Orthopedic Surgery Prep & Recovery in West Des Moines

Soft tissue therapy before and after joint replacements, spine surgery, and orthopedic repairs

Surgery can give you your life back. A new knee, a new hip, a repaired shoulder. But surgery is only one part of the story. How your body gets ready for it, and how it heals afterward, makes a big difference in how you feel six weeks, six months, and six years later.

I’ve spent more than 25 years working with athletes and everyday people before and after orthopedic surgery. My clients have ranged from 9 months to 93 years old, and some of the most rewarding work I do is helping someone walk, climb stairs, or get back on the golf course after surgery.

Book your visit or call 515-778-3100.

Before surgery - getting your body ready

Most people come to me after surgery. I wish more came before.

By the time someone needs a joint replacement, they’ve usually been compensating for years. They’ve been limping, leaning, guarding, and shifting their weight to the other side. That pattern doesn’t just live in the knee or hip. It shows up in the opposite hip, the low back, the shoulders, and even the feet.

I can start working with you anywhere from 3 months to 3 weeks before your surgery. In that time, I’ll work to:

• Ease the muscle tension that’s built up around the joint and through the rest of your body

• Relax the areas that have been working overtime to protect the painful joint

• Help your soft tissue go into surgery as relaxed and mobile as possible

• Help you get to know how your body feels and moves before surgery, so you have something to compare to afterward

It works really well when you do physical therapy at the same time. My work focuses on the mobility of your muscles and connective tissue, and PT builds the strength to support it. That way, your body is ready to support your recovery as soon as surgery is done.

After surgery - caring for the whole body, not just the joint

Every incision cuts through layers of fascia, the connective tissue that wraps and connects every muscle, bone, and organ in your body. Clinical anatomist John Sharkey explains that surgery “disrupts the connective tissue, the fascia, and it can also then lead to scarring.” He says the goal is to help “make sure that the scar is anatomically correct,” and that this is “done… through appropriate manual therapy with movement therapy as well” (Savannah Alalia interview).

Once your surgeon has cleared you, I focus on:

• The soft tissue around the joint, to help it move more freely as you heal

• The scar and the tissue around it, once your incision is fully closed

• Stiffness and circulation in the surrounding area, including the bruising below the joint that often surprises people

• The rest of your body, which has been working hard to protect the surgical joint. Walkers, crutches, and favoring one side all take a toll on your shoulders, back, and opposite leg.

The bruising no one expects

Here’s something most people aren’t warned about. To reach the joint during knee or hip surgery, the surgical team pulls, positions, and holds the leg. Hip surgery often uses traction. That can leave bruising well below the surgery site, sometimes down the shin and into the ankle and foot. Gravity also pulls bruising downward as you heal.

Clients are often surprised, or worried, when they see it. It’s another reason I look at the whole leg, not just the incision. I work carefully around bruised areas. If a bruise comes with calf pain, heat, redness, or new swelling, call your doctor right away.

I’ve been the patient too

I don’t just read about surgery and recovery. I’ve lived it.

Here in Des Moines, I had my knee repaired by Dr. Jeff Davick, a sports medicine and knee surgeon with DMOS Orthopaedic Centers (DMOS). In 2015, I had my hip repaired by Dr. Marc Philippon, a hip surgeon at The Steadman Clinic in Vail, Colorado (Vail Health). He corrected my FAI (femoroacetabular impingement), repaired my labrum, removed the bursa, and lengthened my IT band. Over the years I’ve also had MRIs, injections, and a torn annular disc in my low back.

I’ve worked with physical therapists for many years, for my orthopedic injuries and for vestibular therapy after my concussions. So I know what it’s like to sit in the waiting room, wonder what the MRI will show, do your home exercises when you’re tired and sore, and wonder whether you’ll ever feel like yourself again.

That’s why I care so much about the team approach. I’ve been the patient, and I know how much it matters when everyone is on the same page.

Recovery doesn’t end when the scar heals

Here’s something no one talks about. My hip surgery was 11 years ago, and I only have three tiny scars. But I still feel the scar tissue catching where the surgery was.

When the weather turns cold, windy, or rainy, my scars start to feel stuck. So I still care for them regularly. When it’s cold and windy, I work on them every day. When it’s warmer, it might be once or twice a month.

