Tim Turner, PT, at Rehabilitation Works, views rehabilitation as a type of restoration process that restores a person to function. He noted that rehab is thought of most often as neurologically-involved patients with a spinal cord injury or a stroke going to a rehab unit. “But in all reality rehabilitation is any type of process or assistance that we give an individual who is not functioning at what we would consider a normal or optimal level,” Turner says. “From a pitcher in baseball to a grandmother who fell down and broke her hip.”
Today more arthroscopic and laparoscopic surgeries are being performed than ever before, and although they cannot replace open surgeries for certain conditions, they dramatically affect rehabilitation. “It significantly decreases the recovery time,” Turner remarks. “You don’t have wasting of the muscles because of prolonged immobility when you had an open surgery. You also don’t have the fluid build-up that you did when you had an open surgery because you don’t cut as many capillaries or veins so you don’t interfere with the normal fluid flow or circulation.” He said there is less pain as well, so a patient can start rehab sooner with more mobility.
Rehabilitation depends on the type of surgery that was performed. Some patients may have passive range of motion or a period of immobility after surgery, Turner explains. Rehabilitation is different for people who have undergone open surgery. “It’s usually a little bit slower pace,” he says. Open surgery is traditionally much more involved.
Every individual recovers at a different pace, based on certain factors. The length of time of inactivity prior to surgery and how long an individual had the problem are both factors. Turner said if the problem existed for a long time, the person may not have the muscle strength and their walk or gait may have changed. If the problem existed for a shorter period of time and the individual managed to stay relatively active, their recovery would probably be better and quicker.
An aging population has had an effect on the field of rehabilitation. “Personally I’ve seen more active older patients which is kind of nice,” Turner comments. He said people are playing golf and are more physically active at an older age.
Consequently, seniors are experiencing more injuries. “That’s a newer problem,” he says. “The upside is they’re more active longer and I think generally they’re healthier.”
An integral part of successful rehabilitation is working on home exercises, and Turner said everyone in the clinic leaves with an exercise program. “The individual determines how successful their rehabilitation is going to be,” he explains, “and that is how much work and effort they’re willing to put into it. It’s really important that they buy into the fact that even if it was an injury and they were in perfect health before, it’s going to take some effort on their part. A therapist can’t do it for them. I fully believe that if someone does their exercises, I can’t guarantee them that they’ll never have to come back, but the chances of them not coming back are much improved,” he remarked.
Rehabilitation has also been affected by improvements in technology. Turner believes that much of the basics that were done when he left school about 20 years ago haven’t changed, “but the techniques that we apply have been refined,” he says. Arthroscopic surgery versus an open surgery is an example of a technological progress, and that physical therapy has improved recovery. “I think also that we don’t treat patients as cautiously as we used to and that’s a good thing,” he explains. “Hip replacement surgery used to mean a week long hospital stay but today it might be two days. All that is a realization of improved techniques and improved technology,” Turner says. He added there are now places that do open hip replacements as outpatient surgery. As a result, physical therapists like Turner see patients sooner. “We have an opportunity to get going sooner, and the sooner the better,” he says.
