Orthopedic Physical Therapy for the First Weeks After Surgery
The operation may be ten minutes from your front door. The hard part starts when you get back to it.
Plainview is largely 1960s and 1970s split-levels, and in most of them the bedroom and the only full bathroom sit up a half-flight from the living room. On the second day home after a knee replacement, that half-flight is the whole day.
Plainview is unusual in that the surgery is rarely the difficulty. There is a 219-bed hospital on Old Country Road with a total joint replacement program, ranked nationally for orthopedics. People here often have the operation a few minutes from home, done well.
Then they are discharged, and the difficulty begins — because a joint replacement does not end at the hospital door. It ends somewhere around week six, in a house that was built in 1968 and has not been consulted about any of this.
Most people arrive at surgery well briefed on the operation and barely briefed on the twelve weeks afterwards — which is the part that determines how the joint actually works a year later.
A split-level puts the living room on one level and the bedroom and full bathroom half a storey above it. In normal life that is nothing. On crutches or a walker, with weight-bearing restrictions and a leg that will not yet do what it is told, it is the single decision the day is organized around.
People manage it in one of three ways: they take the stairs far more often than they should, they sleep downstairs on a sofa that is far too low to stand up from, or they simply go up in the morning and stay up.
None of those is a plan. All three are common.
There is also the part nobody mentions. In your own house, with family visiting and everyone quietly watching to see how you do, an ordinary flight of stairs becomes a performance. That is worth naming, because the pressure to look fine is one of the most reliable ways people overdo it in week two.
Care is delivered one-to-one by a licensed physical therapist who is also a Certified Strength and Conditioning Specialist.
After a joint replacement that matters more than it might sound. The early weeks are about protection and range; everything after that is progressive loading, and a joint that is never properly loaded never fully returns.
Joint replacement is the clearest example here, because the demographic and the hospital make it common. But orthopedic physical therapy covers a good deal more: a shoulder that has stopped reaching overhead, a rotator cuff repair, an ankle that never quite recovered from a fracture, arthritis that has been managed and is no longer managing, back and neck problems with a structural cause.
Not all of it involves surgery. A fair amount of orthopedic work is done specifically to postpone or avoid it.
A good deal of it never involved an injury at all. Where the working day is spent mostly at a desk and then in the car, the pattern is a familiar one: hip flexors short after nine hours folded, glutes that have stopped contributing, a mid-back that has forgotten it rotates. It usually announces itself as low back pain that is worst on the drive home — the same journey this page is otherwise about, taken in the other direction.
There is a particular irony to living this close to a hospital. The journey there for surgery is easy. The journey back for outpatient rehabilitation, three times a week, on a new knee, is not.
Getting into a car is one of the harder movements in the first fortnight after a hip or knee replacement, and it comes before and after every appointment. For a driveway on a slight rise, with a couple of steps to the door, the trip costs more than the session returns.
There is also what a therapist can only see in the house: which side the handrail is on, how deep the treads are, whether the bed is too low, and where you would actually fall if you were going to.
Call (516) 357-4247 and tell us what has been done and when.
Your therapist reviews your surgical precautions, range, strength and swelling — and the stairs, bed and bathroom you have to work with.
Your plan is built around your surgeon’s protocol and the layout you are recovering in.
Follow-up visits happen at home, and the plan progresses as range, strength and weight-bearing status change.
Plainview Hospital is the closest, and a good number of local joint replacements are done there. Others come home from elsewhere in the county. Strength Works PT is an independent practice with no affiliation to any hospital — care is arranged directly with you, and works alongside whatever protocol your surgeon has set.
That depends on your weight-bearing status and how the stairs are built — tread depth and which side the rail is on both change the answer. Usually it means learning a safe technique for that specific flight, deciding early how many trips a day is sensible, and setting up downstairs so the answer is not “one trip, then stay put.” Your therapist works it out on the actual stairs.
Often yes, and it is worth asking early. Strength before surgery tends to make the weeks after it easier, and there are practical things that are far simpler to sort out beforehand — where you will sleep, whether a chair is high enough to stand from, whether a second handrail would help. Discuss timing with your surgeon.
Follow your surgeon’s instructions — protocols vary by procedure and by surgeon, and the timeline exists for a reason. Once you are cleared, your therapist works around your precautions and weight-bearing status rather than against them, and coordinates with the surgical timeline.
No. You can begin with a direct evaluation.
New York’s direct access provisions allow a licensed physical therapist to evaluate and treat you without a physician referral, for up to 10 visits or 30 days from your first treatment, whichever comes first. If your care should continue beyond that, we will tell you what is needed and help you arrange it. If Medicare is paying for your care, your plan of care also needs to be signed by your physician, which we help arrange. Neither one holds up your first appointment.
Strength Works PT is credentialed with Medicare and Aetna. Plans differ, so call and we will check yours before anything is booked.
If your plan is not one we bill, or you would rather keep the plan out of it, you can pay for your care directly. Either way you know the cost before the first visit.
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If the operation is done and the house is now the obstacle, Strength Works PT brings physical therapy to your door. Call (516) 357-4247.
Medically Reviewed by: Dr. Said Haschemi, DPT, CSCS
Review Date: Jan. 2026
