7 minutes reading time
Recently, Shannon Perrine of WTAE Channel 4 News in Pittsburgh featured a story on a patient of ours, Karla White. The focus of the story being Karla's same-day hip replacement surgery. It was a short, yet informative piece on the work of her surgeon and the rehabilitative process with special attention to the factors that played a role in a very successful outcome. If you have not seen the story, head to our Facebook page and check it out. All of our social media links are here on the website. You'll find them at the top of the page.
After the story aired yesterday, I had a number of thoughts that came to mind. Primarily these thoughts centered around how many medical professionals and the general public have a misunderstanding of the training and qualifications of chiropractors and strength & conditioning specialists. Especially as they relate to rehab, be it from injury or surgery. Many may find it unconventional and, at times, silly that one seeks out the professional help of a chiropractor or strength coach for the oversight of their rehabilitation.
Traditionally, once a patient is ready to begin post-surgical rehab, this process is guided by a physical therapist. It’s conventional thought and accepted practice. You have surgery, then you go to physical therapy.
That said, there are post-surgical patients who will seek out a chiropractic rehabilitation specialist to manage their rehabilitation. And, depending upon the setting and patient, strength & conditioning specialists may be involved as well.
Now there may be a few thoughts running through your mind right now. Maybe thoughts such as:
“Wait….chiropractors aren’t qualified to do post-surgical rehab!”
“Why would you use a strength & conditioning specialist for a rehab patient? Those are only for athletes!”
This news story has opened up the opportunity to help educate, so let’s address these questions or concerns.
Are chiropractors qualified for post-surgical rehab?
The reality is, when patients seek a provider for their post-surgical rehab, they may choose to seek a professional who is not a physical therapist. Some may not have the flexibility to make their own decision, but for those patients are looking for the best person for the job and they will exercise their right to make that decision. Regardless of title (PT or DC), patients must be in the hands of a provider who has the professional training and expertise to handle their rehabilitation appropriately. Providers must be competent and efficient for the sake of minimizing post-surgical complications and improving outcomes.
I’ve highlighted this before in previous writings, but my residency truly provided professional training very few chiropractors ever receive. During my 3+ year residency, I managed or co-managed numerous spinal, shoulder, hand/wrist, hip, knee, and foot/ankle post-surgical rehabilitation programs. Our department at Palmer College of Chiropractic worked with local orthopedic and neuro surgeons to co-manage routine as well as highly complicated surgical cases within the Quad City area. Meaning, we saw everything from athletic injuries to total joint replacements.
I don’t stress this to simply pump my own tires, but to convey to our audience that I’m not new to post-surgical rehabilitation and there are chiropractors out there that have similar training and expertise as well. We don’t exist on the level of physical therapists nor are we claiming to be physical therapists. Physical therapists have their own unique training and skill set. The ones I know do outstanding work for their patients.
The point I’m trying to make is that it is possible for chiropractors to have a background in functional and post-surgical rehabilitation. These chiropractic rehabilitation specialists are qualified and are capable of successful post-surgical rehab outcomes.
What is the value of Strength & Conditioning during post-surgical rehab?
For all those that want to be evidence-based, exercise and strength training literally helps more musculoskeletal conditions that all other treatments. The same can be said of post-surgical rehab as it is all about regaining range of motion, strength, and functional capacity. If you have the privilege of having a knowledgeable and qualified strength & conditioning specialist in your corner, they will provide enormous value to the post-surgical recovery process.
Yes, the involvement of strength coaches may be more commonly used in the athletic world, within the collegiate, professional and international ranks. But, when available in the private sector, they add an immense advantage as the rehabilitative process is very time sensitive and it’s critically important no time is wasted. The more quickly a post-surgical patient can regain adequate strength and movement quality through gradual exposure to the functional demands of strength training, the more quickly they are able to return to their activities of daily living, job, or sport with confidence and minimal complication.
Strength coaches are experts in what almost all musculoskeletal conditions will benefit from: exercise and strength training. Keep in mind, they must have the appropriate qualifications. Not all strength coaches are created equal and those that are capable of being involved with a post-surgical patient are rare. I can't stress that enough. These professionals understand their role and the best results are seen when they work together with the rehabilitation specialist to ensure ideal outcomes for the patient.
Post-Surgical Rehab Success is All About Team
The success of the post-surgical rehab program is not solely dependent upon any one specific individual involved in the process. Successful post-surgical outcomes take on a team dynamic. In this case, the surgeon, rehabilitation specialist, strength & conditioning specialist, and patient all had critical roles.
For Karla, she had a tremendous orthopedic surgeon in Dr. Julius Huebner. Due to a congenital condition and progressively worsening degenerative joint changes to the left hip, Karla underwent direct anterior approach total hip replacement in late May 2016. This surgical approach is essentially a “surgical strike” as described by Dr. Huebner in the video. His surgical procedure resulted in no damage to adjacent tissues and structures. The procedure was a precise as you can get, enabling same-day hip replacement surgery and a faster recovery.
The Rehabilitation and Strength & Conditioning Specialists
In preparation for her surgery, she worked with the team at Gallagher Performance during the months prior to her surgery to improve her post-surgical rehab outcomes. Her pre-surgery rehab program enabled Karla to remain as functional as possible during that time. Pre-surgical rehab programs are never easy and quite challenging. However, Karla is a tremendous patient who demonstrated nothing but commitment and patience, knowing that the work she did prior to surgery meant having that much less to do post-surgery.
Likewise, during the course of her post-surgical rehab program, Karla worked one-on-one with either myself or Ryan. I managed the early phases of her rehabilitation recovery, implementing manual therapy and exercise. This continued as she progressed to more strength training focus in her rehab. That's when Head Performance Coach, Ryan Gallagher, designed and implemented her strength & conditioning program. The collaborative focus was on developing ideal movement patterns to spare her joints, thus improving the health and relative function of her legs, hips and spine. Exercise selection and progressions were based on post-surgical guidelines, tolerances, and functional capacity all while ensuring adequate strength and movement control were demonstrated.
As for Karla, she was the ideal patient. She was compliant and motivated throughout the entire process. Karla loves to be active and workout, which only added to her motivation. A motivated patient is so refreshing to work with for countless reasons. The rehabilitative process can be frustrating at times, with obstacles and ups-and-down marking the road. As challenging as rehab can be physically, rehab can be even more challenging mentally. To her credit, Karla was always willing to work, even when she was frustrated or progress was slow. She always worked hard and focused on the little details. It’s because of her attitude that she demonstrated and her drive to regain the quality of life she desired that she is where she is today.
The combined team effort was the key to the success of this post-surgical rehab story. This theme must be present to ensure a patient has the outcomes they desire. It’s a privilege to be involved, providing our services to complement the team effort required during the post-surgical process as we recognize our role in the rehabilitative process. We thank Dr. Huebner for his medical expertise, Karla for being outstanding to work with, and WTAE’s Shannon Perrine for her excellent coverage of the story.
At Gallagher Performance, our focus is on developing the resilience of our clients and patients. We are committed to utilizing cutting-edge, patient-focused progressions to help every individual we work with not only achieve but also exceed their goals. With our extensive training and knowledge in chiropractic, manual therapy, sports injuries, rehabilitation, and performance-based training, we work with all individuals who are interested in living healthy, active, and pain-free lives.
More related reading: