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Physical Therapy�

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GETTING YOUR BODY READY

Practicing these exercises

will help prepare

your lungs for

after surgery

Deep Breathing & Coughing

Breath in slowly through your nose and fill your lungs as deeply as you can.

Hold that breath in for 8-10 seconds

Push the air out of your lungs with a deep, strong cough or two.

This allows your lungs to get used to working a little more during your recovery.

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Your lungs are very important in the recovery process. Since you will be taking it slow in the beginning of your recovery, your lungs will not be required to work as hard as they might before surgery. We also want your lungs to be as healthy as they can be so starting deep breathing and coughing exercises now will get them used to the workout when you need it. The number of repetitions isn’t as important as the technique and the muscle memory you will be creating.

Take the deepest breath you can through your nose

Hold it for as long as you can up to 8 seconds

Slowly release that breath through your mouth

Coughing will help to clear out anything sitting in your lungs and making it move along

Later we will go over a device that we give you while you are in the hospital to help do this more efficiently, but practicing this at home will be very beneficial in your recovery.

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PLAN FOR YOUR REHABILITATION

Pick an Outpatient Physical Therapy location
Get your home set-up with the adaptive equipment you’ll likely need
Expect to have exercises whether at home or at your therapy site
Prepare yourself to be ready to ask for help (temporarily) after surgery

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Start looking for an outpatient physical therapy clinic you would like to use after surgery.

All of the physical therapy clinics on the Peninsula are familiar with our program and the surgeons preferences for your recovery.

You may decided to choose a clinic that is close to your home, or one that you’ve worked with previously.

If you need help choosing a location, you can reach out to a program coordinator or your surgeon to get some suggestions.

Depending on your provider, a referral will be sent out the week prior to your surgery or immediately upon your discharge from the hospital.

Regardless of when they officially receive it you can call your selected location and give them a heads on as to what procedure you’re having and when.

They may be able to tentatively put you on their schedule before they officially get the referral to secure you a timeslot.

The peninsula has limited skilled nursing facilities to help with rehab so please plan on going home after surgery instead of to a rehabilitation facility.

Patients also tend to heal faster and better in their home environment.

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ADAPTIVE EQUIPMENT

Lending Closets:

Hospice of Central Peninsula:

262-0453

Independent Living Center: 262-6333

CPH Lending Closet:

714-5670

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(EM)

There is some equipment you will need in the first 5 days to 4 weeks post-operatively.

We encourage you to start looking for those items now so you are not rushed to get them and you can make sure the items you get work for you and your home.

While your insurance might cover it, they may choose not to cover something else in the future and you will only need these items for a short period of time.

You can ask family, friends or neighbors or check out the local lending closets.

If it is garage sale season, you can also check those out too.

Must have items:

2 wheeled walker (2 wheels in the front, offers the most stable support in your weakest recovery time);

cane or crutches (lend aid with stairs or might be a transition between a walker and nothing);

toilet seat frame (allows for support getting onto and off the toilet as well as making it so you don’t have as far to go when sitting~ just remove the bucket and place over your toilet);

shower chair or transfer bench (depending on your recovery zone bathroom, which is easiest to get to and what seat might you need while you regain your strength and balance).

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LEG EXERCISES

Start now!
Do these simple exercises
Strengthen arms
Practice with equipment

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PHYSICAL EXPECTATIONS AFTER SURGERY�DAY OF SURGERY

Get out of bed before midnight

Operative leg will be weaker (thigh muscle)
Steps in place
Walk to bedside commode
Walk to the bathroom

Safe transfers in/out of bed

You’ll be tired (first night especially)
You’ll need help to get up

Begin exercises

You have 4-6 weeks to:

Knees- regain your range of motion
Hips- allow your bone to grow strong around your prosthesis

Continue pain management with nursing

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One of our more important goals for you will to be getting out of bed the day you have surgery.

We will make sure that your

vital signs are stable
pain is controlled
spinal anesthesia is wearing off enough that you can feel your feet beneath you.

You will either get out of bed with your nurse or physical therapist for the first time.
How much you “walk” will be decided by your and the person helping you once you are on your feet.
You will either

March in place for a few steps at the side of your bed
Walk to the bedside commode to because you need to go to the bathroom
Walk to the bathroom because you are ambitious and want to get started on this recovery road

Your physical therapist will go over safe transfers in and out of bed so we know you can do it on your own when you go home.
You will start working on those muscle exercises from the beginning of this presentation.

Show off your physical therapist!

Remember that your physical therapist will check with you and your nurse to make sure your pain management is on track and determine a time with you on when they will come work with you.

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PHYSICAL THERAPY DISCHARGE CRITERIA

You need to be able to:

Get yourself up and out of bed with minimal help
Get yourself to places within your recovery zone (about 50-100 ft)
Safely navigate stairs

Know your precautions:

Hips: DON’T FALL and your specific precautions
Knees: DON’T FALL

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PROVIDER DISCHARGE CRITERIA

You need to have:

Adequate pain control
Toleration of regular food and fluids
Stable vital signs
Good results from blood lab values
Satisfactory mobility performance with a walker
A friend or family member to transport you

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Recovery Schedule	2-4 Weeks	4-6 Weeks	6-12 Weeks
Appointment with Surgeon	Yes	Yes	Yes
Outpatient Physical Therapy	2-3 x per week	1-2 x per week	On Your Own
Pain Meds: Opioids and Over the Counter (OTC)	Opioids + OTC	OTC	OTC
Assistive Device	Walker	Cane	Not Needed
Personal Hygiene	Shower Only	Shower Only	Bath/Hot Tub
Driving (as directed by surgeon)	No	No	Yes
Long Car Rides / Air Travel (as directed by surgeon)	No	No	Yes

Post-Operative Recovery Schedule

In the first 2-4 weeks:

You will have a few follow up appointments with your surgeon

Knee replacements and Dr. Innes hip replacements will be going to outpatient physical therapy 2-3 times a week

That frequency will be determined with your, the surgeon and physical therapist

You could be taking prescription and over the counter pain medications

You will more than likely be using your walker

Showers only at this point to help keep your incision protected from infection

There is a strong change you will not be released to drive during this time but your surgeon will go over that with you after surgery as your progress with therapy.

You will want to discuss any long distance car rides with your surgeon and not plan any plane rides.

During weeks 5-6:

You will still have follow up appointments with your surgeon but less frequently

Knees will be going to outpatient physical therapy should be cutting down physical therapy appointments to 1-2 times a week

That frequency will be determined with your, the surgeon and physical therapist

Dr. Reyes hip replacements will be starting physical therapy in this time frame

Prescription pain medications are likely no long needed but over the counter pain medications can still be utilized as needed.

Hopefully you will have transitioned off the walker and move towards a cane if you still need a device

Showers only still to help keep your incision protected from infection as it is still closing

Your surgeon will let you know if driving is allowed yet or not.

You will want to discuss any long distance car rides with your surgeon and not plan any plane rides.

The last phase are weeks 7-12:

You might have a couple of appointments if any at this point.

All outpatient physical therapy appointments should be wrapping up by this time but you still have work to do at home.

Over the counter pain medications can still be utilized as needed.

You should not need any physical aids to help you walk unless you are having issues with the other leg.

You are free to resume all other activities such as swimming, hot tub, baths, driving, long trips and plane rides ☺