People with musculoskeletal pain resort to a “quick fix” solution to alleviate them of their agony. An acute or even a long standing musculoskeletal pain, especially after trauma, can be treated conservatively through protection by splinting the part, rest, ice application, therapeutic exercises and electromodalities available in a physical therapy centre. It is sometimes unfortunate that a person in pain has to undergo surgical intervention when his condition fails to respond to the conservative treatments previously administered. At present, advances in orthopedic surgeries have made the procedure an easier way to fix a condition when pain continues to be unresponsive to the conservative treatment. Physical therapy plays an important role in the faster improvement of symptoms, may it be non surgical or a after a surgical procedure.
C.K. was a patient of mine for post operative physical therapy rehabilitation for a left hip replacement. He had been previously fitted with an internal fixation for a fracture of the left femur. However due to nonunion of the fracture due to failure of the internal fixation device, the head of the femur suffered significant wear. Subsequently, the patient underwent a total left hip replacement procedure. Complicating his post surgical recovery was his history of poliomyelitis. This lower motor neuron disease had severely affected his left leg’s musculature especially its strength. Intensive physical therapy which concentrated on therapeutic exercises targeting the hip stabilizers was emphasized during the treatment. But due to the complications of poliomyelitis, the muscle paresis around the hip joint had made the treatment very challenging. After being able to complete long term physical therapy rehabilitation, he was able to return back to his functional capability. In any given physical therapy rehabilitation treatment, patients compliance to the exercise protocol, both in the rehabilitation centre and as a home exercise program is the key element that points to the success of any rehabilitation program.
An ideal physical therapy rehabilitation especially when a surgical procedure is being considered, involves patient’s education before the surgery, after surgery with a direct physical therapy intervention and a long term self management through home exercise program carried on by the patient after discharge from physical therapy.