PSA from VSA: Set The Tone For Your Rehab

After rehabbing athletes from injuries for a decade+ now there is one thing that stands out; what you do in the beginning really matters.  Especially after surgery, there are plenty of factors that can slow down your recovery.  In this article I will break down a few topics and how our recovery toolkit can address those issues and allow you to progress quicker. 

The first thing most people will notice after surgery (besides pain!) is how swollen their joint is.  Your body doesn’t understand the difference between a well-trained surgeon with a scalpel and a madman with an axe.  It only understands damage.  This increased fluid in your joint has been shown to shut down your muscles which is called arthrogenic inhibition.   The longer your joint is swollen, the longer your muscles stayed turned off.  And as the well-known adage goes: if you don’t use it, you lose it! This increased muscle loss can take extra months to regain towards the middle and end of your rehab, so it makes far more sense to not lose as much in the beginning. 

Another factor in this muscle loss is that before most orthopedic surgeries these days, patients are going to receive a nerve block.  This helps to moderate some of the aforementioned pain that you will have after surgery, but this nerve block also blocks the ability for you to contract your muscles after surgery.  Again, leading to more time where your muscles are shrinking and more you have to recover later.  The sooner we can get these nerves and muscles back “online”, the less muscle you lose.  

The recovery toolkit has two good options that for most surgeries can be used immediately; ice and NMES.  The Hyperice unit can induce what is called focal joint cooling.  Not only will this help reduce the acute inflammation in your joint, but it has been shown to help improve your muscle activation as well.  Less swelling = more muscle action.  This joint cooling can also help reduce your pain before exercise which allows you to do more reps and sets. Yet some patients will still have trouble activating their muscles and that’s where NMES can help. 

Like a car with a bad battery, sometimes all you need is a quick jumpstart.  Neuromuscular Electrical Stimulation (NMES) is a unit that can apply a jumpstart to your muscle through gel pads (electrodes).  This allows you to get a firmer muscle contraction which will keep those muscles from degrading.  Most times patients will perform volitional contractions along with the electrical stimulation to help retrain the brain on how to fire those muscles.  This unit can also be used when watching tv or working on the computer to achieve extra contraction volume.   

Why does all of this matter? For most surgeries the sooner you can get back your strength, the sooner you will be able to do the things you want to do.  Set the tone for your recovery and make your PT happy!