Izzi Ord-Kinnear, Physiotherapist (Palmyra clinic)
Surgery can be quite a scary thing to go through, and knowing what to expect straight afterwards can help make recovery feel a little less daunting. Understanding when to see a physiotherapist after surgery and what to expect at that first appointment can help you feel more prepared and in control of what happens next.
Every recovery is different, but there are some common questions and milestones that apply to many types of surgery. In this article, I’ll walk you through the process of post-operative physiotherapy, from when to book your first appointment to what happens during your session and how your physio can support your recovery. This applies to most orthopaedic surgeries, from knees, hips and shoulders through to ankles, wrists and spines.
When To See A Physio After Surgery
This is probably the question I get asked the most in clinic, and the honest answer is: it depends on the surgery and what your goals are. Generally, we like to see people between days 3 and 14 post-operative.
For some surgeries, like knee replacements or ACL reconstructions, coming in earlier is really helpful. Getting the knee straight and the quads working again on can makes a big difference down the track. A prompt physio session is also a good idea if you’re struggling to move around comfortably on crutches, have a lot of swelling, or have a goal like getting back to work or sport as soon as it’s safe to do so.
For other surgeries, closer to the 14 day mark is sufficient. This might be the case if your surgeon wants the area protected in a sling, brace or boot for a period of time, or if you have a wound review with them around 10-14 days.
I would suggest 14 days as the latest for that first appointment. The early weeks are where we can make the biggest difference with stiffness and swelling, and also with how confident you feel getting moving again. (If you’re feeling unsure, you can always give us a call and we can talk it through).
What to bring to your appointment
It’s really helpful if you can bring along:
- Your surgeon’s referral or operation notes
- Any rehab protocol your surgeon has provided
- Your brace, sling, boot or crutches
- A list of any medications you’re taking
- Comfortable clothes so we can see the area (shorts for knees and hips, a singlet for shoulders)
I also recommend writing down any questions you have beforehand. It’s very easy to forget once you’re in the appointment, especially when you’re tired and a bit sore.
What happens in the first few appointments
The first appointment
This is all about getting to know you and understanding where you’re at. We’ll have a chat about your surgery, how you’ve been since, and most importantly what you want to get back to. Whether that’s walking the dog, getting back to work or playing sport, your goals will guide the plan.
We then check how everything is settling, including pain, swelling and the wound area itself. We may take some gentle measurements of your movement and strength, and have a look at how you’re walking or using the limb. These give us a starting point so we can track your progress over time.
We also go discuss the practical things that often get missed, like how to use your crutches properly, how to get in and out of bed or the car, and how to wear your brace or sling correctly. You’ll leave with a few simple exercises to do at home and a clear idea of what the next few weeks will look like.
The next few appointments
The following few sessions are where you’ll start to notice progress. Depending on your surgery, we’ll work on getting your movement back within your surgeon’s limits, switching the muscles back on (the quads after knee surgery are a classic example), managing pain and swelling, and getting you walking and doing everyday tasks more normally.
We will keep progressing your home exercises as you’re ready. Early on, we usually see people once or twice a week, then space appointments out as you become more independent.
Does physiotherapy after surgery hurt?
There may be some discomfort, as your body has been through a lot and moving a joint after surgery can feel stiff and a bit strange at first. But post-op rehab isn’t about pushing through pain – we work within your surgeon’s guidelines and at a pace that suits you.
As a general guide, some mild soreness during or after your exercises that settles within a few hours or by the next morning is normal. While sharp pain, or pain that keeps getting worse and is still there the next day is something to let us know about.
It’s also completely normal to feel nervous about moving after surgery. Part of our job is helping you build your confidence back up.
The road ahead
Every recovery is different, but most follow a similar pattern:
- Protect: letting the tissues heal, managing pain and swelling, and following any brace or weight-bearing restrictions.
- Move: getting your range of motion back and walking or using the limb more normally.
- Strengthen: rebuilding the strength and control around the joint.
- Return: getting back to work, the gym, sport or whatever activity is important to you.
One thing I tell my patients is that feeling better doesn’t always mean you’re ready. Pain usually settles well before your strength comes back, so it’s really important to keep going with your rehab even once things start to feel fine.
Working with your surgeon
We work closely with surgeons and follow their protocols, so you can feel confident we’re all on the same page. If your surgeon has given you specific restrictions, we’ll build your rehab around them and keep them updated if anything comes up.
Most recoveries go smoothly, but please contact your surgeon, GP or the hospital if you notice any of the following:
- Calf pain, swelling, warmth or redness in your leg
- Shortness of breath or chest pain (call 000)
- Fever, chills or feeling generally unwell
- A wound that is red, hot, oozing or opening up
- A sudden increase in pain or loss of movement, especially after a fall
- New numbness, pins and needles or weakness
If you’re ever unsure whether something is normal, we’re just a phone call away. There’s no such thing as a silly question after surgery.
What you can do at home
Most of your recovery actually happens between your appointments. Doing your exercises little and often, managing swelling (elevation, and ice if your surgeon is happy with it), getting good sleep and eating well all make a big difference. Also try to be patient with yourself – recovery isn’t always a straight line.
Common questions
When can I drive again? This depends on the type of surgery, which side it was on, and whether you can safely do an emergency stop. Your surgeon needs to give you the all clear, and it’s a good idea to check with your car insurer as well. We can help you work out when you’re physically ready.
When can I go back to work? This really depends on what you do. Some people with desk jobs are back within a week or two, while physical jobs can take a lot longer. We can help you plan a gradual return to work.
How many sessions will I need? It varies a lot between surgeries and people. Smaller procedures might only need a handful of sessions, while bigger surgeries usually involve regular appointments over a few months. We’ll give you a better idea after your first appointment.
Final thoughts
Post-op rehab is one of my favourite parts of my job. Seeing someone come in on crutches, nervous to even bend their knee, and then a few months later getting back to the things they love is so rewarding. It isn’t always a smooth process, but with the right plan and support physio after surgery is certainly worth it.
If you have an upcoming surgery scheduled or have recently had an operation, we would love to help you through it. Feel free to book in or give us a call if you have any questions.
