At the time of this writing (9/25/21), I am 53 years old and have had two hip replacements, one in 2017 and one in 2018. The physical therapy (PT) for each was one week of in-home PT starting the week following the surgery, followed by one to two months outpatient PT. After my first hip replacement, because of a scheduling delay, I could not start outpatient physical therapy until four weeks after my surgery; therefore, I would have 2 weeks of “nothing” in between my in-home PT and outpatient PT. For me this was unacceptable because of the necessary tissue remodeling involved at that crucial stage. Two weeks of inactivity that soon after surgery could have lasting implications on my long-term recovery, and I knew this. So, I took the concepts I was given by the in-home physical therapist and added exercises I knew to be helpful applying sound exercise science principles and progressions. I genuinely designed my own physical therapy program. Now, I don’t suggest this for someone who does not have my background and qualifications, but inactivity is possibly just as bad as overdoing it. So, I did my PT on my own for two weeks before I was able to actually see the outpatient physical therapists (which again, I do not recommend for someone who does not have the background and experience I do). I might have advised someone who does not have my education and experience level with exercise, to get professional help for the two-week gap. Or, at the very least, continue to do the prescribed exercises for your in-home physical therapy until the outpatient therapy begins. However, in this case, I started to design my own system using applied principles of corrective exercise and rehabilitation science that I had learned over the years. As I waited for my outpatient physical therapy to begin, the therapeutic workouts I had put together for myself seemed to be going well. These included bodyweight exercises, light resistance training, mobility and flexibility, and included some exercise in the pool.
After the two weeks went by, time had come to go to the outpatient physical therapy office for the first session. I showed the therapists what I had been doing. I also explained that I was a trainer and strength and conditioning coach and had a master’s degree in exercise science, with a concentration in performance enhancement and injury prevention. After explaining and demonstrating what I had been doing, they then said to me, “You don’t really need us… you’re doing great on your own… you are weeks ahead of where most people would be… call us if you think you need help.” But please note from my story… even with my education and experience, I fully planned to attend, and comply with, the physical therapy program that the professional therapists planned for me. So again, don’t try to go it alone. They gave me the go-ahead to continue on my own, and if they had not, I would have continued therapy with them.
So, at that point, I continued with my physical therapy, and two months went by. I had been doing a better and more diligent job on my physical therapy than would usually be the case for someone working with a physical therapist. The average person working with an outpatient physical therapist would not have seen the same progress. Still, at the end of the two months, I realized I was far from genuinely recovered, even considering that I was probably way ahead of where most people would be. After all, do you sincerely think for one second that myself or anyone else is back to normal after surgery just because two months of physical therapy is over? That would be a ridiculous notion. This situation is not a yes or no/on or off one. It is a progression. So, this only confirmed what I had already known from dealing with injury rehabilitation in the past (my own and my clients and athletes); when medically prescribed physical therapy ends, there is still a massive gap to getting back to 100% function. Therefore, a training plan that takes a person from the post-physical therapy stage back to 100% function is necessary.
If you are interested in ongoing post-surgery or post-injury recovery programs to bridge the gap between physical therapy and optimal performance, click here)