Your surgeon fixed the structure. What happens in physical therapy determines what you can actually do with it. Post-surgical outcomes aren't decided in the OR — they're decided in the weeks and months of rehabilitation that follow. At Solas PT, Dr. Cisneros sees you every single session, tracks your response day to day, and advances your recovery based on how your tissue is actually healing — not on a generic protocol printed before you arrived.
"I can confidently say he is one of the greatest doctors I've ever had the privilege of working with. After two hip surgeries, I wasn't sure what my future would look like physically. Today, I'm not only able to move pain-free, but I'm back to squatting and actively involved in orthopedic training and bodybuilding. That level of recovery speaks volumes about his skill and dedication."
"Dr. Cisneros is so knowledgeable and helpful! If I could give 10 stars I would!"
"Dr. Cisneros is one of a kind. Not only is he excellent in making you feel better but also getting you moving like you're supposed to again. He is so kind and compassionate and just an overall good person. Do yourself a favor and book an appointment — you won't regret it one bit!"
The OR fixes the structure. Physical therapy determines what you can actually do with it. A perfectly executed ACL reconstruction doesn't guarantee a return to sport — the rehabilitation that follows does. A rotator cuff repair that restores the tendon doesn't guarantee full overhead function — the mobilization, strengthening, and progressive loading in the months after does.
This is why the quality of your post-surgical PT matters as much as the quality of your surgery — and why a generic, aide-supervised, 15-minute session three times a week isn't an adequate substitute for individualized, clinician-directed rehabilitation.
Dr. Cisneros follows your surgeon's post-operative protocol precisely — and within those parameters, individualizes every aspect of your care to how your specific tissue is healing, responding, and progressing.
One of the most critical and consistently mishandled aspects of post-surgical care. Early, appropriately dosed movement reduces swelling, prevents scar tissue adhesions, protects the repair, and accelerates tissue remodeling. The clinical skill is knowing exactly how much is appropriate — too little is as damaging as too much.
Post-surgical symptoms change every single session. Swelling, pain levels, range of motion, and tissue response all shift in ways that require real-time clinical judgment. This only happens when the same clinician sees you every visit — not when you rotate through staff who don't know what you looked like two days ago.
Manual techniques, positioning, and appropriate loading are the primary tools for managing post-surgical pain and edema. Medication manages the floor — skilled PT determines the ceiling of how fast you can move through early recovery.
Post-surgical rehabilitation follows a structured progression through three phases. What happens in each phase determines what's possible in the next. Skipping steps — or completing phases inadequately — doesn't just slow recovery. It changes the ceiling of what full recovery looks like.
The most critical and most commonly mishandled phase. The goals are protecting the surgical repair while initiating early, appropriately dosed movement. Immobilization is not protective — controlled early mobilization is.
Common failure in insurance PT: Therapist avoids early mobilization out of excessive caution — or applies it without knowing the appropriate limits. Scar tissue forms. Range of motion is permanently limited before Phase 2 even begins.
The bridge phase — building strength and neuromuscular control as tissue heals. What gets addressed here determines whether the functional phase is possible at all.
Common failure in insurance PT: Hip abductor weakness and single-leg instability never addressed in a post-ACL female athlete. Six months post-op, not ready to begin sport-specific training — and at elevated re-injury risk if cleared prematurely.
The final phase — sport-specific or activity-specific loading, return-to-sport testing, and clearance criteria. This phase is only possible if Phases 1 and 2 were completed correctly.
Common failure in insurance PT: Patient arrives at Solas PT in the functional phase with unresolved Phase 1–2 deficits. Full progression isn't possible — the recovery ceiling has already been lowered by inadequate earlier care. The cost to the patient is time, money, and permanent limitation.
The compounding cost of inadequate early care: Insurance-based PT is often less expensive per session — but patients who enter the functional phase with unresolved deficits require significantly more total treatment, often at a higher-quality clinic, to approach their recovery ceiling. One-on-one care from the start is not a luxury. Over the full arc of recovery, it is reliably the more efficient and less costly path.
Each procedure has distinct healing timelines, surgeon protocols, and phase-specific goals. Dr. Cisneros tailors care to the exact surgery — not a generic "post-op" protocol.
One of the longest and most protocol-critical rehab processes in orthopedics. 9–12 months from reconstruction to safe return to sport. Quad and hamstring symmetry, neuromuscular retraining, hop testing, and sport-specific loading — all must be completed before clearance. Re-injury rate after premature return is significant.
