Can exercise help to avoid surgery?
When an injury occurs - your amazing body can heal itself. It is designed to protect itself (PAIN!!) so that it can heal. Often the only thing that gets in the way of this healing is us and our busy lives. If we take the time to pace ourselves and listen to our bodies, have the rest or the movement it requires to improve – we can recover from just about any injury. Sometimes it does need a little help to be told what it should avoid, what it should slow down on, but movement almost always helps pain levels settle down.
Research has shown that what an x-ray or MRI finds often doesn’t correlate with symptoms – you can have the worst MRI in the world: full of disc bulges and pinched nerves, but suffer no pain or disability, and vice versa – you can have the most horrible pain and there be no findings on a scan. This means that people can function 100% and pain-free with big meniscal / cartilage tears, no ACL, multi nerve compression or missing half their rotator cuff muscles. Therefore, how relevant is what they find on the scan to your specific case?
Sometimes the symptoms and scans do correlate and unless symptoms are extreme and unbearable, majority of the time conservative management (physiotherapy / exercise rehab) will have the same long-term outcome as surgery – with less scar tissue and less overall money spent. Strengthening up the weak muscles around a painful knee, helps to settle the pain and avoid a knee arthroscopy. Doing rehab prior to back surgery can avoid the back surgery altogether as the muscles strengthen and support the inflamed areas to let it heal itself. And as we get older – ‘degeneration’ in all joints become the norm – 85% of 80-year old’s have degeneration in the spine. Degeneration is like wrinkles – it occurs to everyone as we age, varying to a degree amount and location, but the pain has more to do with the physical state of everything around it than any present degeneration.
If surgery is required, gentle exercise before surgery is the best way to ensure everything is in the best shape going in to the operation, which in turn gets you back on your feet quicker and shortens your recovery time. Rehabilitation after surgery of course helps get everything back to normal as quickly and safely as possible, minimising long term issues of scar tissue, stiffness, swelling, weakness and pain.
Managing your load is the most difficult but crucial part of this – not doing too much or too little – start with an activity you like, work out how much you can do without being ‘stirred up’ all day and do this with a gradual increase each day. Physiotherapy helps you manage your activity levels, giving you specific parameters to work between and prescribing specific exercises that help to improve pain and activity levels, to minimise ‘flare ups’ as well as recurrence of pain. Whether it is pre-hab, post-operative or to avoid surgery, physio and exercise can help to improve joints, muscles, nerve sensitivity, ligaments and tendons