Saturday, July 26, 2014

Knee Replacement Rehabilitation Is Not Linear

Knee Replacement rehabilitation is not linear, in other words, what I stress to my patients and clients is to expect the unexpected at times. Every day is a new day and you will, experience  variations after surgery As much as I mentally prepare them to expect the typical ups and downs of pain and swelling that goes with this type of surgery, it still seems to catch many off guard.

Those first several weeks once you get home can be very challenging. You will have some good days and expect to have some rough ones as well. Rough meaning your surgical knee will swell more or, you will experience more pain and cramping for instance.

As I have mentioned in previous posts, this is just part of the trials and tribulations of knee replacement surgery. And, no matter how many times I inform my patients that they can and will experience this phenomena, many still are not quite sure how to deal with it and appear to be caught off guard.

There is no magic exercise or positioning of your knee that will give you relief from this experience, maybe temporary but you will not be able to avoid it.

What causes this fluctuation of pain and swelling? Additional movement in other words, staying on your feet a little longer once home, the big one is trying to ween yourself off the pain medication too fast. This is the biggest problem I find in home rehabilitation.

As you have been probably told by your orthopedic surgeon and physical therapist already, expect these pain and swelling variables to continue for at least six weeks out from surgery. For some maybe longer.

You can ice your knee, elevate your knee throughout the day, monitor closely your walking and how much time you spend on your feet but, it will be difficult to avoid this experience it seems everyone has their day with it.

This is how you learn quickly what " doing too much " is, it is different for everyone. We all will have to learn the hard way in other words.

Remember, if you do experience this you are not falling behind. Too often I get patients upset , depressed, or in tears thinking they are falling behind. Nonsense! Learn to deal with it.

If you have comments or questions please leave one. If you would like to share your  experience, please leave it to share with all of your new joint replacement brothers and sisters.


Richard Haynes PTA,CPT
Total Joint Fitness LLC
http://www.richardhaynes.com
http://www.total-jointfitness.com

" Where Fitness and Rehabilitation Never Ends"


Sunday, July 13, 2014

Develop The Mental Edge During Physical Rehabilitation

In my daily work in the physical rehabilitation profession, I see all types of people. After all, in the world no two people are alike. I think we all know that. What separates our success and failures and how we respond them is our mental outlook, our attitude in other words.

I not only see this in physical therapy and the recovery of my patients but, also in the world of fitness and those individuals who are trying to lose weight for instance.

What I have learned over the years is that as a physical therapist, we not only responsible for making sure you have a laid out and clear cut path to rehab success through well defined exercise programs but, I like to include that I want to be sure you as a patient or client of mine have instilled in you that mental edge, that will to win at the game of physical recovery in other words.

The physical component no doubt is important but, your mental outlook will be vital to your success.

Yes, I do take physical rehabilitation seriously and making sure you recover completely and, are functioning at a higher level then you did before knee replacement surgery is what its all about.

I like to make sure you understand in the few weeks that  I am working with you that,  you are getting 100 per cent of my abilities and in return I need 100 per cent of yours. Any PT will ask and expect the same.

Motivation to succeed and to see the long term results are the key. During your initial recovery, understand that you re in training. Every sport has a training period before the season starts and you have have one as well.

So understand that there will be some pain and discomfort involved. Understand that the price you pay now by going through the exercises to get your knee to bend and extend properly and effectively will only help you walk correctly and maximize you overall quality of life through better mobility and less chronic pain.

By telling me or any other therapists that you did not do the exercises or follow through on the pain management recommendations is setting you up for failure and disappointment.

Remember, ultimately you are responsible for your rehabilitation success!  You can be pointed and prepared to go in the right direction but you, have to put in the work and have that desire to conquer and overcome all obstacles to be a success.

Develop that mental edge that you will be a winner by focusing and visualizing what you want to do and look like after the rehab is over. You will have another chance now at life to enjoy it and live like you were meant to live.

Mental toughness right now is the key. Have that talk with your PT. They are your teacher and cheerleader right now, they should be more then someone that walks in to your home and throws a few sheets of exercises at you and says good luck.

Both of you working together and you understanding that " what does not kill me, makes me stronger" will then reap the fruits of successful total joint replacement recovery!

Leave a comment or question on what you do or how can you push yourself through those moments or ideas that you can add to this post.


Richard Haynes PTA, CPT
Total Joint Fitness LLC
http://www.richardhaynes.com
http://www.total-jointfitness.com

" Where Fitness and Rehabilitation Never Ends"


Thursday, July 10, 2014

Total Joint Replacement and Chronic Pain

I think most of us can agree on that having either a knee, hip, or shoulder replacement is not something to take lightly. There are a number of areas that you need to understand prior to surgery that can affect your overall experience after surgery.

