Surgical Prehab and Rehab

Surgical procedures for orthopedic injuries typically involve a follow-up regimen of physical therapy, often both before and after the surgery. This practice, however, is not consistently applied to pelvic surgeries, despite the vital and intricate role of the pelvic floor. Unfortunately, this oversight means that many patients, dissatisfied with ongoing symptoms post-surgery, seek out therapy independently.

The concept of 'prehab' is about enhancing pelvic health prior to operations like prostatectomies or pelvic floor reconstructions. Studies indicate that outcomes improve significantly for patients who receive pelvic floor physical therapy both before and after such surgeries.

Pelvic floor physical therapy is essential both before and after various pelvic surgeries, including:

• Hysterectomy

• Repairs for Pelvic Organ Prolapse, such as cystocele, rectocele, enterocele, urethrocele, and anal prolapse

• Mesh Excision

• Procedures like Hemorrhoidectomy, Fissurectomy, and Sphincterotomy

• Prostatectomy

• Surgical treatment for Endometriosis, including excision and ablation

• Vestibulectomy

• Cesarean Section

• Pudendal Nerve Decompression

• Gender Affirmation Procedures

• Hernia Repairs

Symptoms

• Pelvic discomfort

• Issues with urination, such as urgency, frequent need, hesitancy, weak flow, and incontinence

• Bowel-related problems, including urgency, frequent need, hesitancy, incomplete evacuation, and difficulty in emptying

• Erectile dysfunction

• Discomfort during intercourse

• Sexual dysfunction, including pain or reduced/absent orgasm

• Pain in the abdominal area, spine, hips, and legs

How we can help

Our approach to pelvic floor physical therapy is designed to mitigate musculoskeletal and nervous system issues before surgical procedures. However, if you didn't receive physical therapy before your surgery, we're still equipped to aid your postoperative rehabilitation. Patients generally start physical therapy between six to eight weeks following their surgery. In the initial evaluation, our physical therapist will discuss your medical history, current symptoms, and any changes or persisting issues post-surgery. We'll review your surgical reports and any past diagnoses, focusing on your experiences with pain and functionality. Understanding your journey is crucial to us.

What to expect

At your initial appointment, we will start by taking your medical history, followed by a comprehensive musculoskeletal examination of your pelvic area. This will include assessing your posture, joint alignment, any muscle restrictions or trigger points, the health of your connective tissue, and muscular strength. An internal examination is often part of this process, but it's entirely optional and will only be conducted if you feel completely comfortable with it. This exam is much more relaxed and comfortable compared to a typical ob/gyn/urologist visit, and it provides essential information about your pelvic muscle tone, strength, and coordination. If impairments are found during the exam, the physical therapist can treat the problems with manual therapy techniques resulting in pain relief and improved function. Following the exam, we'll discuss our findings with you and outline a personalized treatment plan aimed at achieving the best results. Most patients start feeling better after their first session and see significant improvement by their third visit.