Saturday, January 24, 2015

Stretching After Knee Replacement Surgery

Quadricep Stretch
Once you have had knee replacement surgery, I have mentioned the fact that your physical rehabilitation really never ends. You should not get to the point where you say "oh well, I am as good as I will get" or better yet, " whats the use after all  I am 80 years old".

Those are two examples of poor reasons to stop your rehab and fitness programs. And even though strengthening and range of motion are important during your rehabilitation, stretching is also a big part of the rehabilitation process and even bigger after your PT sessions are over.

In fact after having my own knee replaced in 1999, I credit a number of things to its longevity. And  one of those " things" I do to keep my knee mobile and moving properly during gait and basically feeling like my original knee is stretching after my weight workout, or before my workout when training legs.

I personally stretch a minimum of five times a week after my weight training and cardio workout.

By properly stretching, you keep the soft tissue around the joint replacement pliable and able to move smoothly and, it gives you the opportunity to keep your prosthesis working through its full range of motion and working smoothly like it was designed to do.

I have worked with many patients and clients in the past that did not keep up with an exercise or stretching program years after joint replacement and found many of them not only have some pain in the affected areas but have a restricted range of motion as well.

If you loose the range of motion you originally acquired after physical rehabilitation you may find not only a decrease in your in your ability to walk correctly which changes your gait patterns and creating pain and discomfort in other areas but, you may also begin to have varying degrees of pain within the joint itself.

Its important that you understand that once a joint is replaced it is not to be forgotten about if you plan on staying active and keeping your physical limitations to a minimum.

Hamstring Stretch
After taking a long daily walk or riding your bike or weight training. make sure you spend a few moments at the end of the workout to stretch you quadriceps, hamstrings, and calves.

If you have had your hip or shoulder replaced then you will naturally have other muscle groups involved as well.

Calf Stretch
Hamstring Stretch

Stretching should be an important part of your continued physical rehabilitation and fitness programs. For best results stretch 3-6 times a week. Some will stretch daily others less. Find out what works for you!

Richard Haynes PTA, CPT
Total Joint Fitness LLC

" Where Fitness and Rehabilitation Never Ends"

Saturday, January 17, 2015

Total Joint Replacement Surgery And The Emotional Highs And Lows

Having joint replacement surgery initially is not only a  painful event but, also for some it can be an emotional roller coaster. In other words, between battling and trying to stay ahead of the pain curve and having days where you seem to be stuck and not making any progress, can weight heavily on some patients minds.

Many times I find that even though patients may have gone through a joint replacement educational class at the local hospital, they still seem to be unprepared for the trials and tribulations that they will go through for the first two to three weeks when they get home.

The emotional highs and lows though not necessarily experienced by everyone, seems to affect older patients. The healing process that I have mentioned in previous posts is not linear. Patients seems to expect that each day will get better and better. Though many will admit they understand this is not the case, they still expect a quicker and steadier recovery.

The knee replacement for instance is the surgery that seems to be more variable with pain and swelling differentiation each day for the first few weeks. Though this cannot be completely avoided, it can be better controlled by closely monitoring your activity levels and taking your pain medication as prescribed and elevating the affected leg while using ice.

The day to day changes in pain and swelling will frustrate many even after explaining to the patient the causes and how to control it.

Also getting advice from 15 different friends and neighbors or reading knee replacement forums all day written by people who had the surgery in the past, will cause some to wonder if, they did the right thing by having the surgery, to why am I not healing as fast as my neighbor said he or she did 10 years ago?

The surgery is explained and sometimes presented as something that will create a little inconvenience at first but " you will feel better in no time". Therefore some will not understand the care and detail involved in keeping pain under control and, what are reasonable expectations in regards to the the time it takes to heal.

Understand that everyone will heal differently. Some people will progress a little faster then others and some slower then others. Some joint replacement surgeries may have been more complicated then others therefore you end up with a longer rehabilitation.

Keeping an even response to the day to day highs and lows and learning to listen to your body in what it is telling you will help you from over reacting and becoming totally unrealistic in your healing process.

Being impatient as if that is some sort of badge of honor by the way, may be your  worst enemy. Hard work and dedication is important no doubt but, working yourself to death with the more is better workout plan is creating the perfect storm of increased pain, swelling , and many a sleepless nights.