I’m not recovering from an injury right now, but I still see my physical therapist regularly for ongoing care. Even after a successful surgery, my body didn’t go back to exactly how it was before my injury. Caring for it became a routine, very much like brushing my teeth every day. It’s just part of my new world.

It’s amazing that surgery can repair joints damaged by injury, arthritis, or wear and tear. But in my experience, a repaired joint is never quite the same as it was before. Ongoing care can help you keep moving well for years to come, and I’m here for that part too.

When your MRI says “unremarkable”

One of the hardest moments in recovery is getting your MRI or X-ray results back and reading the word “unremarkable.”

It’s really hard, because you can feel that something isn’t right. Sometimes you can’t even describe it exactly. You just know you have discomfort, pain, or something that isn’t moving the way it should. I’ve been there, and your experience matters.

MRIs and X-rays are wonderful tools, but they don’t show everything about how your muscles and connective tissue are moving, or how a scar may feel to you day to day.

I don’t diagnose, and I’ll never tell you what your scan missed. What I can do is look at how your soft tissue feels and moves across your whole body. Together, we work through it step by step, using a process of elimination to find the areas where your muscles and connective tissue feel tight, restricted, or tender, and work on them. If something needs another look, I’ll encourage you to go back to your doctor or PT, and with your permission, I’m happy to share what I’ve noticed with them.

Why I look at the whole body

During a dissection lab with John Sharkey at King’s College London, I followed scar tissue and watched it pull on tissue much farther away than I ever dreamed possible. A scar isn’t just a line on your skin. It can tug on structures far from the incision.

That’s why I don’t just work on the knee after a knee replacement. I follow the tension where it leads, often along the opposite diagonal of the body. A stiff new knee may be connected to a tight hip on the same side, or to a shoulder on the other side that’s been gripping a walker for weeks.

Precision, not force

My work is about precision, not force. After surgery, your body is already in protection mode. If I go in with too much force, your nervous system braces and your tissues guard.

So I find exactly the right spot and the right direction, and I let your body tell me when it’s ready for more. I work with your body, not against it. Tight and healing areas can still feel tender while I work, and I’ll always check in with you. One client called me a “bloodless surgeon,” because I work with detailed precision rather than force.

What the research says

A 2024 review of 11 randomized controlled trials with 940 knee replacement patients found that adding massage to standard rehab reduced pain at 7, 14, and 21 days after surgery and improved knee range of motion at 7 and 14 days. The authors concluded it “can be used as an adjunctive treatment for rehabilitation” after knee replacement (Journal of Orthopaedic Surgery and Research, via PubMed Central).

Nutrition before and after surgery - what I did, and what research shows

I can’t prescribe supplements or tell you what to take. But nutrition was a big part of my own surgery prep and recovery, and these are questions my clients ask me all the time. Here’s what I did, and what the research says. Please take it to your surgeon or doctor and decide together what’s right for you.

When I had my hip surgery with Dr. Philippon, his team gave me a nutrition plan, and I followed it. Here’s what the research shows about the pieces my clients ask about most.

Vitamin D. Low vitamin D is very common in people having joint replacements. One review found more than half of patients were low (Journal of Clinical Orthopaedics and Trauma, via PubMed Central). A 2024 review of more than 146,000 knee replacement patients concluded that “vitamin D deficiency results in poorer outcomes of primary TKA, with improved outcomes after supplementation” (Journal of Orthopaedic Surgery and Research, via PubMed Central). If you’re curious about your level, it’s a simple blood test you can ask your doctor about well before surgery.

Vitamin C. Your body needs vitamin C to make collagen, the main building block of scars, tendons, and ligaments. In one randomized study, knee replacement patients’ vitamin C levels dropped sharply after surgery, and the researchers wrote that “TKA results in VC depletion” (Knee Surgery, Sports Traumatology, Arthroscopy). In another study of knee replacement patients, those given vitamin C after surgery had lower rates of complex regional pain syndrome, a hard-to-treat nerve pain condition (International Orthopaedics, via PubMed).

