Most people expect to undergo a course of physical therapy after their elbow surgery to help the area recover and to restore normal function, but fewer people are familiar with how they can benefit from working with a physical therapist in anticipation of undergoing the surgery. Many times after we’ve sustained an injury or if we’ve been dealing with symptoms for a long time, we naturally decrease our level of movement and exercise to avoid provoking uncomfortable or painful symptoms. You may have even undergone a period of immobilization in a sling or cast to allow an acute injury to heal. While this choice will most likely accomplish the goal of reducing our symptoms, it doesn’t necessarily put us in the best position for an easy recovery from surgery if pain, stiffness and weakness in the area are present.

If the surgery isn’t an emergency, there are many ways that a physical therapist can help prepare you and your body for the upcoming procedure. It is normal for inflammation, weakness, and stiffness to develop in response to surgery, especially if a period of restricted use or time spent in a cast or sling is required. The better condition the elbow and, let’s face it, your entire arm is in prior to surgery, the easier it is to recover to your normal activity level.

COMMON ELBOW SURGERIES

People undergo elbow surgeries for many different reasons. Sometimes, in the case of acute injuries like a dislocation or a fracture, elbow surgery becomes an emergency. In those cases the focus of physical therapy will be on recovery after the fact. Many other surgeries, however, may happen after a period of conservative care and chronic symptoms. While there are several types of surgeries for the elbow, here is a list of common surgeries that may benefit from a course of prehabilitation:

• Bicep tendon repair
• Ulnar nerve decompression
• Elbow replacement
• Extensor tendon repair
• Arthroscopic debridement
• Total Elbow replacement
• Synovectomy
• Tommy-John Surgery

If you decide to work with a physical therapist to help with preparing for elbow surgery, your entire treatment plan could consist of around 8-20+ different physical therapy sessions that will each last 60-90 minutes. Once you complete your customized physical therapy treatment plan, you will be able to continue to do the prescribed stretches and exercises utilized during your PT sessions yet in the comfort of your own home.

WHAT CAN YOU EXPECT FROM ELBOW SURGERY PREHABILITATION?

My team of therapists will individualize a prehabilitation program just for you, however, there are many elements that are common across different prehabilitation programs. To help you gain a better understanding of what to expect, here is a list of some common goals for elbow surgery prehab:

Set expectations: Having an idea of what to expect after the procedure can ease some of your anxiety and help ensure you have what you need to support your recovery. Getting to know your physical therapist before surgery will help build trust with them when it comes time for post-operative care. They can also advise you on any equipment or modifications to your home that might be necessary, help you understand what kind of help or support you will need from others, and prepare you for how your body may feel after surgery.

Manage pain and inflammation: Pain and inflammation are natural results of injuries. They alert us that we need to protect the injured area and that the body is taking steps to start the healing process. In some cases, however, your surgeon may require that your injury is “quiet”, meaning it can tolerate some stress and activity without causing significant swelling or other symptoms, before they want to operate. If this is the case, or if surgery is delayed for any reason, learning strategies to manage pain and inflammation in the meantime will help you stay comfortable and as active as possible.

Learn how to function with one arm: If you will be leaving the hospital in a cast or sling, learning how to perform some daily tasks with one available arm can be very helpful. Sometimes you don’t realize where you will need assistance until you have tried some of these activities and it is important to have the right support and equipment ahead of time.

Build or maintain strength and flexibility: While the brain knows that surgery is intended to “heal” the injury, the body views the surgical procedure as another injury to the tissues. Though the surgeon may have sewn a torn ligament or repaired your muscle, which will ultimately improve your symptoms and get you moving again, the body will need to heal from the effects of the surgery before that can happen. Maximizing strength and flexibility prior to the surgery can help decrease muscle atrophy and stiffness following the procedure which can ultimately quicken your recovery. Additionally, addressing any impairments in other areas of the body can help you handle the recovery more easily. It is not uncommon for the shoulder, wrist and hand to experience loss of range of motion, stiffness or weakness in response to an elbow injury and getting a head start on addressing these areas is a great idea.

So, if you are looking to get a head start on your recovery and improve the chances of a good surgical outcome, elbow surgery prehabilitation may be right for you. My team of therapists and I would love to stand by you on both sides of the operating table. Call Evolve Physical Therapy to schedule an appointment with one of our physical therapists today.