Sunday, December 14, 2014

Will I Need To Go To Outpatient Physical Therapy After Home Health PT ?

This is a question that I get a lot from patients after the first few in home physical therapy treatments after knee or hip replacement surgery.

That answer of course will depend on several things  however, the biggest factor will be how you have progressed with your in home physical rehabilitation in the first place.

There was a day years ago that I saw all my knee or hip replacement patients for a total of six weeks for in home PT. My goal in six weeks was to be sure you did not need to go to out patient PT.

I did not necessarily tell my patients that but, that is what I worked towards and designed my home exercise to accomplish. If I did not prevent you from having to attend four to six more weeks of PT at a local PT clinic then, I felt I did not get my job done.

However today, in 2014 going onto 2015 many more orthopedic surgeons have their own out patient PT clinics with their own PT staff therefore, they learned they can make more money by getting you  home health for the first two to three weeks then, having you finish physical therapy in their clinics.

Many patients I treated that brought the question up either had difficulty obtaining transportation or may not have the insurance coverage to help off set the costs for example.

Out patient physical therapy does have its benefits and will have equipment and moralities like hot packs, tens units for pain relief, and strengthening equipment etc... that your home health PT may not be able to obtain easily.

So how do you know if you need Outpatient PT?

* Are you finding excuses as to why you could not do your exercises yesterday? So in other words you are behind in your recovery as per your PT and the goals that have been set.
* Can you bend or flex your knee approximately 110 degrees after four weeks?
* Can you extend your affected leg straight out when sitting in a chair? after four weeks?
* Are you walking without a cane independently in the home and using a cane if you walk more then 700 feet outdoors?

These are just a handful of examples that if you cannot do all of these you may be candidate for out patient PT.

Be sure to check with your orthopedic surgeon prior to surgery on his or hers rehabilitation  protocol.

Again with the limited number of in home visits given and, the constant change in regulations, you may be expected to attend out patient after several weeks of PT and once the acute pain has subsided.

And for some of you, out patient PT may be the best option as it provides a change of atmosphere, gets you out of the house and, gives you the chance to work not only with another PT but, a change in equipment and intensity will be needed to make your surgery a success.

Richard Haynes PTA, CPT
Total Joint Fitness LLC

" Where Fitness and Rehabilitation Never Ends"


Wednesday, December 10, 2014

Your Health Is Priority #1, Dont Let Daily Stress And Family Drama Stop Your Fitness Program

The saying " health is wealth" is very true. If we don't have our health we really got nothing right? Our lives can be reduced to basically existing. Now of course it all depends on the severity of the health issues. Just when you think you have it rough, someone else is going through even harder times.

I know friends for instance who allow their work, the stress of daily living, and family drama for instance which causes mental anguish to interfere with their daily workout routines and not making time to get to the gym. They skip their scheduled session.

Sure we all have days that can be more trying then others but the time you devote to your daily fitness and strength training routine should not be jeopardized because of obstacles and malfunctioning employers.

My first line of business Monday-Friday is to get up early and get to the gym by 5:00 am to get my workout in for one hour. I learned many years ago that no one cares or will care about your health and well-being more then you!

By getting my workout in first thing, the rest of the day is a breeze. If you wait to work out until after you get off work, chances are you will have missed visits to the gym. Its to easy to say " tomorrow is a better day".

Family drama or workplace problems due to poor planning for example will not constitute an emergency on my part any longer. Years ago it did not anymore.

You have to prepare not only your body but your mind for the long haul in life. Living and constantly putting out fires and dealing with non-productive time is not for you. Do we have to address problems and emergencies in life? Sure we do but, they will have their place after, I take care of myself.

Selfish? Well you have to be a little selfish at times when it comes to your health and well-being. That's the way it is and that is life in general.

Your time first thing in the morning in building and maintaining your health and fitness belongs to you then, the rest of the day you turn  over to living life and dealing with its unexpected peaks and valleys.

Richard Haynes PTA, CPT
Total Joint Fitness LLC

" Where Fitness and Rehabilitation Never Ends"


Friday, December 5, 2014

Three Habits Of Highly Effective Knee Replacement Rehabilitation

In 19 years in the physical therapy industry and, working in the field of fitness, I have seen my share of total knee replacement patients and, even have gone through a knee replacement myself.

After working with these patients and helping coach them along in getting their knee or knees back to a functional level, I have found several key attitudes they all seem to have.

