Postsurgical Rehabilitation: Tendon Surgery


During the past 4 weeks

Scoring categories

How would you describe the pain you usually have in your groin?

0. None

1. Very mild

2. Mild

3. Moderate

4. Severe

Have you been troubled by pain from your groin in bed at night?

0. No nights

1. Only one or two nights

2. Some nights

3. Most nights

4. Every night

Have you had any sudden, severe pain—“shooting,” “stabbing,” or “spasms” from your groin?

0. No days

1. Only 1 or 2 days

2. Some days

3. Most days

4. Every day

Have you been limping when walking because of your groin?

0. Rarely/never

1. Sometimes or just at first

2. Often, not just at first

3. Most of the time

4. All of the time

For how long have you been able to walk before the pain in your groin becomes severe (with or without a walking aid)?

0. No pain for 30 min or more

1. 16–30 min

2. 5–15 min

3. Around the house only

4. Unable to walk at all because of the pain

Have you been able to climb a flight of stairs?

0. Yes, easily

1. With little difficulty

2. With moderate difficulty

3. With extreme difficulty

4. No, impossible

Have you had any trouble getting in and out of a car or using public transportation because of your groin?

0. No trouble at all

1. Very little trouble

2. Moderate trouble

3. Extremely difficult

4. Impossible to do

How much has pain from your groin interfered with your usual work, including housework?

0. Not at all

1. A little bi

2. Moderately

3. Greatly

4. Totally




Table 21.2
Functional pain classification scale of Puffer and Zachazewski [18]






















Classification

Characteristics

Type 1

Pain after activity only

Type 2

Pain during activity, not restricting performance

Type 3

Pain during activity, restricting performance

Type 4

Chronic, unremitting pain


Postoperative rehabilitation consists of three separate phases.


21.3.1 Phase I


Phase I occurs during the first week after surgery. Patients are discharged home with full weight bearing using crutches for assistance. The goal is to allow the wound to heal to prevent reattachment of the adductor longus tendon [4].

When a complete tenotomy is performed, some authors advise only regular ice packs 10–20 min several times a day for the first week [14, 15]. We advise a closed-chain adductor strengthening exercise program starting 2 days after surgery. By postoperative day 3, patients are instructed to stretch the legs (without pain) into wide abduction every 2–3 h (Fig. 21.1). Some advise the use of pillows between the legs when sleeping to maintain abduction [4, 16].
Aug 11, 2017 | Posted by in ORTHOPEDIC | Comments Off on Postsurgical Rehabilitation: Tendon Surgery
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