Procedures
Physical Therapy and Rehabilitation
Physical therapy and rehabilitation are central to orthopedic care, both as a treatment in their own right and as the work that follows an injury or an operation. Dr. Nikolaj Wolfson builds a rehabilitation plan into the treatment of every patient he sees in San Francisco.
What physical therapy and rehabilitation involve
Physical therapy is the guided use of movement, exercise and hands-on technique to restore motion, strength, balance and function to an injured or painful part of the body. Rehabilitation is the broader process a therapy program sits inside: the staged return from an injury, an episode of pain, or an operation back toward the activities that matter to a person. A program is built around a specific diagnosis and set of goals, and it changes as the person progresses.
Depending on the problem, a program may work on range of motion, on the strength and activation of the muscles around a joint, on the mechanics of walking or of a sporting movement, on balance, or on managing swelling so that the rest of the work can be done. In many orthopedic conditions the muscles around a painful joint weaken and the joint stiffens, and each makes the other worse. A well-directed program is aimed at interrupting that cycle.
Situations where therapy is often part of the plan
- Joint pain and stiffness, including arthritis of the hip, knee, shoulder or other joints
- Sprains, strains, tendon problems and other sport or overuse injuries
- Recovery after a fracture or other orthopedic trauma
- Preparation before a planned operation, and the structured recovery that follows one
- Weakness, loss of balance or difficulty walking that has developed alongside a joint problem
How a program is arrived at
The starting point is a diagnosis. Dr. Wolfson will take your history, examine the affected area, and review your imaging, because a therapy program that is not matched to the actual problem is unlikely to help and can sometimes aggravate it. From there the discussion turns to what you need to be able to do, what has already been tried, and what is realistic. The plan is communicated to the therapist who will work with you and reviewed as you progress. Rehabilitation after joint preservation surgery in particular depends heavily on the patient being able to take part in a guided program, and that is part of the conversation before any procedure is planned.
How therapy fits with other treatment
Therapy is frequently combined with other non-surgical measures.
- Education and lifestyle adjustment. How to load and protect a joint through daily activity.
- Bracing and appliances. External support that changes how force passes through a joint while strength is rebuilt.
- Injection and other office-based options. Measures that may reduce pain enough for a program to be carried out.
Where surgery is needed, rehabilitation does not become less important.
- Preparation beforehand. Work on motion, strength and general condition where time allows.
- Structured recovery afterwards. A staged program matched to the operation and to how the tissue heals.
What to expect when you consult Dr. Wolfson
Dr. Wolfson, MD, FRCSC, FACS, is board certified in the United States and Canada, and he explores non-surgical treatment wherever it is reasonable. At a consultation he will explain what he believes is causing your problem, what a rehabilitation program would be aimed at achieving, and what your part in it would be. He treats patients as partners in their own treatment, and rehabilitation is the clearest example of that.
Schedule a consultation in San Francisco
Dr. Nikolaj Wolfson evaluates orthopedic problems and plans rehabilitation at Wolfson Orthopedics, 2300 Sutter Street, Suite 207, San Francisco. New patients are welcome, and telemedicine visits are available.
This page provides general information about physical therapy and rehabilitation and is not medical advice. It is not a substitute for examination, imaging and diagnosis by a qualified physician, and it is not an exercise prescription. Every case is different and requires individual evaluation. If you have severe pain, an obvious deformity, loss of function, fever, or an injury from a significant accident, seek medical care promptly.
Contact Dr. Wolfson if you would like to setup an appointment. If you are a new patient, please book all in-person appointments with Dr. Wolfson via telephone.
If you live outside of the San Francisco Bay Area, you can request a complimentary phone consultation with Dr. Wolfson to assess your case. Please call or e-mail us to set up your complimentary consultation.
Common questions
Can physical therapy help me avoid surgery?
For some conditions, a well-directed program is the main treatment and no operation is needed. For others, the underlying structural problem is not something therapy can change, though therapy may still have a role. Which of these applies to you can only be determined after an examination and a review of your imaging.
How long does a program last?
That depends entirely on the diagnosis, on what was done if you have had a procedure, and on how you respond. Your surgeon and therapist will discuss a plan with you and adjust it as you go rather than fixing a length in advance.
Do I need a therapy program before an operation?
Sometimes preparation beforehand is useful, and sometimes it is not appropriate. It is worth asking about at your consultation so that the plan covers the period before as well as after any procedure.
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Make an appointment
Dr. Wolfson is accepting new patients in San Francisco.