Monday, May 25, 2015

Constipation After a Knee Replacement

You would think the overall pain and discomfort after knee replacement surgery would be enough for any human to have to handle right? But not quite, along with the trials and tribulations of a surgical procedure as we age is something called constipation.

The older the patient, the more of a problem constipation becomes it seems. I had my knee replaced when I was 44 years of age for instance, and quite honestly do not remember constipation being on the list of things I would never forget after that surgery.

There may be several reasons why this is such an issue and, it appears if everyone no matter what there age is would follow, the problem of becoming constipated would either be greatly reduced or really become a non factor at all.

I have seen more knee replacement patients then I can count for physical rehabilitation over the years, and of all the patients that have had a real battle of constipation on their hands, it seems they fall into one of three categories,

  • You Are Not Drinking Enough Water. Many patients that I come into contact with are not drinking enough water. Many say they are but in reality they are not taking enough in. I have more then once run across family and other caregivers that indicate the patient is not drinking water like they have been instructed. Do not wait until you are thirsty either to drink, as you age your thirst mechanism is not reliable any longer and if you get thirsty more then likely you are in the beginning stages of mild dehydration already.

  • You Are Not Mobile Enough. Many patients I see as they get older generally are not walking enough after surgery. Its hard to explain to each patient how much walking they should do but, you have to listen to your body and follow the cues. Walk every hour if you can using the appropriate assitive device. If your physical therapist has started to walk you outside then , continue to follow the program each day. You may need supervision with you to start with.

  • You Have Experienced GI Tract Problems In The Past. There are some of you out there that have problems with your GI tract to begin with, either through prior surgeries or, other injuries. Though your surgeon may be aware of this, be sure you explain this to the MDS involved in your case to help resolve the issue before it gets out of hand. Your pain medications may need to be changed for instance.

 These are just three common problems we run into when it comes to problems with constipation after surgery. We in physical therapy will be pushing the mobility end of things and the high volume of water intake along with eating plenty of high fiber foods providing you are not on restrictions by your physician.

The home health nurse will be able to supply you with ideas to get your bowels moving with some ideas regarding over the counter medications, warm prune juice, a bottle of magnesium phosphate etc... Knowing if you are diabetic also will come into play regarding some mixtures.

Between the surgery itself shutting down your GI tract and on top of that, a heavy dose of potent pain medications, can make one miserable if you have not had a bowel movement in about four to five days.

Though it may be embarrassing for some of you to bring the subject up , be sure you mention to your PT or home health nurse if things are not moving like they should. In most cases your nurse and PT anyway will be attuned to the matter as it is quite common.

Keeping a regular schedule will make things a bit more tolerable during the rehabilitation process and should not be ignored. 

Richard Haynes PTA, CPT
Total Joint Fitness LLC

" Where Fitness and Rehabilitation Should Never End"



Saturday, May 9, 2015

Avoid Complacency As You Age, Keep a Chip On Your Shoulder

Complacency in life is something that all of us can quickly fall victim to.  As we become more successful for instance, many people tend to let up or not work as hard as they once did to achieve that success. After a time many will see that success fade due to lack of urgency in keeping that success.

For many other as we age, we have believed that age old advice that has been passed down generation after generation that, we need to start slowing down, to take it easy after all " your getting older". Taking it easy way of life causes you to lose that edge we need to stay strong, healthy, and successful.

This is something that creeps up on all of us quickly if we are not careful. Take a look at most of America as we age, look at the physical condition  of the typical senior, out of shape, massive loss of muscle mass, blood pressure problems, having difficulty going up and down stairs, chronic diseases set in due to lack of care, etc.... all due in a majority of cases due to a lifestyle of over indulgence and lack of physical and mental exercise due to a lack of urgency to do the things required to stay healthy.

Taking it easy is not the course you want to take to be successful in life no matter what successful means to you.

To be successful and to maintain a dominant life where you call your own shots and live independently, starts by being dominant when it comes to your health and physical fitness.

By having a chip on your shoulder does not necessarily mean you have to walk around  angry at life and at people, no, I am talking about  having an edge to you that you will not be controlled any longer by poor physical health, a weak body and negative thinking.

I mean you get angry enough at the situation that you cannot keep paying doctors co- pays every month for medical problems that you can easily avoid, by getting out of bed in the morning and get started on that exercise program consisting of strength training, cardiovascular training and stretching.

I mean having a chip on your shoulder that you get angry enough that you no longer are intimidated by a long flight of stairs and wondering if you can get to the top or not.

Getting determined enough that you are going to lose that extra 20-30 pounds you have been walking around with and thanks to that plus, your overall poor physical condition, have to take insulin shots to control your type 2 diabetes.

