Post-Op Progress: Dr. Larry Davidson on Why Tailoring Physical Therapy Can Improve Outcomes
Physical therapy is a cornerstone of surgical recovery, providing the structure, guidance and support needed to regain strength, mobility and confidence. But no recovery follows a perfectly straight line. Dr. Larry Davidson, a leader in minimally invasive spine surgery, recognizes that the most successful outcomes come when therapy plans are developed in response to the patient’s progress, setbacks and changing needs.
Knowing when and why to adjust to a physical therapy plan can help patients and caregivers take an active role in healing, reduce frustration and ensure long-term success. Progress is rarely linear, and recognizing signs that it’s time to adapt can prevent setbacks. Open communication with your care team ensures that therapy remains both safe and effective throughout recovery.
The Dynamic Nature of Recovery
Every surgical recovery is unique. What works for one patient may not be ideal for another, even after the same procedure. Age, pre-existing conditions, fitness level and lifestyle all influence how the body responds to therapy. While therapists follow evidence-based protocols, the best plans are flexible, shaped by real-time feedback, clinical observation and patient input.
Adjustments may involve modifying the intensity of exercises, changing the type of movements prescribed, altering the pace of progression or introducing new techniques to address emerging issues. These changes are not setbacks but personalized responses that keep recovery on track and aligned with the patient’s needs.
Signs It May Be Time for a Plan Adjustment
Recognizing when to modify a physical therapy routine can prevent unnecessary discomfort and keep recovery on track. Patients and caregivers should watch for:
- New or worsening pain – While some soreness is normal, sharp, radiating or escalating pain signals the need for reassessment.
- Swelling that does not improve – Persistent or increasing swelling can indicate strain or irritation.
- Plateaus in progress – If strength, range of motion or endurance stops improving despite consistent effort, the plan may need to change.
- Accelerated progress – In some cases, patients may regain function faster than expected and can safely advance to more challenging exercises.
- Emergence of compensatory patterns – Favoring one side of the body, limping or altered posture can create new issues if not addressed.
By bringing these signs to their therapist’s attention, patients can help tailor their care plan to current needs.
How Adjustments Support Recovery
Setbacks can occur for many reasons, including overuse, illness, unrelated injuries or emotional fatigue. Adjusting therapy in these cases helps protect healing tissues, while maintaining progress. Therapists may temporarily reduce exercise intensity, focus on pain management strategies or prioritize gentle mobility work. These pauses or slowdowns are not failures but strategic steps that respect the body’s current capacity. With proper guidance, most patients regain momentum and return to more advanced phases of therapy.
Not all adjustments result from challenges. Some patients progress faster than anticipated, demonstrating improved strength, stability and endurance ahead of schedule. In these cases, therapists may introduce more demanding exercises, functional drills or task-specific movements to match the patient’s abilities. Dr. Larry Davidson notes that the timely advancement of therapy reduces boredom, increases engagement and helps prevent under-training that could limit outcomes.
New Symptoms Deserve Prompt Attention
Any new symptoms during therapy should be discussed promptly with both the therapist and surgeon.
These may include:
- Numbness or tingling in the limbs
- Sudden weakness
- Changes in bladder or bowel function
- Unexplained dizziness or balance issues
Such symptoms may indicate nerve involvement or other complications that require medical evaluation before continuing or adjusting therapy.
Advocating for Plan Modifications
Patients and caregivers play a critical role in shaping the therapy process. Open communication ensures the plan aligns with both clinical goals and the patient’s lived experience. Advocacy tips include:
- Speak about challenges – If exercises cause pain, fear or confusion, share this with the therapist so alternatives can be explored.
- Share personal goals – Whether you aim to return to work, care for your family or pursue hobbies, these objectives can guide therapy adjustments.
- Ask about milestones – Understanding what to expect helps patients gauge whether therapy is progressing appropriately.
- Request clarification – If the purpose of an exercise is unclear, ask for an explanation to build confidence and commitment.
Therapists value this input as it supports the development of more personalized and effective care plans.
The Therapist-Surgeon Connection
Optimal recovery often requires collaboration between the rehab team and the surgical team. This partnership forms the backbone of patient-centered care, where each provider brings their expertise to guide a safe and effective recovery process. When adjustments are needed, whether therapy exercises, activity levels or assistive devices, therapists may consult with the surgeon to confirm that changes align with post-operative precautions and healing timelines. This dialogue helps balance the need for progress with the necessity of protecting the surgical site.
The ongoing exchange of information ensures that modifications support, rather than compromise, the surgical repair and that care remains consistent and coordinated. Shared updates help catch potential issues early, such as signs of delayed healing, excessive pain or reduced mobility, allowing timely interventions that can prevent complications. By keeping all providers informed of the patient’s status, this collaborative approach not only safeguards physical recovery but also boosts patient confidence and engagement throughout the rehabilitation journey.
Examples of Common Adjustments
To give context, here are some typical ways therapy plans may develop:
- Early stages – If swelling limits motion, therapists may focus on gentle range-of-motion work and positioning to reduce inflammation.
- Mid recovery – When endurance improves, walking distance goals may be increased, or resistance levels may be added to strength exercises.
- Later stages – As patients approach functional independence, therapy may shift toward more dynamic tasks, including balance drills or sport-specific movements.
Each adjustment is designed to meet the patient where they are and help them move forward safely.
The Value of Flexibility
Rigidity in a therapy plan can frustrate patients and limit recovery. Flexibility allows therapy to remain challenging yet achievable, supportive and progressive. Small changes, made at the right time, can make a significant difference in how a patient feels, moves and heals.
Adjustments reflect responsiveness to the patient’s unique journey rather than a deviation from the plan. They demonstrate that care is personalized, flexible and guided by real-time feedback. This approach empowers patients to stay engaged and confident, even when progress takes an unexpected turn.
Recovery Is a Team Effort
Healing is not a straight path. Adjustments in physical therapy are part of a thoughtful, responsive process that prioritizes patient safety, satisfaction, and long-term function. By staying engaged, communicating openly, and working with trusted professionals, patients can ensure their therapy plan continues to meet their needs at every stage of recovery.
True recovery happens when patients and providers work as partners, each bringing valuable insight and commitment to the process. It’s a shared journey built on trust, adaptability and mutual support. With the right guidance and a willingness to listen to the body’s signals, patients can turn challenges into progress and setbacks into steppingstones. Together, the care team and patient create a pathway not just to healing, but to lasting strength and renewed confidence.