Post-Surgery Fitness Testing

Typical clearance timelines (always verify with YOUR surgeon):

• Orthopedic Surgery:
  • • Joint replacement (hip, knee): 8 to 12 weeks, after PT clearance
  • • ACL reconstruction: 4 to 6 months, after return-to-sport protocol begun
  • • Rotator cuff repair: 4 to 6 months, after ROM restored
  • • Meniscus repair: 6 to 12 weeks, per surgeon protocol
  • • Spinal surgery: 3 to 6 months, per surgeon clearance
• Cardiac Surgery:
  • • CABG (bypass): After Phase II cardiac rehab completion (typically 12 weeks minimum)
  • • Valve replacement: 12 weeks minimum, after cardiac rehab
  • • Requires cardiologist clearance, not just surgeon clearance
• Abdominal Surgery:
  • • Laparoscopic: 2 to 4 weeks minimum
  • • Open abdominal surgery: 6 to 12 weeks
  • • Hernia repair: 6 to 12 weeks depending on repair type
  • • Bariatric surgery: 4 to 6 weeks, once diet progressed
• Thoracic Surgery:
  • • Lung resection: 8 to 12 weeks minimum
  • • May need pulmonary function tests first
• Gynecological Surgery:
  • • Hysterectomy (laparoscopic): 4 to 6 weeks
  • • Hysterectomy (open): 6 to 8 weeks
  • • C-section: 6 to 8 weeks

These are general guidelines. Individual recovery varies based on surgical complications, pre-surgery fitness, age, nutrition, and adherence to post-operative protocols. Your surgeon has final say on timing.

Required documentation and considerations:

• Written Surgical Clearance: Note from surgeon specifically approving exercise testing
• Operative Report: If available, summary of what was done surgically
• Current Medications: Complete list including pain medications, anti-coagulants
• Any Exercise Restrictions: Weight limits, movement restrictions, specific precautions
• Physical Therapy Progress: If in PT, notes on current functional level
• Comfortable Exercise Clothing: That accommodates any surgical sites or braces

We adapt testing for post-surgical patients:

• Equipment Selection: Choose equipment that avoids stressing surgical site. For example, bike after lower extremity surgery, treadmill after upper extremity surgery
• Gradual Progression: More conservative workload increases than standard protocols
• Pain Monitoring: Distinguish between normal exercise exertion and pain at surgical site. Stop if surgical site pain occurs
• Movement Restrictions:Honor surgeon restrictions (e.g., no hip flexion past 90 degrees after hip replacement)
• Brace Accommodation: If wearing knee brace, back brace, etc., we accommodate during testing
• Extended Recovery: Allow extra time for rest after testing if needed

Post-surgical testing provides several insights:

• Deconditioning Assessment: Quantify how much fitness was lost during surgical recovery and inactivity period
• Safe Exercise Zones: Heart rate targets for rehabilitation exercise that challenge without overstressing
• Functional Capacity:Expressed in METs (metabolic equivalents), which correlates to activities of daily living. For example, 4 to 6 METs allows most household activities, 7+ METs allows more vigorous activities
• Comparison to Norms: How does current fitness compare to age and sex norms? This indicates how much deconditioning occurred
• Limiting Factors: Is limitation due to cardiovascular fitness, surgical site discomfort, muscle weakness, or other factors?

Test results guide your recovery exercise program:

• Start Conservatively: Begin exercise at 50 to 60% of peak capacity shown on test
• Progress Gradually: Increase duration before increasing intensity. Add 5 to 10% per week if tolerating well
• Zone 2 Rebuilding: Focus on aerobic base building (60 to 70% max heart rate) to regain cardiovascular fitness
• Combine with Strength Training:Muscle mass was likely lost during surgical recovery. Resistance training 2 to 3 times per week under PT guidance
• Monitor Surgical Site: Heart rate zones ensure cardiovascular challenge without biomechanical stress that might harm surgical repair
• Return-to-Sport Progression: For athletes, testing at intervals documents readiness for sport-specific training and competition

Recommended follow-up testing:

• Initial Baseline: First test as soon as surgeon clears exercise testing
• Mid-Recovery: Retest at 8 to 12 weeks after initial test to assess rehabilitation progress
• Full Recovery Assessment: Final test at 6 months post-surgery to document return to pre-surgery fitness or establish new baseline
• Pre-Return-to-Sport: For athletes, test before clearance for full competition

Stop testing immediately and notify surgeon if you experience:

• Sharp pain at surgical site
• Excessive swelling or warmth at surgical site after testing
• Signs of infection (redness, drainage, fever)
• Unusual cardiovascular symptoms (chest pain, severe palpitations, excessive shortness of breath)
• Dizziness or fainting
• Joint instability or giving way (if orthopedic surgery)

Most post-surgical patients tolerate testing well when appropriately timed and with surgeon clearance. However, always communicate any concerns to your surgical team.

Factors that optimize post-surgical fitness recovery:

• Early Mobilization: Within surgeon guidelines, start moving as soon as permitted
• Adequate Protein: 0.8 to 1.0 grams per pound body weight supports tissue healing and prevents muscle loss
• Sufficient Calories: Do not diet during recovery. RMR testing ($75) can determine exact needs
• Sleep: 8 to 9 hours per night. Sleep is when most healing occurs
• Hydration: Adequate fluid intake supports healing and exercise tolerance
• Medication Compliance: Take prescribed medications as directed
• Physical Therapy: If prescribed, attend all PT sessions and do home exercises
• Avoid Smoking: Smoking dramatically impairs wound healing and recovery

VO₂ Max plus RMR Testing (save $25)

Combining both tests provides comprehensive recovery data:

• Exercise Prescription: Heart rate zones from VO₂ max testing
• Nutrition Optimization: Exact calorie needs from RMR testing to support healing
• Complete Recovery Strategy: Address both exercise and nutrition for optimal healing

VO₂ Max Test: $250

RMR Test: $75

Performance Pack (Both): $300

Fit Evaluations
311 Soquel Ave
Santa Cruz, CA 95062

Behind Hindquarter restaurant (second entrance off Dakota St.)

Phone: 831-400-9227
Email: info@fitevals.com

Call to discuss your surgery type and timing before booking. Bring surgeon clearance to appointment.