Once you see that your life both mentally and physically are being controlled by this lack of urgency and living this take it easy lifestyle, you only then develop that chip on your shoulder to take command of your well-being.

When you get into enough pain  mentally, physically and financially due to poor choices with lifestyle habits that led to your breakdown to begin with, then is when most decide to do something about the situation.

That is not for you! Decide now to get that chip on your shoulder that will get you motivated enough that you are not going down that path of decay as you age.

Your destiny is in your control right now. Today is the day to decide to become stronger, leaner and a whole lot healthier.

Richard Haynes PTA, CPT
Total Joint Fitness LLC

" Where Fitness and Rehabilitation Never Ends"

Thursday, April 30, 2015

How To Prepare Your Body Before Going To The Gym

Health and Fitness is one of those topics that no matter what you think or read in a magazine is the correct thing to do, someone comes along and tells you something that is completely opposite.

One of the questions I get at the gym from various members is whether I eat something before working out?

Until about three years ago I did not eat anything other then re- hydrating my body with water after going all night without it. I did understand that our muscles is made up of a large amount of water in fact, so is our entire body, However our muscles function and respond more efficiently when they are hydrated properly. Something our elderly friends who do not exercise or too weak to get out of a wheelchair need to grasp.

I did not eat anything thinking I was burning more fat and using fat as a fuel source when weight  and cardio training, After all you will find information all over the internet touting the benefits of working out or doing your cardio training on an empty stomach.

There might be some logic in this with those who come in not just a " little overweight" but obese. But that is for another post. For those of us that have an ectomorph frame and with long limbs, building muscle is tough enough anyway so, we need all the help we can get.

For others  like myself who are aging and looking to build and muscle mass, its is highly recommended that you take in a high protein meal before working out. Now some of you may already be doing so depending on the time of day you train,

I belong to the 5:00am club, I believe in training first thing in the morning when my mind and body are fresh and not beat up after a day of trials and tribulations. That makes a wonderful excuse why you didn't get that workout completed in the first place, right?

After waking up your body has been in a catabolic state through the night, in other words, it has been feeding on itself. After 50, you cannot afford to allow this to happen as lean muscle tissue is at a premium anyway. Its can be difficult to build so, you must do everything to maintain what you have and develop.

So before I get to the gym I take in a whey protein shake with oatmeal as my complex carbohydrate source so while I am working out, my body has fuel to operate on without resorting to muscle tissue in search of amino acids and other nutrients for its energy source.

This way  I am able to weight train working on strengthening and developing more muscle tissue without defeating the process by going to the gym on an empty stomach.

Nutrition is just one and maybe, the most important key that will unlock the potential your body has in developing itself to allow you to look and feel your best.

So my take is always before going to your next workout, supplement your body with a high protein and slow burning carbohydrate to help build lean muscle for a strong, fat burning machine.

Richard Haynes PTA, CPT
Total Joint Fitness LLC

" Where Fitness and Rehabilitation Never Ends"

Tuesday, April 28, 2015

How to Avoid Wasting Time and Effort In The Gym

Well I finally made the move from a small town to a much larger one on the west coast of Florida. One of the many reasons I decided to move was the fact I enjoy living in an area that has the population to handle a multiple number of  large gyms and, other assorted fitness centers in the area.

One thing that does not change however no matter where you work out is seeing people that have walked in with good intentions to start an exercise program and are going about things in the wrong fashion. There are no exceptions.

Now I understand when it comes to training,  what works for one, does not work for another along with the fact that everyone has their own style and more then likely have also got just enough information to stay completely confused when first starting out. I went through the same learning curve myself.

What I am getting at are new members that come in and you can see that their form on the equipment, how much weight they are using to start with and, their exercise selection is something that spells the word  INJURY!

I firmly believe that the personal trainers that are working the floor, rather then just walk by these individuals, should stop and help these folks with not only their form to avoid injury but, for newcomers, get them started on a basic full body workout that uses compound movements that will build basic strength and develop a good foundation for the future.

Rather then seeing someone who is older and frail to begin with, jumping on a cable machine doing chest flyes and haphazardly at that, they may want to consider working on something like light dumbbell presses or modified push-ups to help develop a strong foundation to build from and, to help with their functional strength.

Rather then seeing someone who has never trained a day in their life walk into the gym and start doing triceps push-downs because they see someone else doing it, maybe the personal trainers who again are present at the time, instruct these individuals on using a close grip triceps press standing while using their body weight? These are just examples there are many more.

Watching these people day after day come into the gym and work the same muscle groups every day on the same equipment is not beneficial when it comes to making progress and seeing results.