Stay calm, give your surgery time and follow the  instruction that your rehabilitation professional gives you and you will come out much better in the long run.

Richard Haynes PTA, CPT
Total Joint Fitness LLC

" Where Fitness and Rehabilitation Never Ends"

Friday, January 16, 2015

Diet And Your Recovery After Total Joint Replacement Surgery

Over the years I have treated not only a large number of total joint replacement patients but, many general surgical  patients as well. When it comes to eating the right foods after surgery, there are several basic instructions you want to follow to help speed up your recovery and re-energize your body.

Most of us that have had a joint replaced understand the lethargic feeling we go through for weeks after surgery. That comes from a host of things from the actual surgery itself to the medications that have been prescribed.

One of the best things you can do first of all to help clear the toxicity of medications and anesthesia  from your body is to flush your system out with water. Stay hydrated with fresh water and drink a lot of it or at least what you can tolerate. If you are not a heavy water drinker to begin with you may find this difficult.

Water helps in flushing the cells in your body out, cleanse your kidneys and, help clear your mind as well.

Many will find it difficult to come home after three days in the hospital and eat like they should. Again your body has under gone a very stressful event due to surgery and, the medication you have been given has slowed down your metabolic processes.

Start by eating very small amounts of food. The important thing is you have to start eating something to not only feed your muscles and help them in the strengthening process but, you want to get your GI tract back up and running as well. Your digestive system again is brought to a complete stand still during surgery and getting it to start functioning is vital to your recovery.

Generally this is taken care of in the hospital before they release you but not always.

This is the time to make sure each meal has both some protein and slow digesting carbohydrates mixed in together to help with fueling your body for your physical rehabilitation sessions and the healing process in general. Your muscles need protein to strengthen themselves and you need the carbohydrates to help energize your body and keep your body from getting its protein sources by stripping it  from your muscles that need it.

For more information also I have attached a food chart with some ideas to help you as well.

Starting your day with an egg omelette with potatoes and spinach for instance is a way to get your body ready for the rigors of recovery. Fruit and plain yogurt  first thing for those of you that don't like a big breakfast is another example of protein and carbs to help build your body.

Its been found that smaller more frequent meals also is utilized by your body better as well and, does not put a heavy burden on your digestive system either.

If you expect to recover fully after surgery, your diet is just one of several areas that you need to concentrate on to help with your recovery.

Talk to your surgeon and home health nurse or, physical therapist for ideas as well.

The fuel you put into your body will determine how smoothly and efficiently it runs not only during your recovery but for the rest of your life.

Richard Haynes PTA, CPT
Total Joint Fitness LLC

" Where Fitness and Rehabilitation Never Ends"

Sunday, January 11, 2015

Energize Your Body First Thing In The Morning

Whether you are a strong fitness enthusiast, currently working with a personal trainer or, like my clients receiving physical therapy after surgery, immediately upon getting out of bed one of the first things you want to do is stop the catabolic affects of the fasting that took place while you were sleeping.

Properly hydrating yourself with water and adding a protein shake with some carbs added will stop the destruction that the all night fast created. Now most of us will not set the alarm every two to three hours through the night to have a quick protein shake or bite of cottage cheese for instance. So your body is starving for quality fuel first thing in the morning. You want  get your body and metabolism up and running and turn the destructive process into a constructive process.

You can slow down the affects of muscle destruction by getting some nutrients in your bloodstream. Your body is operating all night long and, if it does not have sufficient stores of carbohydrates and amino acids to fuel itself from then, it will start stripping off the required fuel source from your muscles.

Many of the patients and clients I work with in home health are in a weakend and deconditioned state physically. The last thing they need to contribute to is the breakdown of muscle and the overall healing properties of their bodies.

I like to make sure that either my fitness clients or,physical therapy patients and their caregivers understand the importance of nutrition in achieving their fitness or rehabilitation goals. And I start with driving home the importance of feeding their bodies first thing upon waking up.

This advice I give to everyone I treat whether its for general strengthening due to lack of exercise with my geriatric patients or, total joint replacement patients recovering from a knee, hip, or shoulder replacement.

How compliant the client is with this information will help determine their physical outcome.

