Physical And Occupational Therapy

Physical and Occupational Therapy at a Glance

Physical (physiotherapy) and occupational therapy are an integral part of orthopedic health. Both treatment disciplines focus on maximizing or optimizing your level of function while improving/restoring your quality of life. As a non-surgical approach to recovery, occupational and physical therapy target resolving dysfunction. Though both disciplines can be an essential component in pre-operative and/or post-operative care, non surgical conditions may also benefit greatly from physical and occupational therapy intervention.

Basics Tenets of Physical and Occupational Therapy

Orthopedic therapists are trained in the treatment of post-operative orthopedic procedures as well as non surgical conditions such as neck and back pain/pathology, gait dysfunction, arthritis, fractures, sprains/strains, sports injuries, joint dysfunction, hand and upper extremity conditions. Depending on your health problem or the type of surgery you underwent, a physical or occupational therapist may prescribe a customized exercise program following your initial evaluation.

Philosophically, physical and occupational therapy serve to facilitate each individual’s return to function at home and at work within a time-line that is medically appropriate for their condition. The therapist and patient work together to reduce pain, build strength, resolve dysfunction, improve flexibility and restore movement.

In addition to exercise, treatment may include other modalities and therapeutic techniques to expedite recovery. Some of these are:

  • Patient education with proper body mechanics, joint protection techniques and postural correction
  • Joint and soft tissue mobilization
  • Neuromuscular re-education
  • Thermal modalities (moist heat, paraffin dip, diathermy) and cryotherapy
  • Electrical stimulation, ultrasound, cold laser.

An appropriate plan of care is established following your initial assessment. Each individual is involved in establishing appropriate functional goals to work toward which is the foundation from which an effective care plan is built upon. There are multiple variables that are considered when establishing a plan of care and each individual’s recovery may vary depending on these variables. The secret to success with physical and occupational therapy lies within each individual. Your commitment to recovery while following the established care plan should ultimately lead to improvement in function. Your plan of care will very likely include a prescription for therapeutic exercises to be performed at home. This is often an essential component in maintaining gains that are made during the course of care and preventing any regression in function in between treatment sessions. Some of the basic things you may like to know before starting an exercise program are:

1. The initial exercises prescribed may be based on treatment protocols established by the physician and physical or occupational therapist. Some of the initial exercises may be rudimentary and fairly low level but could still result in some delayed onset muscle soreness (DOMS). DOMS is the delayed soreness one might encounter anywhere between 1-3 days following a new exercise or activity and is usually a reflection of the normal physiologic response to stress placed on the musculoskeletal system. This is not a reason to avoid doing these exercises but you should inform your therapist of any and all symptoms encountered in the recovery process, including DOMS.

2. The therapist and physician will determine the appropriate rate of progression with your exercises based on your condition and/or the post-op protocol, tissue healing rates, other underlying health conditions and your physiologic response to the exercises prescribed.

3. If an exercise is causing pain or other unusual symptoms then contact your therapist to discuss whether or not it is appropriate to continue. If you cannot get in touch with your therapist then discontinue that specific exercise until you are able to consult with your therapist.

4. During the early phase of recovery ice and heat may help with some of the soreness, stiffness, swelling, inflammation and or pain encountered as you gradually begin to load and stress the affected body part. Always remember RICE; Rest, Ice, Compression and Elevation. Heat application may be effective in the presence of joint or soft tissue soreness and stiffness while ice is appropriate with pain, swelling and inflammation. Be sure to maintain an open line of communication with your therapist with any symptoms you may be encountering. In the initial phases of recovery we often recommend RICE following your exercises for 15-20 minutes. If ongoing swelling is a problem then we may recommend RICE 2-3 times a day to help manage/minimize the swelling.

5. Do not overdo any of the exercise’s, this may be counterintuitive to recovery. More is not necessarily better in the recovery process. Balancing rest and activity/exercise should eventually leads to a successful recovery.

6. Technique and form are crucial with exercise. Most Exercises should be performed with a slow controlled motion. However, some sport specific exercises or work simulation exercises may require a more rapid cadence of motion. Your therapist will help determine which approach is necessary and provide continued analysis and feedback with skilled observation.

With the guidance of your therapist and your commitment to recovery, maximizing your function and quality of life is a very realistic expectation and outcome. The exact duration of recovery may vary with each condition. Your commitment to health and recovery will ultimately lead to your success with physical and occupational therapy.

American Academy of Orthopaedic surgeons