Case Study: Darius is a 16-year-old male who plays football at a local high school. In an offensive drill, Darius leaps up to catch a pass and comes down hard on his ankle. His teammates hear a snap. He is helped off the field, where the school's trainer ices the foot and ankle for 20 minutes, then tapes it up. The next day at Tennessee River Orthopedics, Darius and his mother are told after x-rays that Darius sustained a trimalleolar fracture requiring surgery. Outpatient surgery is scheduled at Hardin Medical Center's Surgery Department.
This scenario is not atypical. Many young athletes sustain injuries, some requiring surgery and others not. The scene above could be any number of scenarios, such as Grandpa suffering a stroke; what now? Mrs. Posey's two-year-old daughter has been diagnosed with muscular weakness and doesn't seem to be walking well for her age. How will she improve? People of all ages who undergo surgery, experience orthopedic injuries, or have certain conditions will need rehabilitation and physical therapy (PT). Some may argue that the most important part of recovery begins with PT. The main goal of rehabilitation and PT is to help patients regain function, strength, and mobility, as well as manage pain and prevent complications. The specific approach to rehab and PT will vary depending on the type of surgery, condition, or injury and the individual patient's needs.
Post-Surgery or After an Injury
Pain is a common issue after surgery and soft-tissue injuries. Physical therapists are trained to use manual therapy, special exercises, heat or cold applications, or other modalities to alleviate discomfort and swelling.
Depending on the type of surgery or injury, patients may be encouraged to begin gentle movement and mobility exercises – sometimes within hours post-operative. This early mobilization helps prevent complications like blood clots, reduce stiffness, and promote faster healing. In Darius' case above, patients are not typically weight-bearing for four to six weeks until the bones heal. It may also take longer for ligaments or other soft tissues to heal. At a six-week follow-up, x-rays are taken to assess for bone stability and healing, and provided the bone is healed well, Darius will be able to begin PT, generally for six or more weeks.
Needs Assessment
Determining what a patient needs begins with an assessment and evaluation. Sometimes, the patient's overall health, surgical procedure or injury, and any specific post-operative restrictions or limitations are assessed at the first session or right after surgery. The physical therapist evaluates the range of motion, strength, balance, and functional abilities to create a treatment plan customized for that person.
Treatment Options
As the patient's condition improves, the physical therapist will introduce strengthening exercises that target specific muscle groups to rebuild strength and support the surgical site. These exercises typically involve resistance training, bodyweight movements, and bands and light weights, increasing the intensity and complexity as progress is made. Range of motion exercises restore flexibility and improve joint mobility so the physical therapist will incorporate these activities into each session. This also applies to balance and coordination to prevent falls and improve overall stability.
An essential aspect of PT includes functional training. Activities of daily living, or ADLs, are tasks relevant to the patient's lifestyle or occupation. For example, in Darius' case, he wants to return to playing football. The physical therapist will begin adding dynamic movements so that Darius can run, cut across the field, jump, and, in general, do whatever he needs to do without pain or fear of further injury.
During rehabilitation, patients are educated on proper body mechanics, posture, and movements to avoid strain on the injured area. Home exercises are provided to continue progress outside of formal therapy sessions. In some cases, patients may need ongoing PT or periodic check-ins to manage chronic conditions and ensure continued progress and functional abilities.
Rehabilitation and physical therapy are vital components of the recovery journey after surgery, as they enhance the patient's overall quality of life. The collaboration between the patient, surgeon, and physical therapist is essential to the likelihood of successful post-surgical outcomes.
Rehabilitation Therapy at Hardin Medical Center
HMC Rehabilitation Therapy (located inside the hospital) is a state-of-the-art center that treats adults and children in physical and speech therapy in an outpatient setting. Some of the services offered for adult patients include therapy for sports injuries, back/neck/shoulder/foot injuries and surgeries, carpal tunnel syndrome, arthritis, and stroke rehabilitation, to name a few. Services for pediatric patients include therapy for cerebral palsy, genetic syndromes, developmental delays, fractures, and speech therapies. HMC Rehabilitation Therapy has served the community for more than 70 years!
Case Study Follow-up: Darius' surgery went smoothly. The hard part begins with post-surgical recovery and rehabilitation. Thankfully, Tennessee River Orthopedics works closely with HMC Rehabilitation Therapy or a preferred provider for post-surgery PT. The good news is that Darius will completely recover in time to play his senior year and get back into the game of living life to the fullest.