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Apart from the specific instructions given to you depending on the type of surgery you have undergone, the basic general instructions that you should follow after your surgery are as follows:

  • Take pain relieving and other medications as advised. Pain relieving medication should be taken with food. After the first 48 hours of surgery, take the pain medication only when needed.
  • Do not drink alcohol, drive a vehicle, operate any machinery or sign a legal document for the first 24 hours after the surgery as the effects of the sedative and/or the anesthesia administered during the surgery may last for the first 24 hours of the surgery.
  • Use ice packs to control swelling. However, make sure that the ice bag does not leak into the dressing. Ice packs can be used liberally for the first 48 hours and even later, if required.
  • Follow the specific restriction of activity, as advised. Remember that it is easier to prevent developing pain rather than managing it once it has already developed. Rest for a few days after the surgery and keep the operated extremity elevated, above the level of your heart, to control swelling.
  • Keep the dressing clean and dry to promote wound healing.
  • Try to begin physical therapy a day or two after the surgery. Exercises in the first week are usually aimed at regaining joint motion. Strengthening exercises are initiated later. Regular exercises are critical for a successful outcome.
  • Eat a healthy diet and drink plenty of non-alcoholic and non-caffeinated drinks.
  • Schedule your follow-up appointment with your doctor as advised.

Please consult your doctor immediately if you experience any of the following symptoms:

  • Increased drainage from the incision
  • Increased redness around the operated area
  • Increased swelling that does not decrease with ice and elevation
  • Foul odour
  • Fever greater than 101°F
  • Coldness, numbness or blanched white or bluish colour of the fingers or toes
  • Sudden calf pain or shortness of breath
  • Chest pain

Physical Therapy:

  1. For the vast majority of Dr. Rainer's patients, formal, in-office physical therapy following joint replacement is NOT required. However, this does not mean that physical therapy itself is not required.
  2. You should follow the general activity instructions above for a basic outline of how therapy should be performed within your specific limitations.
  3. Always keep in mind that everyone's recovery is different, this is NOT a race, and a slow steady pace to recovery is much more desirable than something rushed that leads to a complication.
  4. The number one, most important therapy you can and absolutely should do as frequent as possible is walking. This can not be emphasized enough. From day one, you should walk every 1-2 hours that you are awake for at least a short walk to the bathroom, to the kitchen, or a short lap around the house. Continue this frequency throughout your recovery and as your strength and endurance improves, increase the distance, ideally getting to a total of 1-3 miles of daily walking by the 3 month mark postoperatively.
  5. In addition, as you are able emphasis can be placed on the following three things, performed 1-2 times daily as tolerated:
    • Joint specific range of motion, strength and stabilization
    • Gait and sit to stand mechanics
    • Core Strengthening
  6. For range of motion, strength and stabilization, you should work on heel slides and straight leg raises while lying on your back and side lying hip and knee flexion and extension exercises. If you feel as though you need more resistance, 1-3 pound ankle weights may be added during straight leg raise exercises AFTER at least 3 weeks. Eventually body weight squats can be cautiously added when you feel your strength and range of motion permit. No weighted squats, unless instructed otherwise, for at least 3 months following surgery.
  7. For gait and sit to stand mechanics, you should focus on walking without a limp, including the use of a gait aid until no longer needed. You should focus on keeping your head up and your eyes out in front of you rather than watching your feet while you walk. The simple act of getting in and out of a chair is another exercise that can both improve your core strength, range of motion and balance. Until you are done with your walker, begin with going from sitting in the chair to standing at the walker and then back down to the chair. As you are able, add in a few steps after standing, away from and then circling back to the chair, to increase the exercise and gait therapy.
  8. For core strengthening, walking and sit to stand exercises are essential and the majority of what should be done. In addition, you can add hip abduction exercises (first standing at the counter and lifting your straightened leg out to the side, and then advancing to doing the exercise while lying on the opposite side lifting your leg in the air when your strength is sufficient), wall sits, planks, and both leg straight leg raises - these are relatively advanced, NOT required, but available if you feel as though you are progressing and would like to do more.
  9. If you have questions about any of the above exercises, please call for clarification.
  10. Lastly, if at your 3 week visit, or at any point in your recovery, you are struggling with your strength, range of motion or gait, and having a formal physical therapy evaluation would benefit you we will happily set you up with an appointment. If you feel as though you would prefer this regardless, please call and discuss this or bring it up at your 3 week postop visit so that we can arrange appropriately.

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Grand Junction, CO 81505-USA


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