Orthopaedic Rehab Protocols
Doing the right exercises at the right dose at the right time.
There are two stages in the treatment of all orthopaedic injuries or conditions – (1) the restoration of anatomy (ie. healing) and the restoration of physiology (ie. function).
The restoration of anatomy is typically achieved by (1) aligning the injured tissues close enough that they can repair the damage and (2) protecting the site of injury until repair tissue is strong enough to take load again. The length of time that an injured tissue is protected depends on the injured tissue(s), the type of injury and the severity of the injury. Example; a fractured bone that is properly aligned may be protected in a cast for 6-8 weeks until sufficient bone healing exists to allow removal of the cast.
In the event an injury or condition cannot be aligned properly (ie. multiple fragments of fractured bone) or the tissue cannot repair itself (ie. knee osteoarthritis), then surgery may be required to restore or replace anatomy. Orthopaedic surgeons restore anatomy through surgical procedures such as ‘repairs’, ‘reconstructions’, ‘revisions’ and ‘replacements’.
Once adequate healing has taken place, a rehab protocol is initiated to progressively re-load the site of injury without disrupting the repair tissue.
Unfortunately, if a patient initiates activity or exercises prematurely it can damage the repair tissue and cause permanent disability and chronic pain. In the case of a patient who has undergone surgery, premature activity or exercise could ruin any surgical procedure and result in permanent disability and pain. Because of the damage and harm caused by premature activity or load, physiotherapists and surgeons are very strict in writing a rehab protocol that sets a clear time table of what a patient can do at each stage of tissue healing.
Problems can also occur if a patient protects an injured tissue too long without movement. In this situation, it can lead to permanent joint stiffness, severe muscle weakness and permanent disability and pain. For this reason, physiotherapists and surgeons require patients to follow up with them in their clinics to ensure they are meeting their rehab goals on time (ie. range of motion, strength, endurance, etc).
In order to achieve the best possible results, timelines and exercises are typically individualized by physiotherapists and surgeons based on the patient’s presentation.
If you see a physiotherapist for the non-surgical treatment of an orthopaedic injury or condition, they will provide you with a written rehab protocol outlining timelines and exercises.
If you undergo surgery, your surgeon will provide you with a written rehab protocol based on the procedure they performed. The surgeon will ask you to share their protocol with your physiotherapist. Their protocol will tell you when they want you to see them again to ensure you’re on-track and on-schedule with their protocol.
Terry Kane, Orthopaedic Physiotherapist (Calgary, AB, CAN)
The service we provide is to search the internet for non-surgical and surgical protocols that are (1) written by physical therapists or orthopaedic surgeons (2) hosted on websites that are independently owned or operated by the authors or clinical facilities and (3) appear in a pdf format.
We are currently updating our inventory of rehab protocols and invite you to check back.