The amount of joint replacements continues to grow, so does the amount of physical therapy taking place as people look to recover.  This article asks for tips from physical therapy professionals who are more than happy to oblige.

Total joint replacement surgery is a taxing process - on both your body and your schedule.  In the long run, your new joint will foster a pain-free and mobile lifestyle, but it takes hard work and commitment to get there.  Physical therapy is the most important factor in regaining strength and mobility post-surgery.  Whether you have undergone or are anticipating a total knee replacement, hip replacement or any other joint replacement, understand that getting the most out of your new joint means getting the most out of your rehabilitation program.  Follow the recommendations of your surgeon and physical therapist, and take a look at some tips we've gathered from physical therapists Helen Funke, Jim Lagrange and Franklin J. Rooks Jr. to stay motivated and moving.

Helen Funke, MSTP, MBA, director of physical therapy at Pioneers Memorial Healthcare District asserts that a vital tool in successful recovery begins even before surgery.  She offers several tips to ensure recovery preparedness after joint replacement operations, including pain management practices, how to keep family involved and staying active.  "Try to stay as active as you can tolerate," says Funke, "and maintain some form of exercise so you are not deconditioned by the time surgery occurs."  It's also important to remember that the more pain medication taken prior to your operation, the more pain medication required afterward, as the body will develop a tolerance.  Keep friends and family involved before and after surgery to help you prepare, assist in your hospital discharge and encourage your rehabilitative practices. "Include family members in the education and hospital stay.  This will give them practice in assisting you and ensuring your comfort upon discharge," Funke says.

Both at home or in the hospital, physical therapy can be initiated in as soon as 48 hours after joint replacement surgery, upon the discretion of your surgeon and/or physical therapist.  This form of rehabilitation is important in improving strength, range of motion and gait.  According to Jim Lagrange, physical therapist with the Mercy Physical Therapy Center in Portland, Maine:

"Physical therapy helps expedite a patient's return, especially for those who need to get back to work or care for themselves at home without assistance from others.  It's also beneficial to those looking to be able to participate in higher-level activities such as golfing, swimming or going to the beach."

Most physical therapy programs post-joint replacement include walking and other movement regimens intended to gradually increase joint mobility.  For example, a patient recovering from a total knee replacement might begin walking with crutches, a cane or walker and graduate from walking indoors to outdoors and eventually up and down hills and stairs.  These programs also involve steady resumption of activities of daily living and household chores, as well as small, repetitive exercises every day to continue improving strength and range of motion.  Lagrange stresses that "Strengthening, range of motion and walking are all hugely important early on in the process and will not harm the joint replacement."

The reality that physical therapy is the driving force in joint replacement recovery is highly stressed, but for some, it is difficult to know when and how much effort to put into such therapy.  The rigor of your rehabilitation plan is to be worked out between you and your physical therapist.  With that said, compliance is key.  Follow your therapist's instruction once you are home and continuing therapy on your own.  Lagrange and Rooks have offered some at-home recovery tips to help you find the medium between overdoing it and struggling to make progress.  Both therapists agree that patients should push themselves to the point that they just feel pain.  Working into a comfortable range is vital.  While pain is inevitable, Lagrange assures that too much pain is not the goal of successful rehabilitation.

"We generally ask patients to back off if they feel sharp pain, if they have lasting pain after they've done their exercises (pain into the next day) or if they have increased swelling or redness.  If they note any of these, I suggest they cut back on the exercise and use ice."

Rooks, MPT, MBA, suggests, "Surgery is trauma.  Pain is the body's warning sign.  Initiating range of motion may be uncomfortable, but pain should subside."  Constant motion is generally good for patients recovering from joint replacement surgery.  "The patient needs to get used to moving the joint in the pain-free range of motion throughout the day, and then work on the increasing motion to the point of discomfort to continue to gain motion."  Just keep in mind that the duration of pain is a sign that you are overworking your body, but as long as joint range of motion isn't improving, or you aren't feeling any discomfort, you may not being doing enough to improve mobility.  For general comfort, Rooks advises pain medicine in conjunction with therapy.

Most joint replacement recovery advice is applicable to all replacements, but differences exist depending on the joint.

For knee replacements:

  • Do not place pillows under your operated knee.The last few degrees of knee extension are difficult to attain, and pillows cause extra trouble by decreasing range of motion.
  • Placing a pillow under your calf is acceptable, as it does not affect range of motion.
  • Get into bed with the side of your body not operated on, and get out of bed on the side of your body which has been operated on.

For hip replacements:

  • Do not cross your legs.
  • Do not bend past 90 degrees at the hip.
  • Do not lie on the side of your body NOT operated on.
  • Keep toes pointed forward when lying, standing and walking
  • Do not allow your operated leg to turn too far in or out.
  • Get in your bed on the side of your body not operated on, and get out of bed on the operated side of your body.

For shoulder replacements:

  • Limit lifting heavy objects for two months.
  • Continue active arm movement within your pain limit.
  • Remember, it may take six months to a year to achieve the optimal benefit of your surgery.

To cover all the bases, keep in mind these basic tips through your journey to recovery:

  • Acknowledge that your strength will be affected.Ordinary activities such as climbing stairs, lifting and performing household duties will require range of motion and strength that you do not have.
  • Don't overdo it.Follow your therapist's direction, and remember to be patient.Achieving strength and mobility may not happen for weeks.
  • Use ice to manage pain and keep swelling under control.
  • Don't neglect your incision.Watch for unusual redness or hotness, which could be sign of infection.
  • Remain compliant, and reach out to your therapist or surgeon with any questions or worries.
  • To stay accountable for your recovery and committed to your rehabilitation plan, involve a friend or family member before, during and after your surgery for motivation and assistance.
  • Set goals, as well.It's OK to adjust them as you make your way through the healing process, but aim to achieve them, seeking help from your support system.

This article provided by Autocam Medical.

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