When David Mathias had bilateral knee replacements last
September, it turned out to be the best choice he ever made,
thanks in large part to the orthopaedic rehab he received
through the FirstHealth Centers for Rehabilitation.
“I had a full week of rehab in-house before I left, which was
outstanding,” he says. “When I was discharged, I had a choice
of which rehab facility to use, and I chose FirstHealth outpatient
rehab. I took my surgery seriously, and I took my rehab seriously,
At FirstHealth Centers for Rehabilitation, orthopaedic rehab is
all about goals and the hard work patients have to do in order to
achieve them. Mathias had a few goals of his own.
“By Thanksgiving, I wanted to get down on my knees to play
with my grandchildren and return to playing golf as quickly as
possible,” he says.
According to Jill Botnick, director of outpatient and regional
rehab services, physical therapists conduct a comprehensive
musculoskeletal evaluation using tests to measure muscle strength,
joint range of motion, walking, balance and more.
The results are then compiled into a list of impairments and
functional limitations that the physical therapist can use to help
the patient improve. “A plan incorporating varying treatment
techniques, like therapeutic exercise and manual joint mobilization,
is then developed to help patients achieve their goals,” says
Before surgery, Mathias prepared himself for what was to come.
He went on a weight-reduction program, exercised extensively to
prepare his legs and arms, and lost 60 pounds. With the surgery
behind him, the hard work began.
“When I first got there, we sat down together, and Kathy
(Holder), my physical therapist, said, ‘Here’s what we think you
should accomplish, but what are your goals?’” Mathias says. “When
she knew what they were, she really geared some of my exercises
toward getting up and down from my knees, and then bending
and twisting for my golf game. It wasn’t a case of opening up a
notebook and saying here’s what you need. They customized my
program for my age and needs.”
Mathias’s therapy lasted seven or eight weeks, with three visits
weekly. For him, exercises involved two immediate goals: knee
strength and flexibility.
“I got on a table and extended my leg straight out,” he says.
“The next part was very painful. I had to lie on my back and slide
my leg back and bend my knee. The goal was to bend it as far as
possible. That was excruciating, but you can’t recover unless you
push yourself through a little pain and discomfort.”
“It wasn’t a picnic,” he says, “but the therapists were fantastic. I
got a real, one-on-one relationship, and that gave me the full benefit
of the services. I really felt like a part of what was going on.”
When his rehab was finished, Mathias was able to accomplish
everything he’d set out to do and more.
“I got to crawl around the floor with my grandchildren, and I’m
also playing golf again,” he says.
For more information on the FirstHealth Centers for Rehabilitation, call
|David Mathias, who had both knees replaced last year, works with Kathy Holder, P.T., a physical therapist with FirstHealth of the Carolinas.
Rehab at home
Home health therapy is often the bridge between
hospitalization and outpatient rehabilitation. The
patient’s recovery at home is crucial to his/her overall
FirstHealth Home Care has a team of physical and occupational
therapists who work closely with their patients, beginning with an
“Based on an extensive assessment of the patient in his or her
own home environment, the therapist can determine the best
plan of care to achieve maximum success,” says Patty Upham,
director of FirstHealth Home Care.
“Before establishing a baseline from which to work, the
therapist determines where patients are in their recovery as well
as where they were before their surgery or injury,” says physical
therapist Bill Robins.
The therapist works closely with the patient to develop realistic
and achievable goals, and patient participation is essential. The
goal is for each patient to reach his/her maximum potential.
“The patients have to be motivated to succeed,” says Robins.
“That makes all the difference. They have to be willing to do the
The road to recovery begins almost
immediately after joint replacement
According to Cindy Sayce, director of
Inpatient Rehabilitation and Acute Care
Programs at FirstHealth Moore Regional
Hospital, the acute care therapist will see
patients who have had joint replacement
surgery the day following their procedure.
“At the very least, we get the patient to
just sit on the side of the bed,” she says. “But
most patients will stand, and the therapist
may even work with them on taking a couple
The acute-care goal for the first three to four
days is getting the patient up and starting to
learn how to move his or her new joint(s).
From the acute-care setting, patients
who have had bilateral (both sides) joint
replacements typically go to the Inpatient
Rehabilitation Center inside Moore
Regional Hospital for further therapy.
There the patient is involved in physical and
occupational therapy for three hours a day,
five days a week, and nurses who specialize in
rehabilitation help patients practice the skills
they learn in therapy.
Patient goals are usually to become
independent with everyday tasks—including
walking, going up and down stairs, self-care
and home-management skills. “Sometimes
patients leave rehab doing more for
themselves then they were doing before their
surgery,” Sayce says.
From inpatient rehab, which usually lasts
seven to 14 days, most patients go directly
home, either for in-home or outpatient
rehabilitation, Sayce says.
Less intensive inpatient orthopaedic
rehabilitation is also offered at the Palmer
Hinson Care Unit at FirstHealth Richmond
Memorial Hospital in Rockingham and at
FirstHealth Montgomery Memorial Hospital
in Troy. For more information on all of the
inpatient orthopaedic rehabilitation services
offered by FirstHealth of the Carolinas, call