(And how I
ended up knowing that exercises will prepare you and help you recover faster)
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| Never rely solely on this to recover from Total Knee Replacement Surgery |
In the summer of 1996 my Dad had a Total Knee Replacement (TKR)
done at DePaul Hospital. Little did I know that my working as a Rehab Tech a
couple of years before this would help him recover from this surgery.
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| This was a familiar site to me. (Pic not my Dad's knee) |
Having work with many patients who had had joint
replacements, I had my Dad PREPARE his body for this surgery. Mostly simple exercises
such as: GLUTE SETS, QUAD SETS, HEEL SLIDES. (Today I would have him use more
complicated exercises as tolerated like: SQUATS, LUNGES, STEPS UPS, HIP
HINGES, ETC.) He was also doing a fair amount of upper body strengthening which
also made it much easier to recover from the TKR. Think about getting out of
bed with plenty of upper body strength verses needing help to get out.
The best part of his PRE-SURGERY exercise program was the
look on the Surgeon’s face when I went with my Dad for his 1st POST-OP
visit. At the time normal recovery included using a walker for a month and then
a cane for a month. My Dad walked into the office on his own after two weeks.
They couldn’t believe it. He was a rare patient that PREPARED his body before
surgery so that his recovery was much quicker than normal. I wasn’t even a NSCA
–CPT yet. (Although I was in the middle of studying for the certification exam.)
Today I would have had a talk with the surgeon about adding
PRE-HAB work to his patient’s joint replacement programs.
HOW DID I DEVELOP THIS KNOWLEDGE?
They say timing is everything. (If I had started showing up
at Barnes West a year sooner, I probably wouldn’t have gotten a job there.)
In 1993 I started volunteering at Barnes-West Hospital’s Sports Medicine Center in Creve Coeur
Missouri. Little did I know where this
would take me.
A few weeks after I starting hanging around there, the Head
of the Physical Therapy Department (Mark) started to take an interest in my
being there. (The reason I was there was to observe the Athletic Trainers) You know
how some times when you meet someone, your personality’s just click. Ours did.
(The other interesting thing about my time there was my personality DID NOT
click with most of the Athletic trainers there. The Head Athletic Trainer and I got
along pretty well.
Little did I know that Mark had plans to hire me to work at
the Hospital. Missouri Bone & Joint
had just decided to move from DePaul to Barnes- West. Barnes-West needed a
Rehab-Tech to work with the inpatients. Mark had decided I was a perfect fit
for the job.
I still remember my first morning on the job. I felt like a fish
out of water, but Mark was a great person to train me and work for. One of the
first things he taught me was how to bend the patients’ knees the first day
after surgery. I took a while to get comfortable causing that much pain, but
Mark had taught me that no one under our care would leave with a stiff knee(s).
I knew where Mark was by listening for the patients’ screams and soon enough I
would be causing screams. He wanted at least 90 degrees of bend that day and at
least 120 degrees before they left for home.
(Unless the Surgeon had given us different orders.)
It use to bother us
when we would hear one of the surgeon’s telling the patients before surgery to
not work the joint if they were having pain. You shouldn’t have to worry about
damaging a joint ANYMORE if it going to be replaced soon. Exercising around
that joint can lead to better recovery and less post- surgical pain.
Another way we could tell how well the patient’s joint would
do after surgery was how much they were willing to go through after surgery.
Some patients refused to bend their knees on their own since the knee was in a
CPM machine. (Continuous Passive Motion) Active exercise (Bending and straightening
the knee using your muscles) will always give better results than passively letting
a machine do all the work. What happens when you can no longer rely on the
machine? You have to try getting the muscles working again anyway and you get
better results the quicker you rely on the muscles. I can still picture one Hip Replacement Patient being wheeled to their room from recover doing ankle pumps, and my first thought was; There is a patient that is going to do well after surgery. (and they did)
My lesson for anyone going if for Joint Replacement (or any
other) surgery: the better your body is prepared before it, the quicker and
better the recovery will be. I.E. BE AN ACTIVE PARTICIPANT IN YOUR HEALTH
INSTEAD OF A PASSIVE ONE.
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