Orthopedic · Kauai
Physical therapy after knee or hip surgery in Kauai
After a joint replacement or ACL reconstruction, the rehab is what decides the result. Video visits make it possible to do that rehab from home, three times a week if needed, without the drive.
- TRICARE, HMSA, and HMSA QUEST in-network
- No state referral requirement; some plans need one
- Video visits anywhere in Kauai
About the condition
Rehab after knee or hip surgery: what is going on.
Total knee replacement, total hip replacement, ACL reconstruction, meniscus repair, and hip arthroscopy each come with a rehab protocol that runs for months. The first weeks are about swelling, range of motion, and walking; the following months are about strength, balance, and returning to work, sport, and stairs. People who do the rehab consistently recover faster and get a better final result. People who cannot get to a clinic three times a week often do not.
Telehealth rehab after knee replacement has been studied in large trials and found as effective as in-person care, with higher completion rates. The same model applies to hip replacement and to the later phases of ACL rehab.
Common experiences
What people with rehab after knee or hip surgery often describe
These are the patterns Dr. Shalem hears most often. Any of them is a reason to book a discovery call.
Stiffness and difficulty bending or straightening after surgery
Swelling and pain that limit walking
Weakness and a limp
Uncertainty about what is safe and when
Difficulty getting to clinic visits
Wanting to return to hiking, running, or sport
Treatment
How physical therapy addresses it.
The program follows the surgeon's protocol: range of motion and swelling control first, then progressive strengthening, balance, gait training, and finally return to stairs, work, and sport with objective criteria. Dr. Shalem coordinates with the surgical team and sends progress updates.
What a video visit looks like
Dr. Shalem measures range of motion with guided techniques on camera, watches gait and stairs, and progresses the protocol at each visit. Early post-op visits can be as frequent as needed because there is no travel.
Coverage in Hawaii
Insurance and pricing
Bring your plan name to the discovery call and we confirm your physical therapy benefit before the first visit.
TRICARE
In-network (TRICARE West). TRICARE Select members can book directly with no referral. TRICARE Prime members need a referral from their primary care manager, and we tell you exactly what to ask for.
HMSA
In-network with HMSA PPO and HMO plans. Some HMSA plans require a referral from your primary care provider; we check yours before the first visit.
HMSA QUEST
In-network with HMSA QUEST (Hawaii Medicaid). We confirm coverage before your first visit.
Private pay
Available for any other plan. HSA and FSA cards accepted.
Referrals
Hawaii allows you to start physical therapy without a physician referral. Your insurance plan may still ask for one (TRICARE Prime and some HMSA plans do), and we check that for you before the first visit.
All of Kauai is seen by video, including military families at Pacific Missile Range Facility Barking Sands.
Questions
Questions people ask about rehab after knee or hip surgery
How it works
How a virtual visit works
Dr. Shalem measures range of motion with guided techniques on camera, watches gait and stairs, and progresses the protocol at each visit. Early post-op visits can be as frequent as needed because there is no travel.
Discovery call
15 minutes, free, by phoneA short call to hear what is going on, explain how visits work, and check insurance or pricing. No pressure to book.
Evaluation
60 minutes, by videoDr. Shalem takes a full history, watches how you move and breathe, and guides the self-assessments she needs to build a plan.
Your plan
Same visitYou leave the evaluation with a plain-language explanation and a short home program, usually a few minutes a day.
Follow-ups
45 minutes, every 1 to 2 weeksProgress checks, program updates, and techniques you can do yourself, for as long as they are useful.
For a video visit you will need
- A phone, tablet, or laptop with a camera
- A private room
- A mat or towel
- About an hour
Questions
Rehab after knee or hip surgery questions in Kauai
Can post-op rehab really be done by video?
For knee and hip replacement, trials have shown telehealth rehab to be as effective as in-person care. Some surgeons prefer an in-person component in the first two weeks; we coordinate with the surgical team.
When should rehab start after surgery?
Usually within the first week. Dr. Shalem follows the surgeon's protocol and timeline.
What about ACL rehab?
The strength, control, and return-to-sport phases translate well to video. The earliest phase and the return-to-sport testing may benefit from in-person components, which we coordinate.
Do I need a referral for physical therapy in Hawaii?
Hawaii allows you to start physical therapy without a physician referral. Your insurance plan may still ask for one (TRICARE Prime and some HMSA plans do), and we check that for you before the first visit.
What insurance do you take in Hawaii?
TRICARE: In-network (TRICARE West). TRICARE Select members can book directly with no referral. TRICARE Prime members need a referral from their primary care manager, and we tell you exactly what to ask for. HMSA: In-network with HMSA PPO and HMO plans. Some HMSA plans require a referral from your primary care provider; we check yours before the first visit. HMSA QUEST: In-network with HMSA QUEST (Hawaii Medicaid). We confirm coverage before your first visit. Private pay: Available for any other plan. HSA and FSA cards accepted.
Your physical therapist
Dr. Elana Shalem, DPT
Doctor of Physical Therapy, University of St. Augustine for Health Sciences, Miami. Licensed in Hawaii.
Dr. Shalem treats pelvic health for women and men, from pregnancy and postpartum recovery to bladder, bowel, and pelvic pain conditions and recovery after prostate or pelvic surgery, and general orthopedic conditions of the back, neck, hips, knees, shoulders, and feet. Visits are one-on-one and unhurried, and she explains what she is seeing in plain language.
More about Dr. ShalemPrefer to write? Send a message.
Questions about insurance, pricing, or whether physical therapy is the right next step? We reply within one business day.
Start with a free 15-minute call.
Tell us what is going on, hear how Dr. Shalem would approach it, and decide from there.