Probably the two that stand out and what you have full control over is your prior level of conditioning before the surgery and, home preparation regarding your home layout, furniture you will sit in etc...food preparation etc...

One area that many are aware of before surgery but, may not fully understand until they go through it is the possible dilemma of chronic pain and, keeping it under control.

I find over the years, that this appears to be more of a problem with knee replacement surgery rather then with hips or shoulders.

There are numerous reasons for the problem of lack of adequate pain control after surgery. This really begins to rear its head once you get home from the hospital. For instance, at the hospital you are medicated properly and usually on time, along with the fact you are for the most part, kept still either in bed or a chair unless you are getting your PT treatments.

Its once you get home that if you are not careful and compliant with the pain medication schedule that the fireworks can begin. Its just a plain fact that once you get home, you will become more mobile and active.

Also, the medication may not be a strong as you were prescribed in the hospital and the delivery method by IV for instance is no longer used, you revert to pill form and, many people do not keep the pain medication at a therapeutic level once they get home. Oral medication will not work as quickly as the  inter venous method.

Pain medication has gotten a bad rap these days due to misuse, even accidental deaths. For others they do Not like " the way it makes me feel" or they do not want to take on the fight of the possibility of being constipated as the drugs will slow down your GI tract. Your Home health nurse and physical therapist can give you ideas to help combat that.

One other big factor is patients trying to take too much on once they get home. Things like making beds, cooking meals, washing dishes because " my husband does a terrible job" or "he cant boil water" will ultimately cause you pain management issues along with increased swelling.

Everyone's pain threshold is different. Everyone's body will react differently and, the amount of swelling will differ.

As I have mentioned in previous posts, you can count on the fact that you will not be pain free. Its just how you manage your pain medication, your rehabilitation schedule and, workload around the home that will determine how painful your overall experience is.

If you have questions or comments regarding your levels of pain or how to handle your pain management, please leave a comment below. Your questions or comments can help many others going through the same thing after joint replacement surgery.


Richard Haynes PTA, CPT
Total Joint Fitness LLC
http://www.richardhaynes.com
http://www.total-jointfitness.com

" Where Fitness and Rehabilitation Never Ends"

Thursday, July 3, 2014

In Physical Rehabilitation, " The Only Easy Day Was Yesterday"

Some you you may have heard this quote made popular by the United States Navy Seals, " the only easy day was yesterday" . I personally prescribe and live my life by it. In other words I plan ahead of schedule what I plan to accomplish that day then, push forward at all costs to get it down. Once done and the day is over, its now in my book considered finished! Now it was easy.

When it comes to your physical rehabilitation, after having a knee, hip ,or shoulder replacement, some of us dread each morning when we get up knowing someone like myself will be visiting your home to take you through your rehabilitation, or maybe you are headed out to a local out-patient clinic for your PT.

Of course we as physical therapists are not there to see how much pain we can cause or, how uncomfortable we can make you feel no. We are there to get you educated and inspired along with setting you up for a successful outcome after your joint replacement.

No one said the physical rehabilitation was going to be easy did they. In fact most patients I talk with have somewhat of an understanding how tough its going to be.

I say somewhat because, no one knows for sure until they go through it. And, as I have mentioned before in my humble estimation, the knee replacement rehabilitation program is the toughest.

So you take each day separately. You will have been given a plan by your Physical Therapist as to what exercises to do along with your daily frequency etc....

Don't worry about tomorrow, concentrate on today's exercise plan only.

There will be days you will not feel like doing the exercises, there will be days when you have more chronic pain and swelling, expect it and be mentally tough enough to deal with it.

Find a way to push through some of this and get it done. Once done, you can put that days exercises in the bank as complete.

When you wake  up the following day, you realize you made it, you got done what needed to get done in other words. Then you will look back knowing yesterday has come and gone therefore it is now easy in comparison what is in store for you today. A new day and new challenges await.

Look at your physical rehabilitation for the first six weeks after joint replacement as a version of basic training. Take it one day at a time. If you think too far ahead its get overwhelming.

Carry on you rehab warrior.


Richard Haynes PTA, CPT
Total Joint Fitness LLC
http://www.richardhaynes.com
http://www.total-jointfitness.com

" Where Fitness and Rehabilitation Never Ends"

Saturday, June 28, 2014

Knee Pain Special Report

How To Control Knee Pain After Knee Replacement Surgery is a special report I have made available to all of you that are looking for ideas that you may not be aware of or, have not been instructed in during your pre-operative joint replacement classes.

