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"

Monday, February 9, 2015

Three Exercises To Help Maintain Your Balance

Maintaining our balance as we age for many can become quite an experience depending on many factors. There have been reams of material written and provided on the internet about this topic as it  becomes a major contributing factor in our quality of life as we age.

There are of course many factors that are involved that can affect ones balance for instance prescription medication, cognition, poor vision, and lower extremity neuropathy just to name a few.

However one of the biggest problems I see when working inside the home with patients and clients is the lack of strength in the legs and hips and, just over all body strength!

That's right, many of us as we age become soft. Many feel that just because they are getting older, they should be "taking it easy" That cannot be further from the truth. In fact, you should become more aware of the fact that your body is physically breaking down and, you can fight back with a short but concise exercise program that can buy years of mobility and keeping yourself independent.

 There are a multitude of exercises to help strengthen your body and improve your static and dynamic standing balance, I make sure I introduce three main exercises that are not hard to do and can be done either at your kitchen counter or, inside your walker.

The three exercises that I recommend are the following:
  • The Heel and Toe Raise 
  • Standing Hip and Knee Flexion
  • The Partial Mini Squat
Start these three exercises and completed for 10 repetitions. As you get stronger then you add more with a goal of 20 repetitions one to two times daily.

Keeping an exercise simple and concise also helps tremendously with patient and client compliance.

There are a number of ways older adults can help in maintaining  or even increasing their balance through a dedicated and disciplined approach when it comes to exercise and being sure that they are wearing proper footwear to start with.

Remember, there is more to helping improve your balance then just keeping your legs strong. A good general strengthening program for your entire body is most beneficial for improving quality of life and, keeping the risk of injury during mobility low.

Be sure to enroll in a exercise program if one is provided in your area whether its exercises that are land based like the example above or water exercises in the pool. Everyone will have different abilities.

Being pro-active in fall prevention and maintaining a healthy mind and body as we age should be priority number one if we want to live a higher quality of life.

Richard Haynes PTA, CPT
Total Joint Fitness LLC

" Where Fitness and Rehabilitation Never Ends"

Friday, February 6, 2015

How Long Should I Take My Pain Medication After Total Joint Replacement Surgery?

This is a common question that I will get asked on my physical therapy visits when in home health. Generally, a total joint replacement patient will come home after three days in the hospital if all has gone well.

While in the hospital you are given a pain cocktail through your IV line that in most cases, does a good job of masking the pain. After a day or so, they will remove the line and place you on oral medication.

Its when you get home where the handling of the pain medication will need to be given in a disciplined and planned approach. Too many times I see patients in more pain then is reasonable because they may be trying to get off the medication too soon.

Or, they are waiting for the pain to become unbearable then decide to take the medication. By then its too late! Once the horse is out of the barn so to speak, its hard getting it back in.

Take you prescribed medication as indicated on the bottle. This is  not the time to be a hero or, to see if you can tough it out. Believe me, the pain after a knee replacement can become your worse nightmare if you decide to go cold turkey too soon.

Too much chronic pain causes many a sleepless night and slows down the healing process. It also will play havoc on your physical rehabilitation program. Talk with both your physical therapist and home health nurse about your pain control and the options you can take if needed.

If the medication you have does not agree with you, call your surgeons office immediately and have them prescribe something else more effective.

Believe me, there isn't any medication that will cause you to be completely pain free for the first two to three weeks when you get home however, the medication prescribed can make your rehabilitation journey and life somewhat more bearable when taken as prescribed.

Richard Haynes PTA, CPT
Total Joint Fitness LLC

" Where Fitness and Rehabilitation Never Ends"

Strength Training and "Old Age", Should I Be Doing It?

Recently I received a patient in home health that had been referred to me due to severe  deconditioning and overall lack of strength. In fact, this patient I will call him Bob for the sake of the blog was so weak he had great difficulty getting out of a chair or getting into the shower. Needless to say, walking was out of the question for fear of falling so the family used a wheelchair.

His wife and family were losing patience quickly with Bob and frustrated that he would not do anything to get himself strong enough to to become more independent.

He was prescribed physical therapy by his family doctor and this is where I entered the picture.

Now, this scenario is much to common in today's world as are population grows older and, many elderly individuals do not have the understanding on how important exercise is.

It was important to explain to Bob the importance of getting back on his feet again and, being able to become more independent will allow him to live a better quality of life. And, how it will help his family immensely, regarding his virtual 24/7 care he required.

He was not sold initially on the home exercise program I devised but after giving it a try and experiencing first hand some results in his strength and mobility in the first two weeks, I slowly was able to make him a convert.

In Bobs case it took not only issuing him the appropriate exercises to slowly break in with but, it took a discussion on the benefits of resistance training in general. Bob was from the old school that strength training was for " younger people" and didn't feel it could benefit someone his age which was 82 years of age.

It has been shown time and time again that no matter what are ages, you can get stronger physically through strength training. Our muscles will respond to resistance training and, get stronger in time to adapt to the challenges that are placed upon them if we are consistent enough with the exercise.

Strength training as we age is as important as ever to help each of us to keep our independence, to help in managing our weight through stimulating your bodies metabolism, building stronger bones through resistance training and helping to correct posture problems due to weak back musculature for example.