Overhead range of motion is the most commonly unrealized outcome after rotator cuff repair — and it's almost always a manual therapy failure. Dr. Cisneros applies joint mobilization and soft tissue work from the earliest appropriate point in the protocol to ensure full overhead function is achieved, not just "functional range."
Early mobilization after joint replacement is strongly supported by evidence and dramatically reduces complications. Regaining full range of motion, strength, and confidence with single-leg activities is the measure of success — not just walking without pain. Dr. Cisneros uses joint mobilization, manual therapy, and progressive strengthening to drive recovery forward.
Labrum repairs protect shoulder stability but require careful progression of range and load to avoid stressing the healing tissue. Posterior capsule tightness after SLAP repair is common and requires specific mobilization to restore internal rotation and overhead reach. Dr. Cisneros manages this progression precisely within surgeon protocols.
Repair and meniscectomy have different weight-bearing and loading timelines — often dramatically different. A meniscectomy returns to full weight-bearing quickly; a repair may require weeks of restricted loading. Dr. Cisneros follows your surgeon's specific protocol and advances range of motion and strength within those parameters.
Post-spinal surgery rehabilitation requires careful attention to fusion timelines, neural recovery, and core stabilization. Dr. Cisneros coordinates directly with your spine surgeon's protocol and addresses the mobility, strength, and movement pattern deficits that spinal surgery commonly leaves behind.
Dr. Cisneros regularly receives patients mid-recovery who started their post-surgical care at an insurance-based clinic and plateaued — or worse, regressed. The pattern is consistent enough to be predictable. Here's what actually happens.
Post-surgical recovery changes daily. A PT who hasn't seen you since Tuesday has no idea how you responded to Tuesday's session. Generic protocols get applied. Critical adjustments — progressing range faster because tissue responded well, backing off loading because of unexpected swelling — never happen because the clinician doesn't have the longitudinal picture to make that call.
This is one of the most common early failures. Inexperienced clinicians either avoid early mobilization entirely — afraid of damaging the repair — or apply it without knowing the specific tissue constraints for that procedure at that time point. Both errors have consequences: scar tissue that forms in week two is far harder to address in week eight.
A post-ACL female athlete at five to six months out who hasn't addressed hip abductor weakness, gluteal activation, and single-leg stability is not ready to begin sport-specific training — regardless of what the calendar says. Clearing patients based on time elapsed, rather than objective criteria, is one of the primary causes of ACL re-tears. These patients arrive at Solas PT unable to be fully progressed because the foundation was never built.
After rotator cuff repair, posterior capsular tightness and restricted glenohumeral mobility are the most common barriers to full overhead function. Resolving them requires skilled joint mobilization — not just exercise. At clinics where manual therapy is performed by aides or not at all, patients plateau with restricted overhead range that then takes significantly longer to recover, if it's recovered at all.
The real cost: Inadequate post-surgical PT doesn't just slow recovery — it permanently lowers the ceiling of what recovery looks like. Patients who spend months in a generic program and then switch to Solas PT often recover significantly — but they are starting from a position that proper early care would have prevented. Getting it right from the beginning is always faster and less expensive than correcting it later.
Research consistently shows that patients who complete prehabilitation before surgery recover faster, regain strength and range of motion sooner, and achieve better functional outcomes than those who start from baseline on day one. The goal is maximizing the starting point — so the tissue you bring into the OR gives you the best possible foundation for what comes after.
As soon as your surgery is scheduled. Even 2–4 weeks of focused prehabilitation produces measurable differences in post-operative outcomes. Dr. Cisneros will coordinate with your surgeon on timing and design a prehab program specific to your procedure and starting point. There's no minimum or maximum — any amount of preparation is better than none.
For most orthopedic surgeries, physical therapy should begin within days of the procedure — not weeks. Early mobilization, when properly guided, reduces swelling, prevents scar tissue formation, and protects the surgical repair far better than prolonged immobilization. Dr. Cisneros will coordinate directly with your surgeon's protocol to determine the appropriate start date and progression parameters for your specific procedure.
The single most important difference is continuity of care. Post-surgical symptoms change day to day — swelling, range of motion, pain levels, and tissue response all shift in ways that require same-session adjustments. At an insurance-based clinic where you may see a different PT or aide each visit, those adjustments don't happen. Generic protocols get applied regardless of how you responded since your last visit. At Solas PT, Dr. Cisneros sees you every session, tracks your exact response to every intervention, and adjusts in real time.