Look it over its a free download. If you have any questions about the information or would like to comment, please leave your questions or comments in the comment box below and I will be happy to answer them.

Learning to control the chronic pain and swelling that can be associated with a knee replacement can be somewhat difficult if you do not learn how to get a handle on it quickly.

Remember prior to surgery you were dealing with a different type of pain known as chronic pain. In other words, it was not going away until you dealt with the cause. After surgery you are now dealing with surgical pain.

Surgical pain will in time clear up. How soon it begins to subside depends on several things including your activity levels after surgery and, how compliant you are with pain management techniques.

Give your knee anywhere from six to eight weeks after the day of surgery before it will give you consistent pain free performance.

Remember what the surgeon said while you were in recovery, " I did the easy part by performing the operation, now you have the difficult part by going through the rehabilitation".



Richard Haynes PTA, CPT
Total Joint Fitness LLC
http://www.richardhaynes.com
http://www.total-jointfitness.com

" Where Fitness and Rehabilitation Never Ends"

Thursday, June 26, 2014

Three Tips To Help You With The Rehabilitation Of Your Fractured Femur

If you have ever fractured your femur, or also known as your ' thigh bone',  you had to learn the among other things about being patient. Fracturing your femur can take months to heal depending on the severity of the fracture, type of fracture and location.

Soft tissue injury when such as large bone is fractured is quite common as well and the healing process is compounded time wise. I went through such an injury myself years ago with a fractured femur in nine different locations from a previous motorcycle accident, and no, I do not ride motorcycles any longer.

Working in the field of physical therapy along with experiencing this type of trauma myself,  I learned three solid tips that will help you in going through the rehabilitative process when it comes to not only healing of the fracture or fractures but, helping you strengthen the area as well.

1. Be Patient: Many will say that's a given Richard but, from what I learned working now in physical rehabilitation for over 18 years, its easier said then done. In fact I battle with it every day myself no matter what it may be. The femur is a big strong bone, therefore it will take some time to properly heal. Remember, the older you are the slower the process. Too many of us including myself are still living in our 20s when it comes to healing and "why is this taking so long".

Fractures cannot be rushed, they will heal in their time therefore relax, and enjoy the process.

2. Follow Your Orthopedic Surgeons and Physical Therapists Instructions: You will be given information regarding your weight-bearing status on the affected leg by your doctor. Be sure to listen and follow this piece of information carefully. Too much pressure and you risk causing further damage, too little weight-bearing and you risk slowing down your recovery.

You will be given even more detailed rehabilitation instructions from your physical therapist. As mentioned above, be sure to follow them carefully. Your PT can give you some insight as to how to monitor your weight-bearing status by showing how to apply the proper pressure. Also, you will be given an exercise handout to follow, be sure you follow it as instructed and understand what you are doing and why you are doing it.

Properly completing your exercises will either make your overall recovery a success or, if you are not compliant, cause general muscle weakness and possibly chronic pain to linger for some time if not permanently.

I broke my femur years ago as a teenager and, to this day I  feel the fact that I was not given this instruction nor did I ever see a physical therapist, has caused an muscle and strength imbalance between my two legs.

3. Be Sure To Get Your Proper Nutrition: This is another area where some feel should go without mentioning however, I see too many patients especially the elderly with fractures not getting the proper diet and nutrition when their body is trying to heal from fracture or other injury.

Getting the proper amount of calcium is vital and you can discuss this with either your orthopedic surgeon or primary care doctor as to what amounts are safe. Generally 2000 mg is what is recommended for adults.

As I have suggested in previous posts, now is not the time to go on a diet. Look at consuming some diary products along with staying hydrated with plenty of water to help your body transport these vital nutrients to the injured area.

A fracture femur is no picnic as it reduces your mobility and ability to transfer etc... Stay positive and follow these three simple but common steps to help you work on that speedy recovery.

If you have any questions or would like to share your story on how you fractured your femur and, what your recovery was like, just write your comments in the comment box provided.


Richard Haynes PTA, CPT
Total Joint Fitness LLC
http://www.richardhaynes.com
http://www.totaljointfitness.com
http://www.total-jointfitnessllc.com

Where Fitness and Rehabilitation Never Ends"



Thursday, June 19, 2014

Three Tips To help In Losing Weight Prior To Or After Joint Replacement Surgery

When it comes to losing weight prior to a hip or knee replacement or, after joint replacement surgery, many find it can be a long frustrating experience. Most of us tend to put on the pounds before we have the joint replaced due to the fact the pain involved in carrying out an exercise routine is just too much.

After surgery, Is really the time to get started in advancing your fitness program and getting on track to shed those pounds you picked up over the months and, in some cases years due to a sharp decrease in physical activity or postponing the surgery.

