For shoulders, this means using pulleys or the other arm to lift the surgical arm. For knees, it involves heel slides or riding a stationary bike with no resistance. Keeping the joint moving is critical for a good outcome.
After knee surgery, the quadriceps muscle often shuts down (arthrogenic inhibition). It “forgets” how to fire due to swelling and pain.
Immediate rehab focuses on “quad sets”—squeezing the muscle to wake it up. Neuromuscular Electrical Stimulation (NMES) uses sticky pads to shock the muscle into contracting, helping the brain reconnect with the muscle fibers.
Surgery disrupts the tiny nerves in the joint that tell your brain where your limb is in space (proprioception). Without this, you are clumsy and at risk of re injury.
Balance exercises are key. Standing on one leg, using a wobble board, or closing your eyes while balancing forces the brain to rely on the joint sensors again. This retrains the automatic stabilizing reflexes.
The extremity is connected to the core. A weak core or weak hips put extra stress on the knees and ankles. Modern rehab treats the “kinetic chain,” not just the surgical site.
Strengthening the glutes and core takes pressure off a repaired ACL or meniscus. It improves overall mechanics and athletic performance.
Even small scars can have adhesions underneath. Once the wounds are fully healed, scar massage helps keep the tissue pliable.
Therapists use manual techniques to mobilize the soft tissue, ensuring the skin glides freely over the underlying fascia. This prevents the feeling of tightness or pulling during movement.
Water is an excellent rehab tool. The buoyancy reduces gravity, allowing patients to walk or move the arm with less weight and stress on the repair.
The warmth of the water relaxes muscles, and the hydrostatic pressure helps push out swelling. Once incisions are fully closed, pool therapy is often a favorite phase of recovery for patients.
BFR is a cutting edge rehab technique. A tourniquet is placed on the limb to partially restrict blood flow while doing low weight exercises.
This tricks the body into thinking it is lifting heavy weights, triggering a massive release of growth hormone and muscle building signals without the mechanical stress of heavy loads. It builds muscle rapidly while protecting the joint.
You don’t go from the couch to the soccer field. The final phase mimics the demands of the sport. This involves agility drills, cutting, jumping, and throwing programs.
Return to sport tests measure strength, balance, and confidence. A patient must pass these objective criteria—not just time on the calendar—before being cleared for competition.
Recovery takes energy. A diet high in protein provides the building blocks for tissue repair. Vitamin C and Collagen supplements may help tendon healing.
Sleep is when the body releases the hormones that repair tissue. Poor sleep slows recovery and increases pain sensitivity. Prioritizing rest is as important as doing the exercises.
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Stiffness, or “gelling,” is common after surgery. While you sleep, fluid settles in the tissue and the joint capsule tightens up. It usually loosens up after a few minutes of movement or a warm shower. This morning stiffness gradually disappears as the inflammation resolves fully over months.
Discomfort and muscle soreness are normal; sharp, stabbing pain is not. Therapy should stretch you and work you, but it should not harm the repair. Communicate with your therapist. If it hurts the “surgery spot,” back off. If it’s just muscle burn, push through.
Ice is your best friend for the first few weeks to control surgical pain. After that, ice is used after therapy or exercise to control the inflammation caused by the activity. Many athletes continue to ice after workouts for months to keep the joint quiet.
Visible swelling goes down in a few weeks, but deep swelling inside the joint can fluctuate for 4 to 6 months. It is the last thing to normalize. If you have a busy day on your feet, expect a little swelling that night; it’s a sign of the joint’s endurance limit.
Yes, mostly by doing too much too soon. If you run before the bone is healed or lift heavy before the tendon is anchored, you can pull it apart. The hardware is strong, but biology is slow. Respect the restrictions your surgeon gives you.
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