One of my first meals of the day before I go to the gym  in the morning is two scoops of a quality whey protein with  two scoops of raw oatmeal added in water. I drink that down within fifteen minutes of getting out of bed. I follow with breakfast once I get back home.

I have been doing this for years now and was doing it also when it I was going through rehab with my own knee replacement.

Your body is a machine and it will operate and recover depending on the quality of fuel you place in it. Both quality and frequency of those meals are important for overall success at any age.

Richard Haynes PTA, CPT
Total Joint Fitness LLC

" Where Fitness And Rehabilitation Never Ends"

Tuesday, January 6, 2015

Air Squats After Total Knee Replacement Surgery

Over the past 15 years after knee replacement surgery, I have noticed more loosening inside the joint in other words their is more joint play as the polyethylene components wear over the years. There is no pain or discomfort involved just a little more " clunking" inside the knee in certain positions.

This is expected over the many years I have been not only walking and on my feet all day but, with the resistance training as well.

I do not squat with heavy poundage's any longer but, one of the exercises I still do twice a week is the air squat.

Air squats is an exercise that you use with your body weight only.  I also immediately superset the air squats with leg extensions for instance to add intensity to the exercise. I may for instance do 20-25 air squats and immediately  follow with 15 leg extensions. I perform three to four sets total with 30 to 60 second rest period between sets.

This is not only a good strengthening routine for your legs but, a nice cardiovascular workout as well.

The idea with the leg squat is to lower yourself as deep as possible, not only does this work your quadriceps and hamstrings but, kicks in the glutes as well, a muscle group that most older Americans if asked, think that it is used for sitting only.

Another exercise combination I use to keep my knee replacement and, legs in general strong is air squats combined with barbell or dumbbell straight legged deadlifts. These work again not only your glutes but, is a great compound exercise for your hamstrings.

The key that I have mentioned in multiple posts over the years is the importance of keeping your knee replacement strong by strengthening the muscles that support the knee joint itself.

Walking alone will not get it done. The geriatric crowd many that I see for instance, would not be able to do air squats or progressive hamstring work that I have mentioned but, for you boomers like myself that are not ready to roll over and die because I have a joint replacement, these are just a couple of effective exercises you can do.

I have done them for over 15 years now so I am living proof they will not harm you. Just make sure if you are not active to begin with, to work yourself up slowly to the exercises mentioned.

Keeping your legs and body in general strong and with lean muscle as we age and after surgery is the best way to assure a better, more vibrant quality of life and looking pretty darn good isn't so bad either.

Richard Haynes PTA,CPT
Total Joint Fitness LLC

" Where Fitness And Rehabilitation Never Ends"

Sunday, January 4, 2015

Getting Older Does Not Mean We Succumb To Both Weaker Minds And Bodies

Depending who you know or associate with, all of us know someone who is from the old school of thought that just because they are getting older that this automatically means they are destined to get heavier, weaker physically and and even mentally.

Research over the years has disproved many of these old 20th century myths and way of thinking however, at the same time, we have to respect the fact that as we age there are changes that are affecting our bodies.

We know that as we age our bodies are working overtime to strip much needed and cherished muscle from our frames which, not only slows down your metabolism causing your body to burn calories slower and adding another reason for weight gain but, losing muscle also has its disastrous affects by making you weaker and losing your ability to keep your independence .

For most of society that has bought into this so called inevitable decline in physical and mental abilities, there is nothing we can do. We become victims rather then victors. In other words they become passive in their health and fitness and fall victim to whatever comes their way.

While others take a more aggressive or pro-active approach and take control of their health by eating cleaner, training harder and, sleeping better.

There is nothing new age or complicated when it comes to how to live a more productive life as we age. Staying healthy has many challenges to it as genetics also has its predominant role as well.

Being pro-active and taking responsibility regarding not only the foods we eat and the fitness programs we undertake but, another big factor is the people we associate with and the books we read play a big part in our overall success as we age.

There is a ton of information on the internet and and numerous magazines telling you how to stay healthy and live a productive life but, it comes down to simply guarding your health through the decisions you make!

Your body and mind needs stimulation no matter what age it is, seeking safety and comfort to a degree is harmful to your growth and vitality.

So what is one supposed to do? First of all, understand that there is always a price to pay and trade-offs in life to be successful.

