Early advice after surgery Archives - The Hernia Clinic

The Rehab Program for Return to Sport

Mr Rob Hicks — Thu, 06 Apr 2023 12:00:25 +0000

If you are keen to return to sport or want to maximise your recovery and take this as an opportunity to improve your strength and condition after surgery then we would encourage you to work with a physiotherapist after surgery.

Your Rehab program should be criteria driven.

This means that you only progress through the phases of exercises if there is no pain reaction to the previous work or morning stiffness the next day. This process typically takes 3 weeks. Hernias are sometimes accompanied by other issues which require attention and this may well slow the process of recovery.

Phase 1

Immediately post-op – Unload structures to allow good initial healing
Reduce pain and inflammation

Phase 2

Return to the normal range of movement
Increase muscle strength, power and endurance
Progress proprioception
Mainly gym/home rehab exercise.
Linear movements

Phase 3

Return to normal function for work and sport
Must be pain-free through all ranges of motion
Gym/ Pool/ Field based rehab
Linear and agility work
Sports Specific

Phase 4

Return to full training/sport/work
Must have completed without reaction all activities required of them for their sport/work
Physio Partners with Rob Hicks and the Hernia clinic

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Core stability and conditioning

Mr Rob Hicks — Thu, 06 Apr 2023 11:52:05 +0000

In the ideal world, we like to have seen the patient in the physio clinic before the op to familiarise them with the core / abdominal work that is required of them. The core muscles are essential to stabilise the trunk. After pain and discomfort in this area, they are often weak and poorly controlled. If Core Stability is not restored then a full recovery will not be achieved.

However, as some of the structures involved in the surgery are integral to the core stabilisers you have to be careful not to strain too much too soon. Therefore working under the control of a physiotherapist with knowledge and experience of the surgery is essential.

Once you are past the ‘danger’ period you can return to pilates and gym work under the supervision of the instructors. Your physio will advise when you are ready.

Conditioning

The Rehabilitation process is patient-specific. There is a lot of general work relevant to everyone but the mid and end-phase rehab has to be tailored to the individual and their needs, from the weekend gardener to the elite sportsperson.

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Restoration of normal function

Mr Rob Hicks — Thu, 06 Apr 2023 11:29:09 +0000

The golden rule after surgery is to avoid activities which are painful. Gradually the discomfort after surgery will subside. Ordinarily, you should expect to feel discomfort in the lower abdomen and groin for a few days. This improves quite dramatically allowing you to return to normal daily activities. Initially, we would advise you to walk yourself to recovery. As your confidence increase you can increase the pace and duration of each walk. As you progress you may safely introduce swimming and cycling to your regime.

The rehabilitation process is very carefully laid out from day one to a full return to activities at the end of week 3. Obviously, this is in the case of a simple straightforward hernia. Any added issues will compromise this timescale. Often hernia is accompanied or the cause of other issues which will be allowed to start healing or be treated by the repair of the hernia.

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Scar tissue minimisation

Mr Rob Hicks — Thu, 06 Apr 2023 11:27:21 +0000

Even the smallest wound leaves a scar. It is essential that this scar does not become tight, thereby restricting the range of movements and normal muscle function. You can reduce internal scarring by stretching at an early stage after surgery. This should not be into pain – pulling and tightness are fine but not actual sharp pain. Normal movements help to prevent the scar from becoming too tight and restrictive. Massage directly to the layers of tissue at the site of surgery stops the scar from sticking together.

Use some massage oil or ‘Bio-oil’ to rub along the scar, gradually increasing the amount of pressure on the scar and layers beneath. In the early phase, you will feel a solid ridge under the scar which is part of the natural healing process. With massage, you can reduce this and also reduce the sensitivity of the scar itself.

A physiotherapist can help with this process in the early stages and we would encourage you to contact one of our physio partners to help with this.

It is particularly important for sportsmen to maintain the function of the lower core muscles. Ordinarily, the individual core muscle layers slide across each other during normal movement and it is important to preserve this after surgery.

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