Post-surgical rehab protocols.
If you are holding a protocol sheet from your surgeon and trying to work out what week four is supposed to look like, this page is for you. A rehabilitation protocol is not a schedule. It is a set of constraints imposed by healing tissue, and the timelines below reflect what the repaired structure can tolerate rather than how quickly anyone would like to progress. Motion Theory works directly from your surgeon's protocol, then progresses you on measured criteria rather than on the calendar.
Who It's For
Patients who have had, or are about to have, a total knee or hip replacement, rotator cuff repair, meniscus repair or meniscectomy, or lumbar decompression or fusion. Useful whether you are still pre-operative and planning ahead, in the first days after discharge, or months out and unsure whether your progress is where it should be. We are on West Broadway, minutes from Vancouver General Hospital and the surgical centres serving the Fairview corridor.
What We Assess
Bring your operative report and any protocol sheet your surgeon provided. We confirm the procedure, the tissues involved, and the precautions that apply, then establish objective baselines for range, strength, and functional tolerance. From there we map where you actually sit against the expected timeline, which is frequently not where patients assume they are.
Treatment Approach
Every protocol below follows the same underlying logic: protect the repair while healing is fragile, restore capacity once it will tolerate load, then reintroduce the specific demands of your work and sport with objective criteria gating each step. What changes between procedures is how long the protective phase lasts and which structure sets the limit.
Recovery Pathway
Weeks 0-2 / 2-6 / 6-12 / 12+
Swelling control and quadriceps activation first, since quad inhibition is the main driver of poor 6-month outcomes. Progressive loading and gait normalization from week 6, then occupational and recreational demand from week 12.
Weeks 0-6 / 6-12 / 12+
Precautions depend on surgical approach, and anterior and posterior approaches differ meaningfully. Early focus on gait quality and abductor capacity, then progressive loading and single-leg control.
Weeks 0-6 / 6-12 / 12+
Tendon-to-bone healing governs everything for roughly 12 weeks. Passive range only while the repair is protected, then active-assisted, then active. Overhead loading is last, not first.
Opposite timelines
A repair needs 4 to 6 weeks of protected weight-bearing to let the tissue heal. A meniscectomy allows loading almost immediately. Patients routinely confuse the two, and applying the wrong one is the single most common protocol error we see.
Weeks 0-6 / 6-12 / 12+
Microdiscectomy, laminectomy, and fusion each follow a different loading timeline. Protected walking first, then trunk and hip capacity, then graded bending, lifting, and rotation matched to occupational demand.
Clinic Location & Access
Located at 1367 West Broadway in Vancouver, Motion Theory is situated in the Fairview medical corridor, in close proximity to Vancouver General Hospital (VGH). We serve patients from Kitsilano, Mount Pleasant, and the broader Metro Vancouver area.
Common Questions
What is the recommended treatment protocol for rotator cuff repair?
Most rotator cuff protocols run in three stages across roughly 12 weeks of tendon-to-bone healing: passive range only while the repair is protected in a sling, then active-assisted and active motion from around week 6, then progressive strengthening and overhead loading from week 12. Repair size, number of tendons involved, and your surgeon's preference all shift these boundaries, which is why the operative report matters more than any generic timeline.
What is the recommended physiotherapy protocol for knee replacement surgery?
Early rehabilitation prioritizes swelling management, restoring range, and reactivating the quadriceps, because quadriceps inhibition is the strongest predictor of a poor result at 6 and 12 months. Mid-phase work introduces progressive strength loading and normalizes gait. Later phases restore full occupational and recreational capacity, with limb symmetry testing before discharge.
How many times a day should you do physio after knee replacement?
Most knee replacement protocols call for short sessions two to three times daily in the early weeks rather than one long session, because frequent gentle movement manages swelling and stiffness better than infrequent intensive work. As you progress past the early phase, frequency typically drops and load increases. Follow the specific frequency your surgeon and physiotherapist set for you.
What physio do you do after knee replacement?
Early work centres on swelling management, passive and active range restoration, and quadriceps activation. From roughly week 6, progressive strengthening, step patterns, and gait retraining take over. From week 12, the focus shifts to the specific demands you need to return to, whether that is stairs at work, cycling, or hiking.
When should you start physical therapy after spinal fusion?
Timing is set by your surgeon and depends on the number of levels fused and the fixation used. Early rehabilitation generally begins with protected walking and breathing mechanics within days, while loaded trunk work is deferred until the fusion is progressing, often around the 12-week mark. Starting loaded work early risks the construct the surgery was meant to protect.
What are the do's and don'ts after rotator cuff surgery?
Do wear the sling exactly as prescribed, do your passive range work consistently, and do keep the elbow, wrist, and hand moving. Do not lift with the operated arm, do not reach overhead, and do not actively raise the arm under its own power until your protocol clears it. The most common error we see is progressing to active movement too early because the shoulder feels good, which risks the repair well before the tendon has attached to bone.
Related Services
Begin Your Recovery
Book AssessmentRegistered Clinicians
All practitioners are registered with their respective provincial colleges in British Columbia.
Evidence-Based
Treatment protocols are grounded in current peer-reviewed literature and clinical guidelines.
Direct Billing
Available for ICBC claims and most major extended health benefit providers.