Chronic low back pain for example, is a frequent complaint of patients of mine for no apparent reason. It's not as if they were seriously injured an in accident for example but, it comes down to having weak low back extensors, weak hamstrings and weak abdominal muscles. Also, elderly individuals will develop weak gluteal muscles or butt muscles due to living a sedentary lifestyle which play a major part in back and hip strength.

These muscles being deconditioned and weak in themselves will cause unnecessary low back pain for example.

I was able to start Bob on  both a seated and supine home exercise program and ultimately a standing routine using his body weight as he got stronger.

The idea was to start slowly with just a few exercises as to not over whelm him to help keep his compliance with the program. I was later able to add both a light dumbbell and a rubber exercise band program for a complete body workout.

Today he is much stronger and able to get out of a chair and bed without his poor wife having to grab him and tug om him risking injury to both. he is able to walk with the aid of a single point cane short distances in the house and, uses a rolling walker when walking longer distances outdoors.

So yes, everyone can benefit from a strength training program and as we get older. Strength training and remaining physically fit should be right up there in importance as our financial plan and estate plans as we age.

What are you doing today to plan for the future when it comes to your physical fitness?

Richard Haynes PTA, CPT
Total Joint Fitness LLC

" Where Fitness and Rehabilitation Never Ends"

Saturday, January 31, 2015

Prehab, Are You Getting Prepared For Your Joint Replacement Surgery?

Over the years I have seen my share of total joint replacement patients. Of all the joint replacement patients I have seen personally, I see more total knee replacement surgeries then any other.

One of the biggest factors I have seen when it comes to a patient having a successful joint replacement rehabilitation is how prepared both mentally and physically they were prior to surgery.

Today it should be a common practice with your orthopedic surgeon, to have you enrolled in a four to six week exercise program before surgery. You want to begin to prepare the muscles around not only the affected joint to be strengthened but, your entire body as a whole.

By getting a head start and, preparing your body and mind for the physical rehabilitation that will take place  after surgery and, the daily dose of mental toughness you better acquire to get through the trails and tribulations of those first four to six weeks, will be mandatory.

Too many times I see patients in today's US health care system that have been shuttled through the process not really grasping what is about to take place when it comes to understanding the complexity of having a total joint replacement. Everyone should understand the sacrifices one has to make to have a successful outcome.

Though the medical technology, equipment used during surgery and, the materials that make up the prosthesis has advanced considerably over the years, the rehabilitation is still all about commitment and hard work on your part!  It will take some work and the ability to see long term, the results you aspire to obtain. Don't get caught up in the day to day ups and downs that you will most certainly go through. It will get better!

Your Physical Therapist and Orthopedic Surgeon should have sat down with you prior to surgery and explained the steps that will be taken to achieve your  maximal effectiveness during rehab.

Be sure that you get a copy of a home exercise program from your surgeon or therapist. Ask your surgeon are they going to prescribe physical therapy prior to your surgery to get you prepared. And if not why?

There should be no excuse today for anyone not to know what is about to take place and how you will be walked through step by step, to the ultimate finish line of a pain free, newly strengthened and a  functional joint replacement.

Richard Haynes PTA, CPT
Total Joint Fitness LLC

" Where Fitness and Rehabilitation Never Ends"

Monday, January 26, 2015

Functional Exercise, The Farmers Walk

After Joint replacement surgery or some other medical illness or surgical procedure, once you get your medical clearance to begin participating in physical exercises again and depending on any other restrictions your MD may have you following, try the Farmers Walk when it comes to helping regain good overall strengthening and conditioning again.

I personally use the Farmers Walk at least two times a week during my workouts to add to my core exercises, to help strengthen my stabilizers through out my body and, its a good little cardio workout to help increase your metabolism to help in the fat burning department.

This is an exercises that anyone can do, being " too old" or " feeling too weak" will not be a good excuse because you can start with as small amount of weight that you can comfortably handle.

You can start by walking around the gym or your home with five pound dumbbells or carry around two 10 pound plates and walk for 30 seconds or one minute. In other words everyone will start at a different pace and using different weight.

As you get stronger you can walk further or if you are timing yourself you will increase your times to add intensity to the exercise.

As you get stronger and conditioning comes back then, you can use a heavier weight. Just go up in five pound increments if needed. Some can go higher again, start with a weight you are safe with.

The Farmers Walk will help you in the following areas:

  • Build overall body strength.
  • Help raises your heart rate and increase your cardiovascular conditioning.
  • Burn more fat and increase lean muscle throughout your body
  • Strengthen your stabilizer muscles and core to help decrease low back pain
  • Increase your dynamic standing balance skills.
There are  many more pros with this exercise then there are cons if you use good common  sense and start with an easy, manageable weight until you get the technique and skills down.

If you go to a gym or fitness center ask a Personal Trainer to run you through this exercises one time to be sure your body mechanics are right. You want to stand erect no bending at the waist and be looking straight ahead.

Don't worry about your pace when walking, start slow and of course be sure you are breathing when walking. People will tend to hold their breath with any type of exertion if you are not an experienced lifter or fitness enthusiast.

If you need any further instructions or have a comment, please leave one below to share with everyone.

Richard Haynes PTA, CPT
Total Joint Fitness LLC com 

" Where Fitness and Rehabilitation Never Ends"