Fish oil (omega-3s). A review in JBJS Open Access notes that omega-3 fatty acids “offer anti-inflammatory benefits” around surgery (JBJS Open Access, via PubMed Central). Fish oil can affect bleeding, so always follow your surgeon’s instructions about whether to take it and when to stop and restart.

Bone broth. Bone broth contains glycine and proline, two of the amino acids your body uses to build collagen. In a study from the Australian Institute of Sport, people who had vitamin C–enriched gelatin (the protein that makes bone broth gel) before activity doubled their collagen production (American Journal of Clinical Nutrition, via PubMed Central). One honest note: the amount in broth varies a lot from batch to batch, and homemade broth tends to have more than store-bought (International Journal of Sport Nutrition and Exercise Metabolism). I like a warm cup of homemade bone broth with a vitamin C–rich food like citrus, berries, or peppers.

A low-inflammation diet. Research links diets high in saturated fat, added sugar, and ultra-processed foods to more inflammation and slower recovery, while an anti-inflammatory diet is “associated with a shorter hospital stay” (PubMed). Mass General Brigham suggests darker-colored fruits and vegetables like cherries, dark leafy greens, and dark berries, plus omega-3 foods like salmon, tuna, flax seeds, chia seeds, and walnuts (Mass General Brigham).

Protein. Experts recommend enough protein around surgery, and eating more protein in the month beforehand is linked to less muscle loss and better wound healing (JBJS Open Access, via PubMed Central).

Please talk with your surgeon or doctor before starting any supplement, especially if you take blood thinners, have kidney problems, or have other health conditions. Your medical team knows your full health picture.

Working alongside your surgeon and physical therapist

My work supports your surgeon and physical therapist. It doesn’t replace them.

Every surgeon has their own protocol. For example, Dr. Robert LaPrade, a knee specialist with Twin Cities Orthopedics in Minnesota, gives his patients a written rehab protocol for their exact procedure, and his office tells patients that “protocols and orders are extremely important for you to adhere to postoperatively” (Robert LaPrade, MD). I agree completely. I’ll ask to see your protocol, and I’ll match my work to where you are in it, never ahead of it.

Sometimes I’ll text with your physical therapist, with your permission, to make sure we’re on the same page. When your surgeon, your PT, and I are all working toward the same goal, your body gets a team instead of three separate appointments.

I also keep learning from surgeons. When my mom needed care for her shoulder, I went with her to Mayo Clinic in Rochester, Minnesota, to meet with Dr. Jonathan Barlow, an orthopedic surgeon who specializes in shoulder replacements, including reverse shoulder replacement (Mayo Clinic). I got to ask a lot of questions and learn more about the procedure and recovery, so I can better support my clients who have it.

• I always follow your surgeon’s guidelines and timeline. Please bring your rehab protocol to your first visit.

• I won’t work directly on your incision until it’s fully closed and you’ve been cleared.

• I’m happy to coordinate with your PT, so we’re working toward the same goals.

• If anything seems off, like new swelling, heat, redness, or calf pain, I’ll stop and send you back to your doctor.

Surgeries I commonly work with

If a joint has had surgery, I’ve likely cared for it. Here are some of the surgeries I see most often:

• Total knee replacement

• Total hip replacement

• Shoulder replacement, including reverse shoulder replacement

• Elbow replacement

• Hip arthroscopy, including FAI and labral repair

• ACL and meniscus repair

• Rotator cuff repair

• Carpal tunnel surgery

• Joint fusions, including the wrist, the foot, and the toes

• Bunion surgery

• Achilles tendon repair and ankle surgery

• Spinal fusions and other back surgeries

Back surgeries and spinal fusions are a big part of my practice. When part of the spine is fused, the areas above and below it, and the rest of the body, have to adjust to move around it.

Don’t see yours? Call me at 515-778-3100 and we’ll talk.

Life after an elbow replacement

An elbow replacement is different from a knee or hip replacement. The bones in the arm are smaller and thinner, so many people who have an elbow replacement are told not to lift more than about 5 pounds with that arm for the rest of their life, to protect the new joint (Cleveland Clinic). Some surgeons allow 5 to 10 pounds (OrthoInfo, American Academy of Orthopaedic Surgeons). Your surgeon will tell you your limit.