1.  They See Their Final Outcome Before They Start.  In other words, they know how they expect to respond and where they are going with the final outcome as far as getting the proper range of motion in their knee and, have a goal regarding what type of lifestyle they want to get back too. Many younger and older  patients want to get back to golfing or long distance biking for instance. Tennis is another sport  I see often that the patient expects to be playing again.

They see themselves in being successful and getting back to living the lives they want before the rehabilitation is even started. They have expectations and believe they will be achieved.

2. They Understand The Importance of Discipline and Commitment.  These patients understand that nothing good comes without a price to pay. The price you have to pay with knee rehabilitation is to follow your surgeons, nurse and physical therapists instructions and, to be sure that you are completing your home exercise program at least two times a day.

They understand that flexing and extending the knee will be painful but, its pay the price now which is temporarily pain or pay the price of regret of not having a properly functioning knee the rest of their lives. Being disciplined with their exercise program is non-negotiable!

3. They Understand The Importance of Proper Nutrition. Some of my best performing and most successful knee or hip replacement patients understood the importance of not only keeping themselves well hydrated with water throughout the day but, knew that it was time to increase their protein intake and not attempt to reduce calories at this time.

Though their doctor or in-laws advised them they need to " drop a few pounds", they understood the concept that while their body is recovering from major surgery, now was the time to pound the calorie's in. Not calories loaded in high sugar content but, fruits, vegetables and low fat, high quality protein choices to help in the healing and recovery process.

The successful patient that recovers quickly knows that the fuel they put into their body will help dramatically in the recovery.

Recovering from total joint replacement surgery consists of more then being passive and hoping for the best, it takes a real commitment to be on the offensive and  take control of your full recovery.

Richard Haynes PTA, CPT
Total Joint Fitness LLC

" Where Fitness and Rehabilitation Never Ends"


Thursday, November 27, 2014

You Will Not Succeed In Rehabilitation Or Fitness By Being Impatient

After working in both physical rehabilitation and fitness for over 19 years, one of the biggest downfalls I witness with both patients and clients is their patience.

This idea that you will respond first of all, after surgery like you did when you were 22 back in 1976 is a fallacy. Yet, I see this quite often in home health after knee or hip replacement surgery.
Its also something I see in the gym when it comes to clients trying to lose weight or build muscle.

Also it seems to be a problem with my patients who are over 70, have had multiple falls, prior to my arrival in the home, are frail and have trouble getting out of a chair and cant understand why they are not showing profound physical improvement after two sessions.

Not to even mention their poor dietary and sleeping habits could have something to do with it.

I myself like to see results come a little quicker in my fitness routines. And there are days I still think I am 20 years old. But at 58, and that's not terribly old, my body just does not respond like it did.

Does that mean I just give and say " ole well what do you expect, I am getting older" no! All of us should  expect more from ourselves and understand that the body will follow our minds.

Old thinking gets old worn out results, we need to think progress and train or rehabilitate with the idea there is no limitations in life.

Of course we have to expect biology and the fact as we age we now have to work harder then ever to get results but, your goals can be reached maybe not as quickly as they once did.

In physical rehabilitation after joint replacement surgery or cardiac surgery for instance, it will take hard work to come back successfully along with understanding there is a time factor involved.

One of the biggest reasons for failure in physical rehabilitation or fitness training is not giving ourselves the needed time to produce those results we are after and, not taking the time to let out bodies recover.

Frustration and despair are psychological situations I see when I work with someone because they are trying to live up to either someone else's expectations or, having a lack of understanding that down time is needed to recover and, more is not better.

Patience is in order and even though most will admit that this is true, few actually practice it.

Allow your body to recover, being in constant motion as if you have to be completely rehabilitated  in one week or you think you have to lose 40 pounds in 30 days is a set up for failure.

Either you slow down and listen to your body or, pay a price of constant frustration and set-backs.

Consistency and being dedicated to your rehab or fitness program along with patience and allowing your body to fully recover and strengthen itself is the way to overall lasting success.

Richard Haynes PTA, CPT
Total Joint Fitness LLC

" Where Fitness And Rehabilitation Never Ends"


Friday, November 21, 2014

Dont Just talk About It, Do It!

Whether its information you are seeking about your knee or hip rehabilitation or, improving your physical fitness, there are probably a million websites out there that seem to say the same thing. Fitness is fitness, rehabilitation is rehabilitation.

