Thursday, May 29, 2014

Why Did I Wait So Long?

Mary Drost, PT          May 2014          Victoria Physical Therapy, PC

      I look in the mirror and what do I see?  Something is not quite right?  It must be my knee!  Why is it bowing inward?   And, why does it make strange noise, like a "gear" shifting?  Why does it always hurt?

      At this point, you should of already scheduled an appointment with your local orthopedist.  As Dr. Who so eloquently informed you, a knee replacement is in your very near future.  Fear and anxiety start to overcome you.  You rush home and begin a web search on total knee replacement (TKR), also known as total knee arthroplasty.  This is a surgery to replace the weight bearing surfaces of the knee joint.  

      Many questions begin to arise.  You remember the Doctor said it would behoove you to lose twenty pounds.  Now would be the right time to get in touch with your Physical Therapist!
      Following are a few suggestions for how to prepare for your TKR:
1.  Get thy self in excuses...where there is a will, there is a way!
2.  Begin specific pre-operative knee replacement exercises, which are not limited to, but include:  
      quadriceps strengthening, hamstring strengthening, range of motion for the knee joint, stretching of the hamstring and calf muscles and riding a stationary bike.  By the way, you will need one of these after surgery, and if you have a choice, go for the recumbent variety (chair-back seat...much more comfortable!)  
3.  Prepare yourself mentally!  Be cautious on taking advice from the general public.  TKR has progressed over the years.  The newer models last 20 years, depending on which type your orthopedic surgeon utilizes and how active your lifestyle is.  The more educated you become on the subject matter, the better off you are.  A well prepared patient has considerably less fear and less anxiety, which equates to an easier rehabilitation experience!
4.  Yes, you will have pain after the surgery, and yes, it will slowly but surely subside as healing occurs.  Just keep reminding yourself "the pain is only temporary!"  Your Physician will prescribe medications to help ease the post-operative pain in your knee.  Your Physical Therapist will also treat you for the pain.
      It is worth considering, deciding who you want to use for outpatient Physical Therapy after surgery.  At the least, speak with your PT, or better yet, go for a few pre-operative visits prior to the surgery.  Your PT can be a world of information to you!

      The Center for Disease Control and Prevention (CDC) recommends every individual exercise regularly to promote good health!  The guidelines are well portrayed on the CDC website.  At the least, individuals in the 18 - 64 age group should perform 150 minutes or 2 hours and 30 minutes of aerobic exercise each week.  This can be as simple as walking, riding a bike or swimming.  The CDC recommends 2 days per week of strength training for all major muscle groups in the body (arms, legs, stomach and back,) on a weekly basis.1  

      Upon interviewing many post-operative total knee replacement patients, the following is the conclusion I have drawn:  It hurts considerably the initial 30 days and you wonder "why did I do this?"  As you go through the process of rehabilitation, by 60 days post-operation, you "see the light at the end of the tunnel" and you "turn the corner" with the rehabilitation process and realize "I will get through this!"  At 90 days post-operation you are pretty much back to your "normal" self and your "normal" routine.  At 6 months post-operation you really do not have any significant limitation other than the obvious (no contact sports or extreme exercise and no running.)  By the time 1 year passes, you will be asking yourself "why did I wait so long?"  

Reference:  1. Document title:  Physical Activity for Everyone: Guidelines: Adults/DNPAO/CDC          361-578-3513          Engage us on Facebook!