Five pounds isn’t much. Researchers point out that even lifting a small bag or opening a door can be enough to go over it (survey of elbow surgeons, via PubMed Central). In everyday life, that can mean:

• Carrying groceries, a purse, or a laundry basket with the other arm

• Not lifting a grandchild, a pet, or a heavy pan with that arm

• Asking for help with heavy doors and luggage, and finding new ways to get up from a chair

• Changing how you garden, clean, and do chores

That’s a big adjustment, and the rest of your body adjusts with it. The other arm, the shoulders, the neck, and the back all start doing extra work. I help care for those muscles as your body learns this new way of moving.

Feet, balance and bunions

Your feet are your foundation. They affect your balance, your knees, your hips, and your back, all the way up.

Foot alignment and strength matter, both before problems like bunions get worse and after surgeries like a bunion repair, a toe fusion, or an ankle repair. If you’re facing foot surgery, it’s worth asking your doctor or podiatrist whether foot strengthening could help in your case.

One free resource I share with a lot of my clients is The Foot Collective (The Foot Collective). It was started by a physical therapist, and its main team is now based in Australia. Their YouTube channel has a lot of helpful free videos on foot strength and balance. My clients have found it a great place to start, alongside the plan from their own medical team.

Which appointment should I book?

• New clients: book the New Client Consultation & Treatment — 75 Minutes. It gives us time to talk through your surgery, your goals, and your surgeon’s guidelines, and still have plenty of hands-on time.

• Returning clients: book Sports & Orthopedic Therapy — 40 Minutes to focus on the surgical area, or 55 Minutes to cover the whole body or go deeper on your upper or lower half.

If you have a surgery date, please tell me when you book.

Frequently asked questions

How soon before surgery should I come in? Anywhere from 3 months to 3 weeks before your surgery date. It works best when you’re also doing physical therapy, so your soft tissue work and your PT strength work build on each other.

How soon after surgery can I start? That depends on your surgery and your surgeon. In the early weeks, I can work on the rest of your body, like the back, shoulders, and opposite leg that are working hard to protect the new joint. I’ll only work directly on the incision once it’s fully closed and your surgeon has cleared you.

Will it hurt? My work is precise, not forceful. Healing and tight areas can feel tender, but I work with your body, not against it, and I’ll check in with you the whole time.

Does this replace physical therapy? No. Your physical therapist guides your exercises and strength. My work focuses on your muscles, connective tissue, and scar, and the rest of your body, so it works alongside your PT.

Why is my leg bruised so far below my surgery? During knee and hip surgery, the leg is pulled and held in position so the surgeon can reach the joint, and hip surgery often uses traction. That, plus gravity, can cause bruising down the shin, ankle, and foot. If it comes with calf pain, heat, redness, or new swelling, call your doctor.

Is there anything I can do at home to help? Follow your surgeon’s and PT’s home program. Many of my clients also ask about nutrition. See the nutrition section above for what I did and what the research says, and talk with your doctor before starting any supplement.

My MRI or X-ray came back “unremarkable,” but I still hurt. Can you help? I can’t diagnose, but I can work with how your muscles and connective tissue feel and move. We work through it step by step, and if something needs another look, I’ll encourage you to go back to your doctor.

I had my surgery years ago. Is it too late? Not at all. Old scars and old compensation patterns can still affect how you move. My own hip surgery was in 2015, and I still care for my scars, especially when the weather turns cold. Many of my clients come in years after surgery.

Ready to get started?

Whether your surgery is coming up or behind you, I’d love to help you move well again.

Book online with Hands On Sports Therapy or call 515-778-3100.

Hands On Sports Therapy 3408 Woodland Ave, Suite 203, West Des Moines, IA 50266 Mon, Tue, Thu: 9:00am–2:30pm | Wed, Fri: 9:00am–12:30pm

Learn more: Sports & Orthopedic Therapy vs. Massage - What’s the Difference? | Meet the Team | Client Reviews

This page is for general education and shares my personal experience. It isn’t medical advice, and I don’t diagnose conditions or prescribe treatment or supplements. The surgeons mentioned here aren’t affiliated with Hands On Sports Therapy and haven’t endorsed my services. Always follow your surgeon’s and doctor’s guidance after surgery or injury.