So you’re still thinking of some surgical intervention for your injury – getting cut open? That’s fine – maybe it’s right for you as long as you’ve fully investigated other treatments and have second opinions as I discussed in Part I. Let’s now talk about what surgery can do to your body because even a surgical incision is no walk in the park.
Actually, don’t think that a controlled incision is necessarily a whole lot less stress to your body than a wound. Sure, I’d say a cut with a knife is better than a gaping wound but it’s still a great amount of stress to your body. We know that a woman who naturally tears her perineum during childbirth will heal much faster than one who is given an episiotomy.
Your adrenal glands will pump out some significant stress hormones to help you heal up and reduce inflammation. Cortisol levels will spike, just as if you were under some other acute stress. It’s a normal response but not necessarily a healthy one, especially if your stress hormones were already an issue due to your chronic pain and immobility. In fact, they most likely already were an issue since you were unable to heal on your own in the first place leading you to even consider needing surgery.
Your immune system will also rush to the aid of this medically-induced injury. It can’t rely on hospital sterilization, and of course you shouldn’t either. A hospital setting is a great place to get an infection such as resistant bacteria like MRSA and a host of other germs.
Let’s not forget possible reactions to anesthesia. This chemical has to be detoxified by your liver and for most people their liver is already having a hard enough time keeping up with other toxic loads whether it’s from their current medications, stress hormones, or unhealthy living environment.
Then there are the reactions to other medications that need to be considered – pain relievers, anti-inflammatories, and antibiotics. Each comes with a host of problems on their own and when you throw them into a drug-cocktail the end result can be questionable. The surgeons and hospital staff are going to follow protocol rather than look at your own unique biochemical individuality, aside from any possibly known allergic reactions. You have to look out for yourself, and this isn’t always easy when you’re the patient and are expected to do exactly as the good doctor tells you.
So you’re out of surgery. Now it’s time to see how well you will heal up after your surgical intervention. The success of this will be greatly determined by how healthy you were going into the surgery. Unfortunately, if you had a longstanding chronic injury, you probably weren’t very healthy in the first place. After all, truly healthy people don’t get injured, barring some accident. If or when health falters and an injury occurs, a relatively healthy individual can bounce back and won’t need surgery to try to help to resolve the problem.
But hopefully, before you head into surgery you are able to get a jump-start on your health. Fighting inflammation is a priority, and this means a diet high in healthy fats, (egg yolks, butter, pasture raised meats, fish, coconut), and little to no refined sugars. Protein intake is also very important for healing. I often suggest at least two grams of protein per kilogram of bodyweight – so roughly one gram per pound.
In addition to your prior health and diet being major factors in healing, what you do with respect to rehab will be a major determining factor as to how well you recover, not only from the surgery but also from the injury that necessitated the surgery in the first place. You can’t just expect the surgery to wash all your woes away.
It would be difficult, if not impossible for me to make solid suggestions to the masses on how to properly rehab post-op. There are too many factors, many of which I’ve mentioned and then once you add in the wide ranges of surgeries available for all different areas of the body it can become quite exhausting. However, one generally good recommendation is this – move as often as you safely and comfortably can. The days of recommending immobility (think hard casts) are mostly over, yet many are still wearing boots, braces, and other devices to restrict motion. No, you don’t want to be in pain and of course you don’t want to hinder healing, but typically the more you move the better. Active recovery is a key component in healing.
Problem Corrected. Problem Still There.
Unfortunately, surgical intervention doesn’t guarantee success and typically surgical successes are nowhere close to one hundred percent resolution of the problem. Many times people don’t get what they were expecting which is relief from some chronic pain.
I’d say the most important thing to realize here is that surgery doesn’t correct muscle imbalances. Muscle imbalances occur whenever there is some stress to the nervous system which in turn reflects itself on the musculoskeletal system. Regardless of the outcome, zero or full success, I’ve never seen surgery correct these imbalances. This means that the true reason for the problem hasn’t been identified and treated properly. It also means that the problem (pain) can return – either in the area where the surgical intervention was or in some other area due to the relationship of joint mechanics (see many other SockDoc articles discussing this).
