Sunday, March 27, 2011

Post Operative Rehabilitation

I am finishing orthopedic surgery this week and thinking back over all the things I have learned. Basically, if it hurts take an anti-inflammatory, when that doesn't work we start poking holes in your joints and if that is no longer helping we fix you surgically. Then you get pain killers, numerous follow up visits and lots of physical therapy.

Bionic Therapy 

I happened to get a sneak peak at patients in therapy and wondered, "who really has time to do rehab anymore?" Every now and then I hear about TENS units as a therapeutic option for pain control and rehabilitation. Once upon a time I came across one and played with it for a few minutes which was rather amusing. Without making any effort at all, the muscle under the pads contract and your body contorts accordingly as if you were signaling the movement. These muscle stimulators take the work out of therapy and let the electricity carry the responsibility. It may not be the best method of recovery, but it is certainly an alternative option. For additional information about LGMedSupply's products visit their online customer blog.

Personally, I feel that physical therapy is designed to be strenuous to muscle to help build tone, resistance, and muscle memory. Getting back into routine activities can be difficult without the proper training and many of the patients we see have mixed feelings about their post-operative therapy. Electrical stimulating devices may be a part of that process, but should not replace the participation in other therapeutic activities. As my use of such devices is limited, I would be interested in hearing your experiences with TENS units and the usefulness of physical therapy.

Question of the Week

A 25 year old active male visits your office after experiencing a twisting injury of his right leg during a soccer match. On exam you palpate and hear clicking when performing a McMurray test. There is a negative Lachman's and posterior drawer test. Varus and valgus stressing shows no laxity of the knee joint. The initial step in management for this patient would be to

A. Immobilization with a leg brace
B. Arthroscopy of the affected joint
C. Prescribe cryotherapy and NSAIDs
D. Obtain an X-ray of the knee
E. Order magnetic resonance imaging of the knee

Answer & Explanation


  1. I had to go into physical therapy a couple winters ago (Nov. '09 through March '10) for lower back pain. The orthopedic wasn't exactly sure what causes my sciatica, but noted a bulging disc, degentrative disc disease and a touch of arthritis.

    I LOVE the TENS. It was almost as good as a massage. It was combined with moist heat and some exercises the physical therapist assistant gave me (all either types of Pilates or inspired by Pilates).

    Pilates mostly consists of flexion and extension exercises, concentrating mostly on the body's core. I recommend it for anyone to help prevent injuries and improve muscle strength and flexibility. I continue to practice Pilates to help keep my back strong and my disc in place.

  2. That's great to hear Beth. Did you have to purchase the unit or just use it during therapy? Are you still using it for your back pain?

  3. Hi, JBatt: (Sorry I'm late in responding. Just now rechecking this post.)

    I used the TEMS during therapy with moist heat. The physical therapist assistant gave me the pads so I could use them if I were to buy a TEMS, but I understand those to cost $200 or so ... much out of my budget.

    I would love to have one though just in case there's some major pain in the future. But I find with frequent stretching and Pilates, my pain is controlled for the most part.

  4. I work in a physical therapist's office and I've seen all sorts of people come through. Emotion is always a big part of job, you see people who are happy and who are hurting. Its always worth it though when you see them walk out at the end of the day better than when they first walked in.

    The practice has been growing so fast lately that we switched to using emr software to help everyone run more efficiently.

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