For over 30 years, I have observed the confusion and frustration of hundreds of athletes during recovery from major orthopedic surgeries. We in the RFV are no stranger to the woes of joint replacements, torn ACLs, meniscal injures, torn rotator cuffs, the list goes on. And while we are fortunate to have the best of the best orthopedic care, there still seems to be a significant gap between what athletes are told about recovery time and the reality of what that actually looks like. We wanted to share what we know from observation, education and personal experience for those undergoing, contemplating or still recovering from surgical procedures.
The most common complaint we hear is, “But the surgeon said … ” and involves promises for a much faster recovery time than the athlete is enduring, like four versus 18 months. Surgeons are not intentionally giving you misinformation as some may believe. The timeline they quote you for your “recovery,” is how long it will take for the tissue/bone/nerves they repaired to heal enough to return to normal life activities. That means drop your kids at school, walk the dog, go to work (at your desk job) and do general life chores. Unfortunately, that does not mean return to sport. Many athletes misinterpret that statement because understandably, they want to get back doing what they love as soon as possible.
The Reality
When you go through a significant orthopedic surgery from trauma or otherwise, there is mild to severe muscle atrophy, loss of range of motion, loss of proprioception, loss of strength and loss of agility. Each of those things takes months and months to rebuild and cannot all be done at once.
Initial Healing
First, the tissue and bone must heal. Pushing too hard too soon will delay that process and even potentially delay healing. Rest and recover, let your body heal.
The Work Begins
Once healed then you can begin to work on recovering range of motion, muscle strength and muscle mass. Once you hit 80% or more of previous strength, it’s time to start layering in more load, complex movements, speed, agility, and the sport performance aspects of recovery. Yes, you can return to a scaled down version of most activities within the mass and strength building phase. However, until you have significant gains, pushing yourself too hard, too soon puts you at risk for re-injuring the surgical limb and also puts you at risk for injuring other limbs. If you return to sport with a movement deficit, you will create compensatory movement patterns, potentially over-stressing other joints above and below surgical location, the back, neck, and the list goes on. This will only cause new pain and new problems—and risking yet another injury.
Dozens of athletes have come to us after being released from PT and they are deeply frustrated. “But I was released and I still don’t feel strong,” they tell us. “I can’t run, and my knee still hurts. What do I do?”
Sadly, PT is covered by insurance for only so long and eventually that coverage runs out. Some PTs are educated in a formula to get you back to daily life, but not to sport. That’s when we come in. We bridge the gap between PT and sport, help with perspective, and provide the support and guidance that is often missing from the medical community during your recovery.
Here are some things we can help athletes manage:
Shift of Perspective
Realistic return to full sport is 18 months to two years from surgical date, depending on the severity of injury/surgery and level of performance desired.
Managing Expectations
Many athletes experience mild to moderate depression during recovery. It’s beneficial for us to recognize the journey is hard and that something you love doing that helps you manage stress has been taken away. And maybe you wrapped your head around an unrealistic time frame, through no fault of your own.
Measured Progression
Through tests of strength, range of motion and agility, we can help you determine when and how to apply certain drills and exercises beyond PT. You may need to revisit these exercises throughout your life. We can help guide you through this progression.
Maintenance
The reality is once you have sustained the trauma of a major surgery it may require a lifetime of work to regain and then maintain the level of performance you are used to.
Age at time of injury/surgery is also a huge factor. Yep there it is again. Age. The body heals more slowly when we are older, and regaining muscle mass and strength and vital balance/agility can be harder. It can all be regained but it may take longer and a bit more diligence and focus to rehabilitate fully.
We have hundreds of athlete success stories: from spiral cord injuries, back fusions, ACL repairs, joint replacements, to rotator cuff repairs and more. Please don’t read this as some sort of overwhelming bummer, but as a dose of reality. If you do need surgery, we can help you manage your expectations and to align your mindset to set you up for success. Talk to friends, reach out to the staff at Ripple Effect, do your own research as you can ahead of time to enhance recovery, and be ready for the journey.
All the best,
The Team at Ripple Effect