Bariatric surgery is a crucial step in the treatment of morbid obesity, but success doesn’t stop in the operating room. Post-surgery requires a commitment to a healthy lifestyle that includes proper nutrition and regular physical activity. The role of physical therapy after bariatric surgery is an essential component of the recovery plan, as it helps strengthen muscles, improve mobility, and prevent complications such as strokes or poor balance through specialized programs supervised by specialists. Physical therapy after bariatric surgery contributes to accelerating recovery, improving functional ability, and may help enhance the long-term results of the operation, enabling the patient to regain activity and self-confidence.
What is physical therapy?
Physical therapy after bariatric surgery is a medical specialty that aims to improve mobility, relieve pain, and strengthen muscles using targeted exercises and techniques based on physical stimulation such as heat and cold or ultrasound. Physical therapy is used to treat a variety of conditions, including muscle injuries, heart and lung issues, impaired mobility after strokes, or even to improve breathing and physical ability after surgeries.
The role of physical therapy after bariatric surgery differs from preoperative therapy. Before surgery, therapy focuses on conditioning the body and enhancing cardiorespiratory fitness, which facilitates surgery and speeds up recovery. After surgery, it aims to gradually restore mobility, prevent complications such as clots or joint stiffness, and improve tolerance to physical exertion. In both cases, the physiotherapist works to develop an individualized program tailored to each patient’s condition and health needs.
Challenges after bariatric surgery
Despite the great benefits of surgery in treating the damage of obesity and the resulting diseases, patients face health challenges after the operation, such as physical inactivity, muscle weakness, balance and breathing issues, poor exercise tolerance at first, and deficiencies in some important nutrients such as iron, vitamin B12 and vitamin D, which requires continuous medical follow-up. Other risks include the possibility of blood clots, infection, bleeding, and surgical complications such as hernias and ulcers. In addition, health conditions associated with obesity should be monitored, especially during the period of rapid weight loss.
For this reason, the role of physical therapy after bariatric surgery is essential to address these challenges by restoring mobility, strengthening muscles, and improving breathing to help minimize complications and speed up recovery.
When does physical therapy begin after surgery?
The timing of starting physical therapy after bariatric surgery varies from person to person and depends on how stable the health condition is after the operation, but it is recommended to begin early movement as soon as possible to reduce the risk of blood clots and complications associated with inactivity. The best time to start treatment is usually determined by the surgeon and the rehabilitation team, often within the first few days after surgery or as soon as the health condition is stabilized.
Early initiation of physical therapy after bariatric surgery not only speeds up the recovery process but also contributes to restoring functional ability and enhancing the long-term results of the surgery. It plays a vital role in making physical therapy an essential step in the weight loss journey, supporting better mobility, and improving overall quality of life.
Physical therapy goals after bariatric surgery
The role of physical therapy after bariatric surgery is pivotal in the recovery phase, not only to help with mobility but also to improve the entire lifestyle. This type of therapy aims to gradually restore physical activity and enhance overall fitness without causing pain or excessive stress on the recovering body. Rehabilitation after bariatric surgery is one of the most important goals:
- Improve mobility and help the patient get up and walk safely.
- Improved breathing and endurance, especially after a long period of obesity-related inactivity.
- Gradually strengthen muscles to prevent the loss of muscle mass (sarcopenia) associated with rapid weight loss.
- Support sustainable weight loss with an individualized exercise program that helps improve the body’s ability to burn calories.
- Enhance balance and motor coordination to minimize the risk of falls or injuries.
- Improve mood and motivation by tracking progress and achieving goals gradually.
The most important exercises and techniques used
A range of exercises and techniques is used as part of the rehabilitation plan after bariatric surgery to help restore physical activity gradually and achieve safe and effective results. The program usually starts with light walking within hours of surgery and progresses later depending on the patient’s ability:
- Low-intensity aerobic exercise: Such as walking and stationary bike to support weight loss and gradually increase the duration to 30 minutes per day, depending on the patient’s ability.
- Muscle-strengthening exercises: Relying on body weight to minimize the loss of muscle mass during rapid weight loss.
- Breathing exercises: To improve the efficiency of the lungs after the operation and enhance exertion capacity, especially after anesthesia and the period of physical inactivity prior to surgery.
- Water exercises: Used in the late stages of rehabilitation (after 4-6 weeks), usually after wound healing, to reduce pressure on the joints and stimulate movement in patients with joint pain or severe obesity, as water relieves pressure on the body.
In addition to exercise, supportive techniques may be used (but are not a priority in rehabilitation), such as massage, electrical stimulation, heat and cold therapy can be used to relieve pain and improve circulation, all of which are integrated into a personalized plan overseen by a physical therapist to ensure safety and effectiveness.
Long-term benefits of physical therapy
The role of physical therapy after bariatric surgery is not limited only to the early recovery phase, but also includes improving overall health and preventing long-term complications. As part of bariatric surgery rehabilitation programs, physical therapy plays a pivotal role in establishing an active and stable lifestyle:
- Reduce chronic pain, especially in the back and joints, through therapeutic exercises and techniques such as heat therapy or electrical stimulation.
- Improving mental health, as physical activity boosts self-confidence and reduces feelings of frustration or anxiety associated with post-surgical body changes.
- Strengthen the ability to commit to a healthy lifestyle by building a regular routine of daily exercise and safe weight maintenance practices.
- Preventing chronic complications such as muscle atrophy, limited mobility, or deterioration in balance and motor coordination.
- Accelerate recovery after any subsequent surgical intervention, as patients who attend physical therapy show better recovery and faster rates of return to daily activities.
Recommendations for bariatric surgery patients on physical therapy
To ensure the effectiveness of the role of physical therapy after bariatric surgery, patients are advised to consistently adhere to the sessions and avoid stopping when they feel a temporary improvement, as real progress takes time and must be gradual. It is essential that a specialist customizes the program to each patient’s individual needs and monitors progress regularly to adjust exercises based on the body’s response.
Coordination with the medical team is also vital to ensure a fully integrated treatment plan. Additionally, psychological and social support—whether from family or support groups—plays an important role in motivating the patient to maintain an active lifestyle. Avoiding inactivity after the treatment program ends is equally crucial to sustain the long-term benefits of physical therapy after bariatric surgery.
Finally, the role of physical therapy after bariatric surgery is not just an additional stage, but an essential element in the long-term success of the operation, as it helps patients regain their mobility, promote weight loss and adopt a healthy and active lifestyle, and continuing physical activity after recovery is the real key to maintaining the results of the surgery and improving the quality of life.
Sources:
- Klein, A. M., Guh, D. P., & Padwal, R. S. (2020). Benefits and risks of bariatric surgery: A systematic review and meta-analysis. International Journal of Obesity, 44(1), 76-85.
- National Health Service. (n.d.). Physiotherapy. NHS.