Now I have found over the years that some are happy to receive some instruction and I have seen others that agree with what you are saying but, revert back to what they know and feel comfortable with.

Sure there is contradictory information in the world of fitness and everyone has to learn their own bodies and how it responds. But to avoid wasting your time in the gym and increasing your chances of getting injured, seek the help of the staff about getting a weight training program designed for you.

There are certain laws in biomechanics and physiology that we all should follow to assure a safe and effective exercise program.

Most of the big commercial gyms may come with an introductory training session with a trainer that gives you a chance to learn some basic movements and exercises along with a question and answer session.

No doubt if you are first starting there is a learning curve you have to go through and in fact, if you have been weight training for years, there is always something new out there to learn as well. No one knows it all!

Making every exercise repetition count and avoiding injury is the best way to assure you a successful venture in your exercise program.

Richard Haynes PTA, CPT

" Where Fitness and Rehabilitation Never Ends"

Friday, April 17, 2015

Your Physical Limits Are Controlled By Your Mental Limits

When it comes to our health and overall fitness, there is much more to it then casually going through the motions on a few pieces of exercise equipment or taking a leisurely walk around the block.

The physical part is easy, its the mental game that determines in all of us whether we will be successful or not when it comes to losing weight, becoming more muscular, or rehabilitating from and injury or elective surgical procedure.

As I have mentioned and discussed with all my in-home patients or clients is this, that the body follows the mind. Our minds should reign supreme over our bodies when it comes to our health, fitness levels or self-esteem.

To let your body dictate your course of action in life whether its starting a new job, or beginning a new fitness routine is setting yourself up for failure. Your body is and always should be, the servant of the mind!

When you hire a Personal Trainer or Physical Therapist to help you achieve your fitness or rehabilitation goals, if they have not sat down with you and discussed the importance of your mental outlook and have not found out what is motivating you to hire them in the first place, you need to look for someone else as fast as you can.

To take a fitness client or rehab patient mindlessly through a workout without incorporating some mental fitness as well is taboo in my personal opinion. I know the mind has to right and focused on what they are trying to achieve, whether its is to lose weight or, to come back physically stronger after surgery.

Every session whether its personal training or, physical rehabilitation the first few minutes before and after the session should be spent on getting into the mind of the person you are working with and, finding ways to motivate them to achieve and aspire to be greater then they thought possible.

Life in general can be tough. its not for the passive. When it comes to your health and fitness either you are all in or your not. Life does not have time for lackadaisical efforts when it comes to your health and overall physical fitness. Have you seen the price of medical care in this country lately?

Your mind will either be your greatest ally in strengthening and developing your body or your worst enemy. You have the choice right now to decide.

Richard Haynes PTA, CPT
Total Joint Fitness LLC

" Where Fitness and Rehabilitation Never Ends"

Sunday, March 1, 2015

Fitness and Rehabilitation While You Are at Your Peak

As they say in life " timing is everything" and you can even add that mantra to the world of fitness and rehabilitation. I get questions regarding " what is the best time to exercise" is it in the morning, the evening, etc... people get torn about this at times because what they may have read or, over heard someone discussing the topic at the gym.

As its been said time and time again, any time is a good time as long as you get it done! it is the consistency that matters not what time of day it is.

We as individuals have times throughout the day that is considered our peak times. In other words we are more physically and mentally alert. Mine for example is early morning. I make it a point Monday through Friday to be at the gym at 5:00am to get in my workouts. I am a morning person.

Others will roll their eyes at such a time. Their optimal times are much later in the day. Whether its fitness or physical rehabilitation after surgery, you take advantage of your peak time in the day or evening and concentrate on physically improving yourself.

If  you are in tune with your body and mind, you know what hours of the day or evening you function at your highest levels. Know that time and be sure you take full advantage of it. You must have your heart and soul into your physical rehabilitation or fitness program if you expect success.

I never encourage my patients for instance after a long day out seeing doctor after doctor to come home late in the afternoon and run through their rehab exercises mindlessly. Going through the motions to say you did the exercises in my opinion is a waste of time.

Better yet, try getting your work in before you set off for a days worth of errands and other appointment's. That is one major reason I get my exercise program completed before I go to work. If I did not, chances are it will not get done later in the day.

So the point to take is, make sure you know you body, know what time of the day you function at your highest level then, if at all possible, plan your physical rehabilitation or fitness routine around that time.

Its results you are after. Make sure you do everything possible to achieve them.

Richard Haynes PTA, CPT
Total Joint Fitness LLC

" Where Fitness and Rehabilitation Never Ends"

Sunday, February 22, 2015

Which Is The Most Cost Effective,The Prevention Or The Cure?

