When to Start Physiotherapy After Surgery
"Start rehab as soon as possible" is a useful slogan, but it's wrong as often as it's right.
For some operations, day-one movement is the goal; for others, two to six weeks of careful protection lets the tissue heal before loading.
The operative surgeon's specific protocol decides - not a general rule, and not a different surgeon's rule.
Start early (within 24–72 hours)
- Joint replacements (hip, knee, shoulder): ward physio gets patients out of bed day one.
- Microdiscectomy and most laminectomies: mobilisation within 24 hours.
- Most general surgery: sitting up, walking, deep breathing starts fast.
Start mid-range (1–4 weeks)
- Post-fracture fixation with a period of non-weight-bearing.
- Some rotator cuff repairs in a sling.
- Caesarean section recovery transitioning to core work around week 6.
Start later (4–12 weeks)
- Tendon repairs in the hand - flexor and extensor tendons need specific immobilisation first.
- Some spinal fusions - bone fusion comes before loading.
- Skin grafts, certain reconstructive surgeries with specific healing windows.
Why timing matters in both directions
Too early: re-rupture, delayed healing, wound issues.
Too late: stiffness that takes months to release, muscle atrophy that needs twice as long to recover, joint contractures that may never fully resolve.
The middle path is specific to the surgery.
How we handle it
We read the operative note before the first session. If there's no note, we call the surgeon's clinic.
We don't guess.
Our first session always starts with confirming the protocol and precautions, then progresses within the safe window.
How to start
WhatsApp us: the surgery, the date, the surgeon, and a photo of the operative note or discharge letter.