Post Operative Advice

This week I have spent quite a bit of time with clients who are back home following surgery or other treatment and needing more support than the NHS can offer.
It seems (in the areas I cover) that with reduction in health service budgets there is less funding for post operative physio and follow up care.
For the clients I have seen this week my input has been invaluable and I feel that I have made a real difference to their recovery time.

The first client is recovering from a hip replacement. The prescribed exercises were hard to follow as his leg was extremely swollen. Following a discussion covering the recovery to date I assessed that it was appropriate to try Manual Lymphatic Drainage to see if the swelling was due to excess fluid. This was successful and enabled the client to resume the exercise programme.

The second client is undergoing chemotherapy as a preventative measure post abdominal surgery.  He was keen to start exercising again and to prevent joints becoming stiff through inactivity.  I took this client through an exercise programme to loosen all the main joints and encourage circulation.  The aim in this case is to do enough exercise to give a benefit but without tiring the client too much.  This will be an on going programme throughout the chemotherapy treatment and the exercise will vary depending on the clients level of energy.

The third client was referred to me by a local GP.  The client was suffering from back pain which had no specific cause.  An MRI scan showed the average wear and tear to be expected by a person in their 50’s but no structural damage.  I assessed the biomechanic function of the pelvis and tested the muscle activation achieved through movement.  As a result of these results I prescribed three simple exercises to try at home and suggested regular attendance at one of my small ‘SELECT’ classes where individual care is given in a class setting.

Many conditions can be helped by specific exercise or massage therapy so do consider this when looking for solutions to pain or for help in recovery from illness and surgery.


Fit for what? An event or for life in general?

Are you aiming to be Fit for a specific event? Fit because it’s good for you?  OR, Fit so you can be active for the whole of your life?

It’s a question I have found myself pondering for a long while and one which has changed my approach to fitness in recent years.

There are several reasons that lead people to join a gym or a class and a several more that prevent people from keeping it up on a permanent basis. To benefit from exercise it must be for life, not just for a few months or in the ‘post-Christmas diet’ weeks.

The question then is what type of exercise can you keep up on a permanent basis? The answer to that question depends on your aim. If you are booked to run a marathon the exercise should be a specific programme ensuring you are in the best physical shape for that event. If you feel that being fit is ‘good for you’ give some thought to exactly what you mean by that phrase. Do you mean keeping your heart healthy, keeping muscles toned, controlling weight gain or simply an all over general fitness? Or would you like to give your body the best chance of keeping you active for the whole of your life?

In recent years I have changed my approach to exercise. I have undertaken extensive training to help those with back pain, arthritis, restricted mobility and other chronic conditions continue to exercise. The results have been amazing and for some life changing. It has made me realise that an exercise programme which aims to keep you active for the whole of your life can be easy to follow and enjoyable as well as beneficial. It is not looking to get you to a high level of fitness where there is a risk of injury. It is not offering any exercises which put unnecessary strain on the joints. It is simply keeping your body in the optimum condition possible while taking account of its current state.

Many of my clients walk, cycle, ride, look after children or are simply busy. In this way they already get a reasonable amount of cardiovascular work. It may be at a low level but it’s done on a regular basis week in week out. What I offer is a complimenting exercise programme to enable them to lead an active life for the rest of their lives.

Key aims are:
Keeping joints mobile
Correcting muscle imbalances
Building a strong core
Maintaining a healthy back
Preventing the deterioration of balance
Ensuring muscles can stretch to optimum lengths.

To take part in a this type of class you won’t need gym clothing and you probably won’t get hot and sweaty. You will benefit from feeling that your body moves more freely, your back aches less, your joints have more range and you will feel more stable when you take part in other activities or sports. You will also benefit from the shared knowledge of what to expect as your body gets older and what you can do to keep reduce the effect of aging process on muscles joints and bones.

Remember that this is general advice. If you have a specific condition I recommend that you book a one to one session first so I can assess the best way to help you.


Post Mastectomy Exercise

‘Following a mastectomy for breast cancer I was given a series of post operative exercises to ensure I regained my arm and shoulder movement. The exerises were helpful but two of them I found particularly difficult to do. I was really struggling and becoming quite dispondent. I returned to my Pilates session two weeks after my operation and Anne came up with great alternative exercises. My arm and shoulder movement continues to improve and I have never looked back.’

I received this feedback from a client recently and it made me wonder how many other people are in a similar situation.
As a physical therapist I have an excellent knowledge of the muscular structure of the body and how it moves. My advice comes from experience I have gained working with clients, assessing what movement they need to regain and how best to achieve it. The results I have seen have been brilliant and I would like to share the most sucessful exercises with other readers. I am not a medical expert so If you are unsure about trying out new exercises do check with your specialist first.

Exercises following breast surgery are essential for the following reasons:
Increasing your range of movement which will be reduced following surgery.
Reducing arm and shoulder stiffness which can lead to aches and pain as well as postural imbalance.
Reducing the risk of lymphoedema by encouraging the lymphatic system to work properly.

You will be given advice regarding starting your exercise programme following surgery and it is important to follow the guidelines you are given. This is likely to involve a small amount of exercise 3 or 4 times a day. Muscles will waste if they are not used, this will cause weakness and stiffness. Surgery often reduces the range of movement and the only way to regain this is stretching exercises.


Shoulder shrugs and lifts: Gently lift and lower each shoulder, circle each shoulder back feeling for maximum movement on each movement.

The Mouse: Lie on the floor on your side with the operated side uppermost. Put the top hand (elbow bent) on the floor in front of you, ‘creep’ the hand along the floor towards your head, and eventually past your head. Return to start position and repeat x 10. This can replace the ‘walking up the wall’ exercise.

The Shoulder stretch: Kneel on the floor with your hands on the floor in front of you. Move your weight forwards onto your hands and walk them away a few inches in front of you. Leaving your hands where they are gently ease your weight back to your knees, then move forward again. Repeat x 10.

The Hand Skate: From the same kneeling position put your hands as wide as you can. Gently move your weight from side to side. This will stretch the area also stretched by the ‘side-on to the wall walk’. Repeat x 10

If you are planning to try out any of these exercises do get in touch with me if there are any parts you don’t understand, or if you sucessfully complete these exercises and would like progressions. Do check with your physio if you have continued stiffness or pain.


The client I worked with on the exercises in this article is now almost five months post op. She has continued with her weekly exercise sessions throughout chemotherapy treatment and although tired comments that the exercise has helped her to feel better.  With the exercise and a couple of sport massages she has achieved full range of movement from her arm and shoulder.  This is an amazing result and I am incredibly proud of her achievement.