10 Nov Staying Strong After Surgery/Immobilization
Being stuck in a boot or cast after surgery is no excuse to not move. While it is imperative to protect the integrity of the surgical site and allow for proper tissue healing, we can still maintain the STRENGTH and RANGE OF MOTION of other more proximal and distal joints. This article will cover some of our favorite lower extremity exercises to do while “immobilized” or “non-weight bearing” and keep you staying strong after surgery. As always, check with your orthopedic surgeon and/or physical therapist to determine which motions and exercise are the right ones for you!
Staying STRONG After Surgery – Strength Exercises
You loose 350g of msucle tissue (~10%) and a reduction of 30% of muscle protein synthesis for every 2 weeks you’re immobilized after surgery.
350g of muscle tissue is the size of your heart!! How crazy is that?! Immobilization, bedrest, and being non-weight bearing (not allowed to bear any weight on a given limb) are an absolute recipe for disaster to your bone, joint, and muscle integrity. Typically with many foot/ankle surgeries, surgical precautions include a period of non-weight bearing for as long as 8 weeks. Even worse, some surgeons don’t even send their patients to physical therapy until 4-6 weeks after surgery. That’s over a month in which you’re losing precious muscle mass and your joints are getting stiffer.
Tissue healing after an injury or a surgery is an important concept to understand. Below in our article on tissue healing, you can learn all about this concept and how you can optimize recovery after an injury!
Early Mobility After Surgery
The importance of early mobility after surgical procedures continues to be supported within recent literature. For example, one study showed that individuals who had hip surgery and were bedbound after had a complication rate of 52% whereas patients who were mobilized early had a complication rate of 36%. The study also showed that early mobilization was associated with lower risk of complications, such as deep vein thrombosis, prolonged post operative swelling, muscle atrophy, and decreased cardiovascular endurance.
It can be difficult to rationalize that you are still able to exercise after you have just had surgery, but fear not! There is always a way to stay active within specific precautions that your surgeon has specified for you. For example, just because you may not be able to bear weight throughout your foot after an ankle surgery does not mean you are unable to perform other modes of exercise, such as upper body weight training. Keeping your body as close to its previous level of function prior to a surgery is going to help optimize outcomes throughout the rehabilitation process.
How To Stay Strong After Surgery
Shown in this video above are a host of different strength and conditioning exercises as well as basic stretches to keep your affected limb in check while you are immobilized. These exercises will keep your glutes and quads strong and your lower extremity mobile. Do these exercises (+more) on the unaffected side as well!
Exercises/stretches in order are: Side-lying hip abduction, clams, evil clams, sideplanks, sideplank clams, hip extension, fire hydrants, hip hinges, long arc quads, straight leg raise, hamstring curl, hamstring stretch, hip flexor stretches. You can find detailed explanations and follow along tutorials of all these exercises in our exercise library.
Looking to get a head start on your upcoming knee surgery with some knee prehab?? Get our this beast of an article for exercises you can do now to speed up your recovery!
Foot/Ankle [P]Rehab Program
The Foot & Ankle [P]Rehab Program is a physical therapist developed, step-by-step program that teaches you how to optimize your foot & ankle health. This 3-phase program will expose you to various foot & ankle strengthening and stabilization exercises supported by science. This program will bulletproof this region for anything life throws at you! Learn more HERE!
Regaining Range of Motion After Surgery
There are numerous way to regain knee range of motion prior to or after surgery. When it comes to ACL reconstruction in particular, one of the best indicators for good post-operative outcomes is normalizing range of motion prior to surgery itself. This is why, in addition to allowing swelling to decrease, surgery is usually held off for a bit after someone tears their ACL. Shown in the video below are just some of the many ways we like to gain back knee ROM. In general, we can classify the exercises as either passive, active-assisted, or active range of motion exercises.
- Passive exercises rely simply on gravity to do the ‘stretching’ work. Exercises like supine knee props, bag hands, or seated knee flexion all rely on gravity to stretch the knee.
- Active-assisted exercises incorporate active movement into the exercise, in addition to an external force like gravity, your other leg, or even another person’s body. An example of this is the supine knee flexion against wall exercise. Gravity is pushing Craig’s knee into flexion, while he contracts his hamstring at the same time to add a further stretch to the quads. Note that this exercise and others can easily be made passive if Craig doesn’t contract!
- Active range of motion exercises use the agonist muscle to move into the range. Examples of this are the long arc quad to achieve full knee extension (using quadriceps) or supine heel slide to achieve full knee flexion (hamstrings).
LISTEN: LIVING WELL WITH LYMPHEDEMA
We hope this article has been helpful to you as you are preparing for your surgery/casting, or if you just got out of the surgery room/cast! Even if you aren’t injured, share this article with a friend or loved one who will be getting surgery/casting as it will dramatically affect their outcome for the better. Take some of the principles from this article to enhance your understanding of staying strong after surgery!
Disclaimer – The content here is designed for information & education purposes only and is not intended for medical advice.