And no one has the magic formula or,exercise program that will get you results any faster. I also know there is so many different variations on how to rehabilitate a surgical knee or how to build more muscle that you will find that the info is mind boggling.

Everyone will respond to rehab or fitness programs differently. Just like all of  us respond differently to certain medications or supplements on the market. The same goes for physical exercise programs.

One of the big factors in you having success in your physical rehabilitation or, physical fitness program will be your desire and commitment to improve and overcome the injury or surgical procedure and, the way it is presented and the communication skills of the physical therapist and /or personal trainer.

The bottom line is,find the combination of factors that works for you and, the instructor that matches not only your personality but,one that shows they have a keen desire to elevate you to a whole new way of life. Bringing you back from surgery or a medical scare better then you ever have been.

The next big step and the most important will be your commitment to take the information and instruction and apply it. If you do not have the will to fight and improve your life or, you are doing your fitness or rehabilitation program for someone else then you will more then likely fall flat on your face.

I see this everyday in home health physical therapy. Someone has fallen or become weak, cant walk safely for instance, a wife, husband etc.... has asked the doctor for a physical therapy to have someone work with them to improve their ability to transfer, ambulate or walk and strengthen themselves.

Unless that patient or individual in any under taking is internally motivated to improve their quality of life or physical appearance then it becomes a waste of time and the insurance companies money!

If youare going to do something about your health, your physical appearance or, improve your quality of life, then get your head into it and make the commitment to work hard and do whatever it takes to be disciplined enough to be a winner!

If not , then its highly recommended to save your time and your instructors time for someone else that has made that promise to themselves that enough is enough!

Richard Haynes PTA, CPT
Total Joint Fitness LLC

" Where Fitness and Rehabilitation Never Ends"

Saturday, November 15, 2014

Your Health, a Good Defense Is a Good Offense

When it comes to health prevention or most things in life that need to be addressed for the best possible outcome, the best defense is a good offense. Its a saying kicked around in the military.

How many of us sit around and try to avoid things in life that we feel will harm our health? Instead of being on the defense all the time, I propose to you today to be assertive and go out and participate in physical fitness activities and get a taste of good, solid competition with others.

Sure, we have to watch the foods we eat, stay away from harmful substances like excessive alcohol intake that will rob you of your vitality and destroy our minds, however, we need to instill and aggressive exercise program and remain disciplined and full- filling  our obligation to ourselves to get and stay in the best possible physical and mental conditioning as possible.

Aggressive exercises are not meaning exercise that will harm you, all of us need to know and understand our physical limitations before embarking on physical exercises if we have not been active in a while. What I mean is something more then just daily walks with the dog around the block.

Instead of looking for cures or some magic pill that the pharmaceutical companies or your doctors are happy to prescribe you, many times the answer  to our physical ailments lie within  us.

Its called getting off the sofa or recliner and get moving. To age and allow ourselves to get soft physically is about the worst thing you can do to yourself. Getting soft physically also generally means you are getting soft mentally as well.

Complacency and a lack of growth  is the number one cause of physical ailments and depression in the elderly in my opinion. Again that's mine only. To stop growing and feel, " I just want to take it easy now" is giving up on life!

To stay happy and fulfilled as we age we not only need to do some soul searching and find out what we would like to accomplish next in life but, also to get serious about our physical and mental conditioning and stay as active as possible.

Again, any exercise program you undertake needs to have a cardiovascular, strength training and, a stretching component in it. I have mentioned this in other previous posts as well.

Each day before you start getting involved in your daily routines , start with 45-60 minutes of exercise five to six times a week.

It not only will help you physically and help in reducing medical costs but, improve your mental outlook on life as well.

And part of your new health commitment is staying away from negative and toxic people. There are plenty of them to go around these days, and you should not have the time to indulge either, in the problems in the world.

Don't wait for physical ailments to come to you, you go and confront them and, work on knocking down obstacles today that can prevent you from living a happier more fulfilled life.

Richard Haynes PTA, CPT
Total Joint Fitness LLC

" Where Fitness and Rehabilitation Never Ends"

Wednesday, November 5, 2014

Exercise Your Basic And Strength Building Movements First

I make it a habit and its a personal way of life to workout at the gym each morning five days a week. So needless to say I have seen a lot of things over the years that make you wonder why many people fail at achieving their strength and overall fitness goals.