When you’ve been injured, either acutely or chronically, sensory nerves called mechanoreceptors are affected. These mechanoreceptors are stimulated by sensations such as touch, pressure, vibration, and movement. If you’re lacking normal range of motion then you have altered mechanoreceptor activity. Surgery can correct this to varying degrees. Of course many natural therapies can as well. However, mechanoreceptor activity is not fully restored until all muscle imbalances are corrected. These muscle imbalances must be corrected via manual therapy techniques, (body therapies performed by skilled chiropractors, physical therapists, and other therapists). Also, dietary and metabolic concerns need to be addressed as inflammatory conditions and free radical damage provoked by a poor diet will continue to alter mechanoreceptors. Altered mechanoreceptors mean you’ll never fully heal and you’re an injury waiting to happen again. This is why you may have a “bad” knee, or “weak” arm, or a “need” for orthotics – your mechanoreceptors suck.
So Yes, Think Twice Before Surgical Intervention
Surgical intervention is sometimes needed. Of course I’m not advising anyone reading this to have, or not have surgery. I just want you to be an informed consumer. (I guess that would make you a consumer of surgery.) There is no going back once the knife hits your skin and usually there is no rush to have surgery. There are always exceptions. Get a second if not third opinion. Ask around for another physician or therapist who practices a different, and perhaps unique (to you) therapy. After all, if you do decide to have surgery you will want to see that practitioner after surgery to help you heal up and hopefully prevent that problem or others from reoccurring.
Happy New Year Doc,
I have pain when I run,squat,or do any kind of lateral movement.I thought I had a knee problem, but recent results from a MRI showed no acute abnormality,or tears.Could this possibly be a glute problem?I really want to get back to running again.Do you think Trigger point therapy on the glutes with added deep tissue massages be a good start?Have you had any of your patients come and see you with my issue?
Sock Doc says
Sure, that’s not an uncommon problem I’ve dealt with. Don’t think that just because a MRI is clean that there isn’t a problem. And even when diagnostic tests do show a problem, they’re sure not going to tell you where the problem originated from or how to fully correct it. (Plenty of this info on this site!)
I am looking for a way to contact Dr Gangami who has written about IUDs. Any chance I got to the right site?
I have a pending IUD removal and have been having left thigh and calf pain. Once IUD is removed how do you suggest I go about seeking to reduce the pain?
Sock Doc says
Both sites are run by me. Ideally you need to find a doc or therapist (or me) to help you deal with the issues.
The IUD came out. It had failed to come out twice and the doc today had to yank it out. Painful. Now will see if symptoms just go away.
I am based in Vancouver Canada. How would I get in touch with you? Is there an email?
Sock Doc says
Your article resonates with me; after a bad fall, and two shoulder surgeries within 15 months and lots of rehab pre and post surgery, I continue to have pain and lack of function with my right shoulder, more specifically throbbing/popping around my clavicle and pain and stiffness on the right side of my neck. I was expecting a better result, especially after the second surgery, and I am exasperated to say the least. Acromioplasty, labrum repair, etc. yet I still have these nagging issues (clavicle & neck).
Your insight about surgery make sense, and people need to be cautious and seek a second opinion at the very least. Do you have any idea why I continue to have pain around the clavicle, which radiates up into my neck? Thanks for all the great information you dispense, by the way!
Sock Doc says
It’s most likely because the surgery doesn’t take care of the muscle imbalances. Check out the Shoulder Video on this site for starters.
Laura Venecia Rodriguez says
I am 61 years of age and have two major bunions. (I am 5’2 and weight 95 pounds). 18 months ago, I tore a ligament in my left ankle/lower left calf – the side with the bigger bunion (the toe is overlapping the adjacent toe). I went to a podiatrist 7 years ago when I fractured my left foot jumping too fast on the mini-trampoline and falling at an angle. The foot healed and I have been wearing orthotics ever since and my bunions got worse, I will admit. Especially since I now seem prone to injury – I have no idea how I tore the ligament. I am quite active – normally walk 4 miles a day, jump on the mini-trampoline for 20 minutes, and do 30 minutes of gentle yoga. I eat a healthful diet dominated by whole grains, cruciferous veggies, some berries, and fish.
I am considering bunion surgery – but, I take it you would oppose it in most cases based on the articles I see here. (I just found your website today) However, I could not find an article specific to bunions. My left foot is still healing (or not quite) from the torn ligament – it just seems vulnerable all the time. Would you be able to work with me via Skype? I am far from your office (I’m in the DC metro area). I would much prefer a natural, holistic approach to my problem. My podiatrist said NOT to walk barefoot and typically, I find it uncomfortable to do so.
Dr. Stephen Gangemi "Sock Doc" says
Bunions are usually from tibialis posterior muscle problems – so check out the foot videos where I discuss that. Also look into some Correct Toes. https://nwfootankle.com/correct-toes
Happy to consult via Skype if you’d like.