Want to start a fitness program? Get into the gym early, start your day off on the right note. To get into the gym early you have to learn to get to bed earlier as well. The later you postpone the daily workout, the better the chances the workout does not get done!

Clean up the junk food in your life. You have to learn to make wiser choices, preparing and eating your meals at home is healthier then taking the easy way out and buying junk at the local fast food restaurants.

And if you have nothing to do but sit home after the age of 65 and watch the days and weeks click off, then find something you enjoy and get involved today. Wasting your time sitting makes you nothing but the walking dead already.

You do not have to become tired and broken down as we age, its up to you to do something about it to change the course of both your physical and mental health.

Richard Haynes PTA, CPT
Total Joint Fitness LLC

" Where Fitness And Rehabilitation Never Ends"

Tuesday, December 30, 2014

Three Daily Habits That The Mature Adult Needs To Implement To Stay Healthy

There is a law in the universe that says " we sow what we reap" and there is of course the law of cause and effect. In other words, how we treat our bodies today will come back to re-visit us tomorrow or in later years. And for some of us, what we did or did not do in our younger years have come back to cash its check today in regards to our health.

There are three daily habits that all mature adults should implement into their lives to help with getting the best maximal performance out of both our minds and bodies. Also, by following these three simple laws, it can save you thousands of dollars in medical costs down the road.

Three common sense and easily followed habits that anyone can start today and habits that I personally follow on a daily basis are,

1. Healthy Mature Adults Get Between 7-9 Hours Of Sleep a Night On a Consistent Basis:   I tend to lean more to 7-8 hours a sleep a night personally. My day starts at 3:15 in the morning for instance so, I am in bed by 7:00pm.

Sleep as we all should have heard by now will dictate your over all health, and the fact that many older adults do not either sleep well at night or, have inconsistent bed time hours does not sit well with your body as we age.

Your body loves consistency, therefore you should be making it a habit to get into  bed at a consistent time each night. Early to bed , early to rise is a good moniker to live by as we age. The fact is as we age does not mean we will not sleep well. That is not a normal part of aging. Either someones inability to sleep is due to lack of physical exercise, your Dr. has loaded you up on multiple medications or, you have too much drama in your life. Find out which one it is and resolve it.

2. Healthy Mature Adults Have a Planned Exercise Program 5-6 Days a Week:  My exercise plan for instance consists of five days a week at the local gym for weight training, cardio exercise and stretching. My sixth day which is Sunday, consists of one hour of a fast paced power walk and deadlifts at the end. Again all done in one hour.

I sleep well at night and feel good everyday in my estimation just due to the fact that  I stay consistent with the exercise program. You can too! The habit of weight training and getting in your cardiovascular exercise and stretching can be done in one hour if you go to the gym and focus on your workout and not get caught up with the gyms Chatty Kathy who will steal your time.

Consistency again is key here. Hit and miss workouts are not productive and do nothing to improve your health.

3. Healthy Mature Adults Eat High Protein And Low Fat Diets:  Your diet when it comes down to it may be the most important factor here of the three, The Diets we ate when we were 20 will not work with our bodies when we are 50.

Our Bodies are trying to strip its muscle mass to begin with as we age so, getting back to the resistance exercise  and, combining that with high protein diets help prevent and slow down that process. High protein consisting of foods like chicken breasts without the skin, egg whites, turkey breast, fish, tuna and flank steak for instance are just several examples. There are many more examples.

Keeping your fat intake low is important to help with keeping your body weight in check, lowering your chances of developing type II diabetes and, other chronic health issues is important.

Keeping your sugar intake low is also important. Your nutritional intake is so important that  I cannot cover it adequately enough in a short blog but, you get the gist of what  I am talking about here.

Your habits in life can either make you a success or a  failure. They can either make you a strong, happy and healthy adult or, a sickly depressed adult as we age. You can choose to live your life anyway you choose but, living it with a healthy mindset and strong body brings the best out in all of us when it comes to an independent and productive life.

Remember, every workout you complete, every healthy meal you eat, every hour of productive sleep you get is a deposit you have made into your own personal health care account. In other words, like it or not your self insured!

If you have any comments or, would like to share some of the healthy habits you follow on a daily basis, please leave a comment below to share with everyone.

Richard Haynes PTA, CPT
Total Joint Fitness LLC

" Where Fitness and Rehabilitation Never Ends"

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"