Physical Therapy for Total Joint Replacements

By: Dr. Brian P. Kinmartin, PT, DPT, MTC, OCS, STC

With a growing population that is continuing to live longer and push the physical demands of their bodies joint replacements, especially of the weight bearing joints are becoming more and more common. For the most part total joint replacements can be performed on any joints of the body, including the hip, knee, ankle, foot, shoulder, elbow, wrist, and fingers with the most common procedures currently being total hip, knee and shoulder replacements.

Once it is determined by your orthopedic surgeon that you are a candidate for a joint replacement your physician may refer you to physical therapy for a preoperative consult. During this consult your physical therapist will discuss the operative procedure, along with any type of preoperative and postoperative management strategies that you should be aware of ensuring the maximal outcome from the procedure is attained.

Following discharge from the hospital, your physician may recommend home physical therapy until you are able to adequately and safely leave the home and attend outpatient physical therapy. Once referred to outpatient therapy, your physician will provide you with a choice of various providers in your geographic area. The most important part of the rehabilitation process in choosing the best therapy provider for you. Your choice of provider should be based upon the facility, education and experience of the staff, and feedback you have received from other patients and family that have had similar procedures and have attended therapy with that provider and at that facility.

Total Hip Replacement

Total Knee Replacement

Total Shoulder Replacement

While attending therapy your therapist will be working with you hands on every session to regain range of motion (ROM) and strength while using modalities and manual techniques to control pain and swelling. Depending on the type of joint replacement you have had as your ROM and strength progresses your therapist will be gradually returning you to your previous functional activities. For lower extremity replacements including total hip and knee replacements this will include transfer training, gait training gradually progressing you off of any assistive device you may of needed following surgery, returning you to normal walking activities which include going up and down stairs. For upper extremity replacements, the most common being the total shoulder, this would include gradually returning to overhead reaching activities as strength and motion permits.

In preparing for the duration of time you should set aside prior to returning to your previous activities following joint replacements, the general trend for outpatient therapy following lower extremity total joint replacements is roughly six to eight weeks, for upper extremity replacements in particular the shoulder the duration tends to be a little longer simply because the shoulder is a much more complex joint and has more planes of movement to rehab. You should allow twelve to sixteen weeks of outpatient physical therapy following total shoulder replacement.

The most important aspect of your rehab is that you are comfortable with your provider, their level of service, and that you maintain constant contact periodically with your physician. Your therapist will send progress notes to your physician indicating your functional level and progression, most likely prior to your scheduled follow up visits. Jointly then they will decide based upon your overall progress and functional return when your rehab is completed.

Professional Rehabilitation Services is a Private Outpatient Physical Therapy Practice with two locations: Pawleys Island, South Carolina and Myrtle Beach, South Carolina. For more information on this topic or to schedule an appointment before or after your joint replacement surgery please contact Dr. Brian Kinmartin, PT, DPT, MTC, OCS, STC, at our Pawleys Island office at 843-235-0200, or Richard Owens, PT, MS, OCS, Cert. SMT at our Myrtle Beach office at 843-831-0163, or visit us at: www.prsrehabservices.com