I went through the same thing before I had my knee replaced. I found over time my overall physical conditioning was deteriorating but, not completely lost due to the fact I had stepped up three areas in my daily routine that helped me slow down the process.

I found that mixing in some cardio work five times a week by using a stationary bike at the local gym for 20 minutes each morning before surgery helped in not only keeping some cardiovascular fitness present but, it also helped in maintaining my knee range of motion and keeping my body weight in check.

This really came in handy during my physical rehabilitation. By using a stationary bike, I was able to keep my body weight off my arthritic knee making it much easier to complete and maintaining close to pain free movement as possible.

When it came to dietary modifications, I went to eating smaller and more frequent meals. In other words I stepped up my eating program from eating just three meals a day to now consuming five to seven meals a day. This way I was able to better curb my appetite and, by eating those smaller meals, help speed up my metabolism which helps in burning more calories.

This is something that is stressed now more often to diabetic patients and individuals that want to lose weight. You can find this information all over the internet these days on just about any fitness site as well. Its become popular as well in medicine to help people keep those blood sugars in check and, from making bad food choices when our hunger gets out of control.

I also made it a point and advise you as well to make sure when you are snacking during the day, to help get those five to seven meals in a day, to make those high protein snacks.Two to three of my meals are protein shakes I take with me daily. I pre-mix three small scoops of oatmeal into a plastic blender bottle  along with two scoops of protein powder and have an instant meal.

I made it a point then and, still do to eat every three hours or as close to it as I can.

These practices I mentioned above can be used either prior to joint replacement surgery or after in helping you to begin to lose that unwanted weight you have gained due to lack of mobility along with some marginal eating habits.

The weight did not come on overnight and neither will you lose it overnight, be patient.

Either keeping yourself in good physical condition before your surgery or, after surgery will not come easy and there is a price to pay but, your health and mobility is worth every bit of it.


Richard Haynes PTA, CPT
Total Joint Fitness LLC
http://www.richardhaynes.com
http://www.totaljointfitness.com

" Where Fitness And Rehabilitation Nevers Ends" 

Thursday, June 12, 2014

Exercise Routines, Writing Them Down To be Successful.

Part of the equation to becoming successful in anything involves setting some goals and then making a plan to achieve those goals. This is where however most people fail. By writing down what you intend on doing, it tends to cement the task in your mind and increase your chances on accomplishing it.  I will admit, I have  made numerous attempts to setting various goals over the years but, never put them in writing when it came to accomplishing them.

I have since learned many years ago that by writing them down increased my chances of accomplishing them ten fold!

When it comes to following through with your exercise and  fitness programs, the same bit of advice holds true. Whether you are training for some sort of fitness competition or, rehabilitating after surgery, you should take the time to write out a detailed plan on how you plan to accomplish the goal.

I have gone into homes over the years for instance where the patient have kept detailed records in regards to what time they completed their physical therapy exercises, taken their pain medication etc....Keeping detail records increases your exercise compliance, especially when someone like myself comes into your home and wants to see how you are managing the rehabilitation program.

I have made it a practice to write down each week what I plan to accomplish in the gym for the upcoming week. It helps me keep on track with my exercise program and gives me time to visualize the exercises and body parts that  I intend on working.

When it comes to your physical therapy for instance, the same method can be used to help you mentally and physically prepare for what lies ahead when it comes to accomplishing your goals for instance after knee, hip, or shoulder replacement. This comes in handy when you are receiving home health PT. It allows you and your therapist to closely monitor your progress. It also helps in keeping your medication schedule on track for improved pain management as well.
.

I will have by Sunday night for instance, a weeks worth of exercise routines recorded in my weekly planner and, what day of the week I plan on exercising the selected body parts. It always helps tremendously in getting yourself organized prior to your physical rehabilitation or fitness routine, this helps in developing the discipline needed to get the job done with less excuses!

Everyone should be able to take 10-15 minutes a week and plan on what you intend on accomplishing with your exercise routine. One of the best tools I have worked with for years is a  weekly planner that I purchase at any office supply store. I plan one week in advance precisely what needs to get done not only in my exercise program but my business life as well.

Writing down what you intend on accomplishing also allows you mentally rehearse the fitness routine or rehabilitation treatment prior to starting it. If you can first see your success in your mind then you increase your chances of successfully carrying it out to completion.

If you have any ideas or routines you use prior to your workouts or, physical therapy treatments and would like to share, please leave us a comment.


Richard Haynes PTA, CPT
Total Joint Fitness LLC
http://www.richardhaynes.com
http://www.total-jointfitnessllc.com

" Where Fitness and Rehabilitation Never Ends"