The question of which is more cost effective, the prevention or the cure when it comes to our health should be a simple one. Yet many people battle with this each day. In fact if you ask most people they will tell you without a doubt that prevention is the way to go.

After all, many of us take our cars in for oil changes because we know it will allow us to get the most use out it in the long run by keeping the motor clean internally. This is what as known as preventative maintenance. Without preventative maintenance on our cars, they eventually begin breaking down and start to drain us financially.

Same should hold true with out bodies. Preventative maintenance includes spending a few extra dollars to eat cleaner more nutritious food as we age. Investing in a gym membership and actually using it several times a week will work wonders in preventive maintenance when it comes to our bodies. Good low fat and high protein foods along with exercise is like giving our bodies that needed oil change.

Many people though they know better, take the gamble and feel that somehow they are immune from the effects of aging and, that they may just get lucky and not suffer any of the consequences of chronic illnesses that affect millions of Americans due to lack of physical activity and poor food choices.

Instead, they end up ultimately losing the game of chance and end up eventually on the merry go round of going from doctor to doctor looking for cures and medications that will help them stay independent and in many cases hopefully still being able to work.

I have found that its cost effective to spend the finances needed to live a healthy life rather then to pay co-pays and deductibles all year long on health problems like type 2 diabetes, high blood pressure, or suffering a case of severe osteoarthritis throughout our bodies due to being extremely overweight.

In other cases, you find people that have lost strength and muscle mass over the years due to lack of physical activity and are unable to even walk around safely without the aid of a walker.  Becoming a senior citizen does not mean you will automatically mean there will be a walker with your name on it waiting for you.

If the time and the money spent in the beginning, working on strengthening our minds and bodies we would live happier lives rather then giving our money to the medical profession which ends up costing everyone in the end.

You can either take the time to work on health prevention now and spend a few extra dollars to ward problems that could have been prevented or, you can spend it later. Either way you will spend the time and money on either prevention or the cure.

I have found and so have many others that life is so much more rewarding and enjoyable when you are in charge of your life through healthy living rather then the medical community running your life.

You have a choice right now where you think your time and money is best spent.
The decisions you make today will last you the rest of your life.

Prevention is the answer that you want to choose if,you plan on living your life with some dignity in the end.

Richard Haynes PTA, CPT
Total Joint Fitness LLC

" Where Fitness and Rehabilitation Never Ends"

Sunday, February 15, 2015

Maintaining Your Functional Fitness

Staying physically fit as we age should be on everyone's priority list today. Years ago it wasn't something that many people took into account when it came to living a quality of life, in fact fitness or exercise was treated as some sort of underground fanatic cult.

Today many realize including doctors, that staying fit by making better food choices and resistance training to build and maintain stronger muscles that will allow older adults to remain functional in everyday activities and remain independent is vital to overall quality of life.

On top of that the escalating costs of medical care and, the constant trips from one doctor to another for medical conditions that  in many cases could have been prevented, is time consuming.

Staying functionally fit as we age is something I like to stress to my physical therapy patients and fitness clients. Functionally fit for example is having the strength to go up and down steps safely. Having the strength and balance to carry in  a bag of groceries from the car, or having the balance and strength to work outdoors whether its gardening or outing with your family.

Having enough gluteal, low back extensor and hamstring strength is important so that you do not suffer from chronic low back pain because the surrounding musculature structures is not strong enough to do the job of support and preventing muscle imbalance.

I witness far too often many of the patients that are referred to me having trouble just getting out of a chair and once standing either falling backwards due to balance issues or when trying to sit down, falling down into the chair due to lack of quadriceps, low back and gluteal strength for instance.

And the sad part is that many patients I talk too feel as if this is something that "just goes along with getting older".

When working with individuals when it comes to general weakness, I like to concentrate and design exercise programs that will emphasize those muscle groups that are causing the problem which generally involve multi-joint exercises.

Exercises such as chair squats with and without using their arms for support, back rows with light dumbbells or thera band, bridging exercises for low back strengthening, and rotational movements are just a few of the many ideas your fitness professionals can use to build a stronger more confident client.

The days of thinking exercise is for" the other guy" is over. As Americans age, more and more adults are battling with chronic diseases and balance issues that can be avoided due to lack of a simple yet effective exercise program to follow. And do I need to remind anyone of the costs of medical care in this country?

Your exercise program is a part of your overall health insurance policy. To think that any of us is going to escape the ravages of decline in health and fitness as we age is pure folly if, we decide to do nothing about it.

A plan to stay fit and active using functional fitness exercises is just one of many opportunities to keep yourself active and healthy and most of all, independent as you age.

Richard Haynes PTA, CPT
Total Joint Fitness LLC

" Where Fitness and Rehabilitation Never Ends"