Returning to exercise post injury or surgery

Common questions we get asked, when can I return, what can I do, what should I avoid, do I need physio?

We always want you to get back to exercise as quickly as possible, however we need to respect the healing times of different injuries. We also need to consider different starting points, and then set realistic goals. It is not uncommon for a person post surgery to ask “Will I run again”, my question often is “did you run before?” So what is important, is your starting point, the surgery you have had, the expected recovery, if there are nay specific precautions we need to comply with, and of course what your unique goals are.

For most injuries there may be a period of time where there is time off from a sport. Exercise is often about routine, so if injured, keeping up with a routine is important. If you have now had surgery and have not exercised in months or possibly years, starting a routine is important.

Stages of returning to exercise post time off.

  1. reestablishing the habit. So if you went to gym, or walked regularly, of went to a pilates class etc, it may be returning to those things even if in a modified form
  2. Assessing where you are currently. One would not start back at gym, if still not coping with a day at work etc.
  3. respect phase of healing. Optimally load for where you are in the healing phase. In the beginning this often means doing less (even if you can do more), and towards the end of healing, this may mean doing more, sometimes more than what you did pre-injury to make you stronger and injury proof. You need to know where you are.
  4. if not exercised in 4 weeks consider that a long time off, and you need to take it slow coming back
  5. Do what you planned to do, and assess how you are over a 24hour period. If you feel good, you can notch it up a bit. If you feel sore, it is easier to drop back. If you do more just because you feel good at the time, it is difficult to establish the starting point, as often you have flared up, and we now need to start more cautiously.
  6. Consider your general health before surgery/ injury and anything else that may need to be addressed.

For those who like a little tech and working with heart rate monitors I do like Phil Maffetone and the 180 Formula  and the MAF test. It is a nice controlled way to return to exercise post injury. If you had fallen into a category of over training and that is potentially why you are injured, the formula will help you come back from injury. If you are quite unfit and need to start with activity, your heart rate will hold you back, and prevent you from getting injured.

It is also good to assess how you got to where you are in the first place. Some of us are boom and busters (do too much- boom, then so exhausted we need to take time off to recover- bust), we could be weekend warriors (pushing ourselves on the weekend and then nothing during the week), persevere-rs (even though in pain, keep pushing on), and some of us just haven’t done anything in ages- weeks, months and years and think we can start where we left off.

We often get asked ” is physio necessary?”. And the answer is it depends. I often think of physio’s as coaches, you may be very familiar around a gym and your sport, but this is perhaps your first injury- perhaps what we offer in that moment is the information you need, and reassurance for where you are- hold back a little now, looks like you can push a little more, yes this is normal for where you are right now. We often say “we treat many people with injury x, but this is your first injury x”

Perhaps your injury or reason for surgery was a wake up call, you haven’t done exercise for ages and now you would like to get back, we can help too. Perhaps you may need more sessions, more assistance with the exercises because exercise is unfamiliar territory and you don’t know where to start.

Our roles as physios is to assess where you are at right now, understand your injury, understand where you have come from and partner with you to get to your end goal. It is the combination of this that will help us partner with you for that next step on the journey to recovery.


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