First, let’s think about what surgery is. For the purposes of this article, we are going to think of it as a Planned Trauma. When you have an operation, several tissue types are cut through, even with laparoscopic surgery.
We need to consider skin, muscle, bone, lymph vessels, blood vessels, and nerves. And remember the connective tissue that wraps around and connects all of those structures, fascia.
All of those structures have pathways, grain lines, minute functions, and relationships with each other that are severed by incisions. During the healing process they will need to find their way back to each other to resume healthy function.
Let’s look at the simplified steps in a knee replacement as an example.
- First, an incision is made over the kneecap. The length of the incision varies from 4 to 10 inches. This cuts through skin, fascia, and sometimes muscle.
- Next, the kneecap is moved aside. This is done while it is still attached to the thighbone through the quadriceps muscle and to the tibia through the patellar tendon.
- Then the femur is resurfaced to remove damaged bone, and the new metal surface is attached.
- The same is done to the tibia.
- The back of the kneecap is examined, and if needed, it too is resurfaced and fitted with a component so that it properly articulates with the new joint surfaces. It is rotated back in place.
- The surgeon then bends and straightens the knee to make sure the joint articulates well before closing the incision over the kneecap.
Wow. It is pretty amazing that we can get our knees replaced if need be. And, this is not an insignificant physical event, as every tissue type has been affected.
When we cut through the skin, we are also cutting through the subcutaneous layer, which is the fat layer that cushions the blood, lymph, and nerve vessels it contains. Blood and lymph vessels heal and reorganize themselves amazingly quickly, and skin also heals easily. The main tissue type here that may need some help is nerve.
In moving the kneecap aside, the muscles of the front thigh, the quadriceps group, is being quite disturbed. Muscles like to stay next to their neighbors, and are attached to each other by fascia in every direction. One of the most common post-surgical dysfunctions we see after knee replacements are inhibited muscles near the incision site.
The saphenous nerve, which is important for the functioning of the knee, and also for your proprioception, can become damaged. We have specialized cells called proprioceptors in our joint spaces that let us know where we are in space. They are why we don’t have to look at our feet to know where we are stepping. Having your proprioception a little off makes you feel unsteady or fragile, a bit unsure of your movements. This is a very common experience after surgery.
This example was of a straightforward knee replacement that goes well.
This is the best possible scenario. Hip replacements are more complex, as are shoulder replacements. Each of these joints have their corresponding affected muscles and nerves.
And then there are other surgeries- to repair trauma, to remove tumors, etc. All of these affect all the tissue types and the web of fascia. You get the idea.
Here at Spring acupuncture, we have tools that can help you finish your healing process and get back to feeling strong again.
The superstars are:
- Motor point acupuncture can help restore muscle function
- Electro-acupuncture can help regain proprioception and nerve impulse strength.
- Trigger Point – Dry Needling as needed
- Individualized Corrective Exercise
- IASTM (Instrument Assisted Soft Tissue Mobilization)
- Kinesio taping to support joint alignment.
If you find yourself post-surgery, supposedly fully healed, all your scans look good, and you’ve finished PT, but you still have pain and dysfunction, we might be able to help.
In fact, we can help as soon as two weeks out from surgery, after your incision has healed.
Interested in learning more?
Call today 208-616-1040