Physiotherapy and Exercise Physiology for surgery recovery

Here at Embody Movement, we have supported many clients across the Sunshine Coast through post-surgery recovery. The first few weeks and months after surgery can be a time of uncertainty as you regain movement and build confidence to get active again.

We offer a range of services to aid rehabilitation and surgery recovery. Our team of Physiotherapists, Exercise Physiologists and Pilates instructors work together to provide a holistic approach to get you moving.

Embody Movement Exercise Physiologist Elle Bonser and Physiotherapist/Exercise Physiologist Courtney Pointon answer some of your most frequently asked questions about recovering from surgery.

How long should you wait after surgery before beginning an exercise routine?

Elle: Timeframes to return to exercise after surgery vary depending on the type of surgery. Be guided by the information provided by your surgeon. For many types of surgery, you will be encouraged to begin gentle movement such as walking within a couple of days. Unless your surgeon specifies otherwise, Physiotherapy and exercise treatment can commence immediately.

Are Physiotherapy and Exercise Physiology suitable for rehabilitation or should patients go through a hospital-based program first?

Courtney: Patients can commence private Physiotherapy immediately. They do not need to attend hospital-based rehab first or can attend both at the same time. Often private Physiotherapy is more effective than outpatients services as it is tailored to the person’s current level of function and goals.

Elle: Exercise Physiologists are university trained health professionals who will tailor exercise programs following surgery to the needs of the individual client. It is not necessary to go through a hospital-based Exercise Physiology program first as we can communicate with your specialist and meet their post-surgical guidelines.

Should you exercise before or after surgery?

Elle: Both! We call it prehab and rehab. Getting your body strong and ready will help with the post operative recovery and exercising again. You are more likely to keep or improve your physical ability/fitness, reduce complications after surgery and reduce side effects. 

By engaging with exercise before any major surgery that requires rehab, a Physiotherapist and Exercise Physiologist will get you exercise ready for what’s to come and also mentally prepared.  You will together be able to assess for baseline measures to work towards post-surgery and make your recovery more beneficial and goal-orientated.

What are some things that people can do post-surgery to get moving again, before beginning with an exercise program?

Courtney: It depends on the type and complexity of the surgery but generally getting up and walking is expected and gradually increased as tolerated. There are usually other exercises that can be included early on, and these can be discussed prior to surgery so you can get started as soon as you’re ready.

Elle: In addition to taking small walks (depending on the type of surgery), keeping on top of pain relief strategies and swelling management are also key to a fast recovery. Eating and sleeping well will help to improve energy levels.

Is there an ideal post-surgery timeframe for beginning to work with an EP?

Elle: Your specialist will often give you a timeframe for progression that they prefer post-operatively. If your surgery was laparoscopic, see your Exercise Physiologist 2-4 weeks following surgery. If the surgery was more complex, it is best to have clearance from your specialist/ surgeon as to who your first point of call should be, a Physiotherapist or Exercise Physiologist.

Do you need clearance from a doctor or your surgeon first?

Elle: After surgery, you will require a clearance from your specialist prior to engaging in a program with an Exercise Physiologist. If you attend without medical clearance, we will be able to undertake the initial assessment and ask you to provide medical clearance before the next session.

Courtney: For Physiotherapy, it is dependent on the surgery. If you have had an orthopaedic procedure, you do not need a medical clearance as rehabilitation is recommended as standard best practice. This differs for cardiac and neurological surgeries. 

How do you assess if a person is ready to work with you? 

Courtney: A medical and functional assessment is completed by your Physiotherapist to prescribe a treatment plan which best addresses your needs and goals. 

Elle: The only criteria to work with an Exercise Physiologist is that you can move. During the initial assessment, a movement profile is completed to determine what you can and can’t do. If there are movements causing significant and unexplained pains, or if you significantly lack range of movement, we may refer you to our Physiotherapist for treatment.

Where do you start? Physio, Exercise Physiology (EP) or Pilates?

