Explaining Your Rehab Time Frames

"How Long Will It Take to Get Better After My Surgery?"

Patients often have unrealistic expectations regarding their rehabilitation prognosis and expected symptoms throughout each stage of the healing process.  I like to use the graph below to help educate patients regarding how long it takes to feel 'normal' post-surgery. While 12 months can seem daunting for many patients, this timeframe is an honest and realistic approach to surgical tissue healing. 

Graph Overview

PHYSICAL THERAPY PHASE (0-3 months)
During the first 12 weeks following trauma or onset of symptoms, patients are generally improving. From a physiological perspective, collagen is maturing, remodeling, and getting stronger. In this stage patients are almost solely attending physical therapy and performing corrective exercises. At the end of 12 weeks, patients likely will feel 60-70% back to their prior level of function. Individuals who perform desk jobs should be back at full duty; more strenuous jobs are still on partial duty.

COMBO GYM + CONTINUED PHYSICAL THERAPY REHAB (3-6 months)
From 3-6 months the patient usually begins their normal gym routine (strength training and cardiovascular exercise) while performing rehabilitation concurrently. I generally think of this phase as someone attending PT 1x/week and performing their gym routine 3-4x/week. In this phase, the individual is starting to feel significantly better, but they have not reached full strength yet. They still have some discomfort (not necessarily pain), and transitional movements, such as getting out of bed and getting up from a chair are still not normal. Ultimately, they still need more work! 

FULL RETURN TO NORMAL ACTIVITY/SPORT (6-12 months)
From 6-12 months, the patient has typically stopped their formal rehabilitation program. They are now performing their normal gym routine and daily activities. The individual continues to progress strength, mobility, flexibility, but now has all the tools needed to be independent. The occasional flare up may occur (especially if a novel training movement is incorporated), but is not anticipated. At the end of the 9-12 months, they should have reached life as usual.

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Closing Points

Many patients do NOT realize how long post-surgery rehabilitation takes. In my active cash-based population, many of my patient's have self proclaimed high pain tolerances and feel better relatively quickly. Despite subjectively feeling strong, practitioners must remember that scar tissue continues to mature and remodel for 2+ years! Strengthening and retraining movement patterns will take months (even after the patient feels better). Reaching 100% pain free and 'normal' activity generally takes longer than someone will anticipate. Being honest and giving appropriate education early on can change a patient's outlook on their condition. Use this graph when educating your patients!
​-Jim Heafner PT, DPT, OCS