The consequences compound over time. If range of motion isn't properly restored in the initial and intermediate phases, the functional phase becomes impossible to complete correctly. A post-ACL athlete who hasn't addressed hip abductor weakness and single-leg instability by 5–6 months cannot safely begin sport-specific training — and is at elevated re-injury risk if cleared prematurely. A rotator cuff repair patient who didn't receive proper joint mobilization often plateaus with restricted overhead motion. Inadequate early rehab doesn't just slow recovery — it changes the ceiling of what full recovery looks like.
ACL reconstruction, rotator cuff repair, shoulder labrum (SLAP) repair, total hip and knee replacement, hip labrum repair, meniscal repair and meniscectomy, spinal fusion, and other orthopedic procedures. Each protocol is tailored to the specific surgery, your surgeon's guidelines, and your individual tissue response.
Yes — and research consistently shows that patients who complete prehabilitation recover faster and achieve better functional outcomes than those who start from baseline on day one. Dr. Cisneros can begin prehab as soon as your surgery is scheduled. The goal is maximizing strength, range of motion, and neuromuscular control before the procedure so your body has the best possible foundation for recovery.
It varies by procedure and individual response. Total knee replacement typically takes 3–6 months to full function. ACL reconstruction takes 9–12 months for safe return to sport. Rotator cuff repair typically takes 4–6 months for full overhead function — longer for large or complex tears. What matters more than calendar time is milestone completion: you advance through phases when your tissue is ready. Dr. Cisneros tracks objective measures at every session so you always know where you stand.
No referral is required to see Dr. Cisneros at Solas PT. For post-surgical care, Dr. Cisneros will obtain your surgeon's post-operative protocol and coordinate care with your surgical team — ensuring your rehabilitation stays within the specific parameters your surgeon has set, particularly in the early weeks when tissue healing constraints are most critical.
Most patients begin walking the same day as surgery, then transition to home health for about 2–4 weeks before entering outpatient therapy. The outpatient phase runs roughly 2–3 months of progressive functional strengthening and mobility work until discharge. Full recovery often takes around 6 months, and longer for some. Dr. Cisneros treats all surgical approaches — the anterior approach tends to recover best because it spares the important gluteal muscles instead of cutting through them.
Right away. Patients typically start walking the same day as surgery while working on bed mobility and transfers, and are usually discharged from the hospital the next day — longer if functional mobility deficits remain. After a short home-health phase, outpatient PT is where the real progressive strengthening happens, and that's where Dr. Cisneros at Solas PT rebuilds your strength and function.
Early on, glute and quad activation is crucial — glute and quad sets progressing to straight-leg raises, then early glute medius/maximus loading with clamshells, bridges, and side-lying hip abduction. From there it advances to functional work: sit-to-stands, single-leg balance, lateral walk-outs, step-ups, and eccentric lowering in a single-leg position. Dr. Cisneros tailors the progression and weekly loading to your specific recovery rather than handing out a generic sheet.
Yes. Early quad and glute activation is the foundation everything else builds on — without it, progressing into the functional strengthening that restores quality of life is much harder. Many insurance-based clinics rely on cookie-cutter 3-sets-of-10 programming and miss the exercise-physiology principles and weekly loading progression that drive results. Solas PT provides specific, tailored programming, one-on-one with Dr. Cisneros every session.
After a posterior approach, surgeons typically advise short-term precautions — avoiding hip flexion past 90 degrees, crossing the legs, and internal rotation — to protect the healing joint. These are usually standard but vary by surgeon, so following your surgeon's specific protocol is essential. Dr. Cisneros works within your surgeon's precautions and coaches you through them while still progressing your strength safely.
Many people can — but only after the right rehab. Dr. Cisneros makes sure strength and movement deficits are fully cleared before progressing into impact activity, which protects the new joint. He has returned higher-level patients to running and CrossFit/Hyrox-style training after hip replacement by building an individualized, progressively loaded program rather than rushing back. The key is not skipping the functional strengthening base.
Post-Surgical Patient
"Dr. Cisneros provided long term physical therapy following my lumbar spinal fusion. He definitely goes the extra-mile to help! His knowledge, professionalism, and courteous demeanor is a breath of fresh air!"
Post-surgical care at Solas PT means the same clinician, every session, tracking your response day to day and advancing your recovery based on how your tissue is actually healing — not a protocol that was written before you arrived. West El Paso · Same-week appointments available.