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Your personal trainer – the next step towards recovery

by Mark Adshead MCSP

Mark Adshead, Managing Director of Physio2go St. Albans continues his series on joint health and fi tness by exploring the increasingly important role of the personal trainer in achieving optimum recovery from injury, joint repair or replacement surgery. Gideon Josephs, personal trainer at Sopwell House Gym calls on his orthopaedic rehabilitation experience in his work with clients to develop a safe yet effective programme to achieve short and long term fi tness goals.

Great expectations

Irrespective of your age, prowess on the tennis court or golf handicap, if your favourite physical activity or sport has been interrupted by an injury or elective surgery, you want to “be fi xed, get better and get back!” Advances in surgical technique and the design and materials used in joint repair and replacement have provided patients with improved range of motion and stability. This improved technology, coupled with new evidence to support the benefi ts of earlier surgical intervention means that younger and more active individuals are returning to sport and leisure activities sooner and with greater expectations for their recovery. How long it will be before you swing a club or a racket is dependent upon the type of surgery and your personal recovery period; the fi nal word rests with your doctor.

Time lines in recovery

After most orthopaedic surgical procedures requiring an in-hospital stay, patients will receive physiotherapy and instructions to follow after discharge from hospital.

Once you are at home the physical rehabilitation and recovery period can be divided into 3 phases.

The early phase, which is almost always entirely under the supervision of the physiotherapist taking care to liase with the surgeon to follow timelines and prescribed postop orders and protocols. In the initial phase after surgery the physiotherapist will be able to:

• Clarify and/or explain what procedures have been done and answer any follow-up questions the patient may have
• Confi rm that the rate of progress is ‘normal’ and if not be aware of any unusual events and refer back to the surgeon if required.
• Carry out pain management treatments and reduce residual swelling which may be preventing expected range of motion
• Increase mobility through exercise, gait training, massage and manual therapy

Physical recovery after any surgery is gradual. In the initial few days and weeks following orthopaedic surgery there is a measurable improvement in such things as pain, swelling, movement, and depending on the specific surgery, strength and balance. As days turn into weeks many patients believe their recovery has stalled; this is often due to the fact that although they are very gradually improving, specific muscle groups still require additional strength and flexibility to carry out certain tasks. As strength and flexibility returns, and anxiety diminishes, carrying out a task that was just yesterday impossible (putting on socks?!) counts as a giant leap forward.

Once the patient has had the required follow-up appointments with his surgeon and has been given the “ all clear “ to begin a supervised return to more vigorous exercise, the patient is then ready to work with a personal trainer. Physio2go will prepare a personalised summary and a handover sheet for the trainer to assist in the initial assessment and programme plan.

The intermediate phase: During the intermediate phase the patient has begun to exercise in the gym/pool under the supervision of the trainer.

Gideon Josephs, personal trainer at Sopwell House stresses the benefits of receiving a detailed referral letter from a patient’s physiotherapist in order to more fully understand a patient’s operative procedure and recovery to date. “ Once I have that information, I can then discuss with my client their general level of fitness before their operation or injury, assess their current abilities (such as strength or range of motion ), and develop an individualised exercise programme to suit their needs.”

The final phase takes place when the client has worked with the personal trainer and is able to return to their previous activities and sport of choice.

Working with a personal trainer ensures that specific exercises are carried out with the correct techniques; working under the supervision of a qualifi ed trainer reduces the risk of injury and prevents setbacks.

Gideon stresses that timelines are different for every patient, tiredness levels always play a major in training, even more so when an individual is recovering from surgery or illness. “My goal is to enable my client to continue on the road to recovery under direct supervision in a safe environment. “