There are many reasons in fact too numerous to mention in one blog posting however, one big reason I find that many older adults show little change in both their strength and physical appearance is because they have gotten away from the basics when it comes to weight training.

Trying to follow the latest trends in fitness can be mind boggling today. What worked 50 years ago, will work today when it comes to getting your stronger and more fit as we age.

Following advice from everyone you meet at the gym will only lead to further confusion. There will always be pros and cons to every movement along with those who, are contrarions even with the most basic movements and their effectiveness.

When your time is limited when it comes to your fitness schedule, you should be looking at the basic movements that will not only build more strength but also, help in areas like improving bone density, lowering cholesterol and, improving your bodies metabolism for starters.

Those basic movements being a rowing  movement for your back, a full or modified squat movement for your legs and gluteals and, a pressing movement for your chest and shoulders. Now these exercises are even more stimulating to your body when done with free weight however, as we age including myself, we are possibly dealing with orthopedic issues and some machines are better to use then free weights to help avoid further injury or exacerbation.

The basic exercises I talk about that you should do before leaving the gym especially if you work out only three days a week are:

Seated Back Rows: This is a good all around movement that will help build a strong back, help with your arm development and improve your posture through stronger muscle and spinal support. Keeping your repetition ranges between 12-20 repetitions will help with not only the strengthening component but, also improve your muscular endurance in the back which can help prevent back pain.

Bench Presses: Whether seated or lying supine on a bench, both are good for the pectoral muscles or chest but also, your shoulders and triceps. This is an exercises that will help in building upper extremity strength as well

Squats or Partial Mini-Squats: These can be done in several different ways as well. This exercise will not only keep your legs, hips and low back strong but, also speed up your bodies metabolism to help with your weight loss efforts and, with high repetitions is a great cardiovascular workout.

Take your heart rate the next time you knock out a set of 20 squats and see what I mean.

With just these three exercises added to your workout plan, you will notice an increase in strength and overall muscular endurance in time with a strong commitment. Of course as you get stronger and more seasoned with strength training, you can free lance a little and try other movements.

But for beginners, simplicity is the key and using these three solid compound movements will get you results that you are looking for to build a good solid strength and fitness foundation for years to come!

Richard Haynes PTA, CPT
Total Joint Fitness LLC

" Where Fitness and Rehabilitation Never Ends"

Wednesday, October 29, 2014

Your Physical and Mental Health is Your Responsibility

Your physical and mental health is your responsibility. How many people do you know that leave both their physical and mental health to chance? I know quite a few my self, how you ask?

By the people we associate with for starters, how many of us know someone that all they have to talk about is how bad their health is? To be honest its boring. And to be even more honest, no one really cares about your health but two people, one is your doctor, the second one is the local mortician.

How many times have you heard me talk about understanding that your body is controlled by your mind. Not the other way around. By associating with people that complain about their health all day and how terrible it is just brings the rest of us down.

Learn to suffer in silence! Understand worrying will do nothing for them or you yourself, it wont change a thing. If your worried about your health, then go see a competent doctor. Yes I said competent. Some as you know are better then others and willing to take the time to listen. Find someone that is willing to find an answer to your health  problems if you have any at all.

Your mental health is guided and determined by your thoughts and what you take in on a daily basis.
Watching hours of negative programming on the TV surely will not take you the promise land of good health and vitality.

Living your life and your daily decisions made by what you see on TV is not the way to go. In my estimation, other then competitive sporting events which I enjoy there isn't much else on.  But that's my opinion and everybody has one right?

Remember, the body is a product of your mind. Think negative and angry thoughts all day and you reap the harvest of a toxic mind and body.  Sure there is nothing wrong with being realistic in life but make sure you keep everything in perspective. The world will not end tomorrow.

You have your physical gym and, you should be attending  a mental gym as well. Your mental gym is where you will take a few minutes of your day in complete silence and visualize and see the type of body you want and, the type of health you desire. This can be done first thing in the morning,

All of your life including your health starts in the mind. You have more control over your physical destiny then you think.

We as individuals just have to stop buying into the " sky is falling mentality in life, watch who we associate with and, be more pro-active in all facets of your life including our health.

Richard Haynes PTA, CPT
Total Joint Fitness LLC

" Where Fitness and Rehabilitation Never Ends"