Courtney: Where you start depends on the client and the type of surgery. We generally start with EP or Physiotherapy postoperatively to set you up with a plan for rehabilitation and you may choose to join a Pilates class from there. All patients must undergo a medical screening assessment by our team prior to joining any group exercises classes to ensure they can exercise safely in a group environment.

Elle: If you have any complex musculoskeletal conditions that may need hands-on assessment it is best to see a Physiotherapist first before seeing an Exercise Physiologist as the Physio can guide our treatment once a full assessment is completed. If function is fine and your specialist has given no restrictions on who to see then you can engage with an Exercise Physiologist who will still run through their assessment protocol and create an individualised plan for you moving forward.

Do Physiotherapy, EP and Pilates offer different benefits when it comes to getting moving again after surgery? 

Courtney: Physiotherapy and Exercise Physiology tend to use a one on one approach. Pilates is more likely to be in a group setting. Physiotherapy offers a hands-on approach whereas the other two modalities don’t.

The best thing about working in a multi-disciplinary clinic is that we will work together to make sure you receive the best treatment.  

Elle: An EP will select exercises best suited to you on the day which may include Pilates. One advantage of Pilates equipment is the use of springs for loading the joints. When the muscle is in its relaxed position, the spring is short and unloaded. As the muscle moves into a stronger position, the spring lengthens so is optimally loading the muscle, making it ideal for rehabilitation. Free weights and traditional exercises can also be included to mimic functional movements used in everyday life.

It can be difficult for some people to learn to trust their body again after surgery. Can Pilates and EP assist with this?

Elle: You might find that post surgery your muscles waste, meaning the muscle strength, tone and definition isn’t what it was pre surgery. With this comes the inability to do movements you once thought were simple and therefore trusting yourself to move again safely is a battle you may face. 

Seeing a Physiotherapist will help guide you through safe movement that is appropriate in that phase of recovery and an Exercise Physiologist will help you get back to doing all the functional exercises that help day-to-day tasks easier again. This applies for any age or goal whether that may be just to be able to lift up grandkids or if you’re returning to sport etc. Pilates is a low impact mode of exercise safe for all conditions and level of strength and fitness. An EP will tailor your session to you. 

What should people be aware of in terms of exercising safely as they recover?

Elle: More pain does not equal more gain. It is important that individuals review with a medical professional to ensure they are performing the correct exercises at the right intensity for their stage of recovery and level of function.

It is easy to create compensation patterns when you are in pain. We work with the patient to ensure any compensation strategies are addressed, support the appropriate return to activity and where relevant, prevent a relapse.

Courtney: Depending on your surgery, return to exercise needs to be graded, giving your body time to rebuild strength and movement without aggravating the surgical site. Your Exercise Physiologist will guide you on what is appropriate and when and how to progress both in sessions and independently at home.

Do you have any advice for people tending to overdo it? 

Courtney: A patient self-reported pain scale is a good indicator. A <4/10 pain rating for a 24 hour period is an acceptable level of pain while attempting to rehabilitate an injury. Anything above this requires immediate cessation of the task and review of the exercises performed 24 hours prior.

Pushing through the pain often leads to an increase in swelling and compensation strategies which will slow your road to recovery. Overdoing it frequently results in the participant requiring complete rest for 48 hours and then when you return to exercise, tolerance can be as though you never started. Performing a little bit often allows you to build tolerance over time without suffering the negative effects of overuse.

Elle: Often, people are keen to return to activities that their body may not be ready for yet. It is important to be patient while your body regains the strength and mobility required to complete some tasks.

If you have recently had surgery or have surgery coming up, the Embody Movement team is here to help. Our Physiotherapists, Exercise Physiologists and Pilates instructors in Caloundra and Currimundi work together to ensure you feel supported throughout your recovery, regain movement safely and achieve your goals. Book an initial consultation now by calling 07 5337 9853.

Origianlly published 26 April 2021, revised and updated 30 January 2024.