Postsurgical Rehabilitation: Hernioplasty



Fig. 20.1
Walking on plane surface



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Fig. 20.2
Starting with pelvic tilt (not shown in picture) and bridge on the right


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Fig. 20.3
Pelvic stabilization with pressure on the ball on the left and lifting the leg on the right


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Fig. 20.4
Rectus abdominis isometric contraction


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Fig. 20.5
Postural exercises for lumbar spine


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Fig. 20.6
Hip control and core stabilization exercise with mirror feedback


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Fig. 20.7
Pelvic control on unstable surface


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Fig. 20.8
Single leg balance at hip and knee flex; the ball on the right makes a better control of the balance


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Fig. 20.9
Trunk and pelvic control in different shoulders placing, on the forearm, on the hand, and on unstable surface


Paajanen et al. [8] give their point of view about the treatment of 60 patients with laparoscopy surgery (endoscopic total extraperitoneal (TEP) mesh placement), demonstrating by their studies that TEP is more effective than nonoperative treatment in athletes. But they didn’t tell us anything about postsurgical protocol. It is easier on items [9, 10] to find protocols on postsurgical pain.

Van Veen et al. [11] describe a 6-week post laparoscopic repair protocol. In the first week, walking 5 km/h is allowed; in the second, aquatic training, power walking, stationary cycling, isometric rectus abdominis training, and step-ups are all admitted. During the third through the fifth, the athlete can do training with weight and normal activities within pain-free limits. At the sixth week, the athlete can get unrestricted training.

A more detailed program, and by the way closer to the author’s activity in laparoscopic approach, is proposed by Ellsworth et al. [12]. The whole program takes at least 6–8 weeks. In the first week, wound care, ice, walk in flat surface, and activities of daily living are allowed. During the second and third week, the athlete starts with light resistive exercise in pool, standing closed chain activities for lower extremities and hip, local activation of transversus abdominis, multifidus, iliopsoas, deep hip rotators, deep tissue massage of adductor muscles, and light stretch (lateral trunk, hip extensor, psoas, hamstrings, quadriceps). At the fourth week, core stability program and proprioceptive/balance exercise will start. Scar mobilization over incisional area will begin. During the successive weeks, the work will increase as far as the cardiovascular activities at the sixth week, when jogging, rope jumping, crossover cariocas, agility and coordination drills, and plyometrics are all allowed.

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Aug 11, 2017 | Posted by in ORTHOPEDIC | Comments Off on Postsurgical Rehabilitation: Hernioplasty
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