Most people are aware that physical therapists play crucial roles in helping patients recover following injuries or orthopedic surgery. But therapists also work with patients to help them get into better shape before surgery, to shorten the post-surgical recovery time and expedite healing. Eighty-two year old Ann B., of Savage, is a good example. For several years, Ann had been plagued by steadily worsening pain in her right knee (four years earlier, she had undergone arthroscopic surgery to repair her left knee). “The pain had become terrible. I couldn’t walk through the living room without having to brace myself on furniture. I put off the surgery for two years, until I couldn’t bear it any longer.”After consulting with her orthopedic surgeon, Randy Lewis, MD, of Twin Cities Orthopedics, Ann decided to undergo knee replacement surgery, and an Oct. 1, 2010 date was set for the surgery. Dr. Lewis told his patient to expect a recovery period of about six months.In the packet of pre-op information the doctor gave her, Ann read about the importance of exercising prior to surgery, in order to enable a better, quicker recovery. She checked with Mark Froemke, PT, the director of physical therapy at Twin Cities Orthopedics’ Burnsville Clinic, who prescribed a daily exercise regimen she could do at home in the five weeks leading up to her operation.“In two visits prior to surgery we identified her limitations and gave her specific exercises,” Froemke explains. “She went home and did them consistently and that obviously made a difference.”Why are pre-surgical, prescribed exercises so important? “If you can go into surgery with a good range of motion and ability to straighten the knee, that makes rehab easier, quicker and less expensive. For example, if you go into surgery with a loss of 10 degrees in being able to straighten the knee, having surgery doesn’t mean you will have good extension of the knee,” Froemke notes. “But if you do exercises to stretch the muscles around the knee, that will make it much easier.”Froemke’s examination of the knee indicated she lacked the ability to straighten the knee and also lacked strength in the quadriceps muscles, which support the knee. He suggested gentle, repetitive exercises to increase the knee’s flexibility – extending and bending the leg, and some mild resistance training using an exercise bike, with the amount of resistance appropriate for her physical condition and age.From his perspective, Ann proved to be an ideal patient, Froemke notes. “If you go into surgery with the attitude that you are going to do the exercises the therapist recommends and are consistently motivated – as Ann was – it makes a big difference in recovery.”“The therapists at the Transitional Care Unit (TCU) at the Masonic Home in Bloomington were also surprised at my recovery and I was released early from rehab to home”, Ann recalled. Post release from the TCU, she returned to the therapy clinic at TCO in Burnsville for three more exercise sessions to stretch muscles and improve her flexibility. She walked with a cane for about a week, and then was able to walk unaided, enjoying her annual vacation in Florida with enthusiasm. “I’m better than I thought I could be!”