Thursday, August 21, 2014

Pain Is Temporary, Regret Is Forever

" Pain is temporary , regret is forever" what a powerful statement when it comes to your physical rehabilitation or physical fitness program. In fact, every physical therapy clinic or gym should have these words of wisdom put up in plain site for all those who walk in.

When it comes down to your rehabilitation after joint replacement surgery, Sure we know its painful and anyone that tells you it is not is not being realistic. Who in the world told you it wouldn't be painful anyway?

There comes a price you as the patient have to pay when it comes to physical rehabilitation as far as doing your exercises as instructed by the physical therapist along with,paying the price now to be sure you are consistent not only in the physical rehabilitation program now but, long after the surgery is done as well.

If you want long lasting results with your knee, hip, or shoulder mobility and strength and, I think everyone does then, you have to go through some pain and discomfort now or forever live with the physical limitations that persist after.

How many times have you heard a neighbor or friend tell you that they " knew someone that had knee replacement surgery but did not do their exercises"?

How many times have you heard or knew someone that had a gym membership but " did not go"?

You will not get results unless you pay a physical and mental price. The physical price is you will have to learn to deal with the pain after joint replacement surgery as it is only temporarily or otherwise known as surgical pain.

How many people say they want to lose weight or get stronger but do not go through the mental and physical discomfort of consistent exercise?

 The mental price is having the discipline or mental toughness to do what you know has to be done to have a successful recovery or to lose that extra 25 pounds you want to get off before surgery.

By not forging ahead and attacking your physical rehabilitation or fitness goals now and learning to be able to withstand some pain and overall discomfort now will come back to haunt you the rest of your life.

Work hard now, train with a vengeance now and, enjoy the fruits of your labor the rest of your life by having a functional and mobile lifestyle.

Richard Haynes PTA, CPT
Total Joint Fitness LLC

" Where Fitness and Rehabilitation Never Ends"

Saturday, August 9, 2014

Three Tips To Help You Achieve Maximum Results In The Gym Or With Physical Rehabilitation

Whether you are working out in the gym in regards to your general fitness or, completing your physical rehabilitation exercises program, there are some crossover when it comes to getting the most efficient, yet productive workout that you can possibly get.

Your success in the gym or, at home during your physical rehabilitation can be assured by following a simple strategy.

All too often I see both in the gym and my home health business, clients or patients that are not either physically or mentally prepared to take on the exercise assignments. To be productive and to make a difference in your fitness or rehabilitation, I find there are key components that will help you get the results you need to be successful.

1.  Stay Focused On Your Goal.  I don't have to tell you how important it is to stay focused and concentrate on what you want to achieve. When it comes to the gym its easy to get distracted by others. When you are at home, distractions include the TV, friends stopping by, etc... use your full concentration to help apply all the strength both physical and mental you can get together to help in either losing the weight you have targeted or, strengthening and rehabilitating your injuries.

2. Prepare Your Body and Mind With a Proper Warm-Up. Getting prepared for your  workout or, physical rehabilitation involves getting your body as a whole ready. A warm-up of lets say five minutes of either stretching, brisk walking or my favorite, using a stationary bike to get the muscles, joints, etc... warmed up is vital to avoid injuries. The older we get the more time we need to put into the preparation.

It also helps in getting your mind locked in to the exercise or rehab program. Mental clarity is key if you expect to be successful!

3. Avoid Over Training. I have mentioned this in previous posts but I still will run across this problem either in the gym or in home health. many of us still are from the old school of " the more the better".

Your body will not respond to treatment like this. In fact you end up negating your previous gains if any, by beating your body into submission. Whether you are trying to build more muscle or, rehabilitating from an orthopedic surgery, caution needs to be used. And for those of you over 50, including myself, read tip #3 again

One of the best things you can learn either as a fitness enthusiast or, during your rehabilitation program is listen to your body. It is very wise and it will give you signals when you need to slow down and take some time off.

Your progress will depend on a  number of factors however these three tips will get you started in the right direction. You have no time to waste.

If you expect success and to reach your goals, you must use simple tried and true rules to get the most out of the your body.


            Richard Haynes PTA, CPT
            Total Joint Fitness LLC

"Where Fitness and Rehabilitation Never Ends"

Tuesday, August 5, 2014

Keeping Your Legs Strong To Prevent Muscle Atrophy and Falls

Heel Raises is one of the best exercises for balance!
Keeping your legs strong either before or after surgery is something you want to focus on to prevent unnecessary pain, general weakness and potential falls.

A majority of the problems I face with seniors on a daily basis in my profession is allowing their legs to lose muscle mass, get weaker and ultimately lead to falls and joint pain that can be prevented or greatly reduced.

On the topic of falls, of course there are multiple factors involved including vision acuity, prescription medications and cognitive abilities. For this post however, I want to cover general strengthening for a moment.

You do not need fancy workout machines nor do you need to spend half of your day exercising either. I tell my patients and clients that if they would work on just three or four simple body-weight exercises once a day, it would probably put me out of business.

The exercises I recommend and teach are:
  • Heel and Toe Raises
  • Hip Abduction and Adduction
  • Hamstring Curls
  • Partial Mini Squats.

Of course there are many more but, simplicity and efficiency is paramount in teaching and expecting exercise compliance. Most people I see anyway are not really interested and what I have to sell, that's right, everyone receiving physical therapy are not as motivated a many people think.

Leg strengthening exercises can be taught with the patient supine or standing, that will depend on their level of conditioning and current level of function.

The exercises above, I  start with one set of each with my patient doing 10 repetitions. Once that rep scheme is mastered then, we increase the intensity by adding more repetitions for instance. There are numerous ways to add intensity to the exercises but again, the patients functional status, age, etc... has to be considered when increasing intensity.

I tend to stay away from exercises that will exacerbate acute pain or add low back problems for instance.

Make it a point to keep your legs strong after surgery once your physical rehabilitation is over or, work on a strengthening program about six weeks prior to having knee or hip replacement surgery, it helps immensely in speeding up your recovery.

If you have any questions or comments about the exercises or, would like a copy of the exercise program emailed to you, simply comment or leave your information in the comment box below.

Richard Haynes PTA, CPT
Total Joint Fitness LLC

" Where Fitness and Rehabilitation Never Ends"

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

" 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

" 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 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

" 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

" 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

" Where Fitness and Rehabilitation Never Ends"