Orthopedic physiotherapy – comprehensive rehabilitation before and after musculoskeletal surgery

Preoperative physiotherapy – preparing the body for surgery

Preoperative rehabilitation, or prehabilitation, plays a key role in orthopedic care. Main goals include:

• improving muscle strength and flexibility,
• increasing joint range of motion,
• optimizing movement patterns,
• patient education on exercise and prevention,
• reducing postoperative complication risk,
• shortening recovery time.

A well-designed prehabilitation program improves surgical outcomes and speeds tissue healing.

Postoperative physiotherapy – an individualized path back to fitness

Each stage of postoperative rehabilitation should match the type of procedure, extent of tissue damage, patient age, activity level, and comorbidities. Depending on the joint operated on, the program differs in scope and intensity.

Physiotherapy after hip surgery (e.g. arthroplasty)

Rehabilitation after total hip replacement (THR) focuses on:

• reducing swelling and postoperative pain,
• early upright mobilization and gait re-education with elbow crutches,
• rebuilding strength of gluteals, rotators, and hip flexors,
• re-educating a correct gait pattern,
• preventing prosthesis dislocation (depending on surgical approach – anterior, posterior, lateral).

Later stages include resisted exercises, core stability training, and functional training elements.

Physiotherapy after knee surgery (e.g. ACL reconstruction, TKA)

After knee procedures such as arthroscopy, anterior cruciate ligament (ACL) reconstruction, meniscectomy, or total knee arthroplasty (TKA), physiotherapy focuses on:

• restoring range of motion (especially extension and flexion),
• reducing joint effusion,
• activating the quadriceps and hamstring group,
• learning to walk without compensations,
• proprioception and dynamic knee stability training,
• progressive loading according to the surgical protocol.

Functional rehabilitation includes plyometrics, sports conditioning, and injury recurrence prevention.

Physiotherapy after ankle and foot surgery

After arthroscopic procedures, ligament reconstructions (e.g. ATFL, CFL), osteotomy, or ankle arthrodesis, physiotherapy includes:

• swelling and pain control,
• gait re-education after immobilization (e.g. brace, cast),
• exercises to improve ankle mobility (plantarflexion and dorsiflexion),
• strengthening peroneal, calf, and foot muscles,
• balance and proprioception training,
• dynamic and functional exercises, including return to sport.

Physiotherapy after shoulder surgery

For shoulder procedures (e.g. arthroscopy, rotator cuff repair, anterior stabilization, arthroplasty), the program must match the operation:

• protective phase: avoiding movements that could stress repaired structures,
• gradual increase in shoulder range (passive then active mobilization),
• strengthening rotator cuff and scapular muscles,
• scapulohumeral rhythm re-education,
• improved neuromuscular control of the shoulder girdle.

The end goal is full upper limb function in daily and occupational tasks.

Physiotherapy after elbow surgery

After arthroscopic procedures, osteosynthesis, or elbow ligament reconstructions, care includes:

• manual therapy to restore range (especially extension and supination),
• soft tissue mobilization to reduce scar tissue and adhesions,
• resisted exercises for flexors, extensors, and rotators,
• proprioception and upper limb coordination work.

Physiotherapy after wrist and hand procedures

Surgery on the wrist and hand (e.g. fracture fixation, tendon repair, carpal tunnel release) requires:

• precise manual therapy and tendon gliding mobilization,
• edema reduction with lymphatic drainage and kinesiotaping,
• restoring grip strength and fine motor control,
• use of adjunct tools (e.g. cross-friction massage, dynamic splinting),
• ergonomic advice and overload prevention.

Trauma physiotherapy (sprains, fractures, dislocations)

Post-trauma rehabilitation includes:

• care after immobilization (restoring range and strength),
• eliminating movement compensations,
• gait or upper limb pattern re-education,
• stability and balance training,
• preventing secondary injuries and reinjury.

Physiotherapy after spinal trauma

After injuries (e.g. compression fractures, instability, surgical fixation), rehabilitation aims to:

• stabilize the affected segment (deep muscle – core stability work),
• reduce pain and improve posture,
• re-educate neuromuscular control of the spine,
• soft tissue mobilization and neuromobilization,
• gradual return to daily and work activities.

Why choose specialist orthopedic physiotherapy?

Professional orthopedic physiotherapy:

• shortens recovery time,
• reduces complication risk,
• speeds return to physical activity