Joints can experience a lot of wear and tear, particularly if you’ve managed to stay active through the majority of your life.
Due to this break down, total knee replacement is one of the highest volume orthopedic surgeries in the US. It’s likely you know someone who has undergone the procedure or is getting ready to.
There were nearly 700,000 total knee replacement surgeries in 2018. Due to increases in population, activity levels, and average weight, that number is expected to increase to more than 3 million by 2030.
Despite how often the procedure is performed, a number of patients (about 1 out of 12) need to be readmitted to the hospital due to complications after surgery. These complications range from infection to wound healing, cardiovascular problems, venous thrombosis, pain, and arthrofibrosis (scar tissue development that limits knee function).
If a total knee replacement is in your future (or someone you know), here are 5 ways you can increase your chances of a successful recovery from surgery.
Prehabilitation is the concept of developing as much strength and range of motion around the knee (and in the legs in general) as possible before surgery. You “pre-hab” by working with a qualified therapist or strength trainer.
By doing so, the theory is that you will have a better surgical outcome, and the research indicates this theory is true. Pre-hab has been shown to:
2. Lose Weight
Weight plays a significant role in your total knee replacement outcome, so much so that certain hospitals have stopped providing the surgery for patients who are extremely overweight. Obsese patients nearly double their odds from infection after surgery. Those who go through surgery at a healthy weight decrease the risk for:
As an added bonus, weight loss should also help those knees feel a little better before surgery.
3. Start rehab early
…And this could mean really early. Ask your doctor how soon they plan to start mobilizing the knee after surgery. Some studies have shown that mobilization within 4 hours of surgery can decrease risks for venous thrombosis (one of the most common causes of hospital readmission).
It can also contribute to a shorter length of stay at the hospital, higher functional scores after surgery, and improved pain control.
Whether your doctor clears you for mobilization after 4 hours or 4 weeks, make sure you adhere to their schedule. Don’t blow off your rehab, as it will significantly affect your chances of a successful recovery.
4. Be Prepared For Setbacks
Expect the unexpected. Even if you’ve done everything right, there’s still a chance there may be setbacks along the recovery process. Make sure your physician and his/her team are educating you on any potential setbacks that may occur after surgery.
By being well educated, you can prepare psychologically for any obstacles in your way during the recovery process and tell yourself that no matter the setback, you WILL make a full recovery.
5. Eat Healthy
If you’re not already well versed on the basics of a healthy diet, now is the time to seek help. Not only will eating healthy help you to lose weight before surgery, but it will also optimize your recovery.
A healthy diet will give you all the nutrients your body needs to make that knee feel brand new. After surgery, your diet might need to be a little higher in protein, fruits, and vegetables. You’ll also want to avoid foods that are likely to cause an inflammatory response.
If you need help in this area, let me know – I’d be happy to connect you with a few of the experts in my network.
If you've already had a total knee replacement and still aren't back to 100%, you'll want to reach out to a member of our team.
We may be able to point you in the right direction to help you restore range of motion, decrease pain levels, build strength, and get back to an active lifestyle.
Click to request a call with a member of our team
1. Wang L, Lee M, Zhang Z, Moodie J, Cheng D, Martin J. Does preoperative rehabilitation for patients planning to undergo joint replacement surgery improve outcomes? A systematic review and meta-analysis of randomised controlled trials. BMJ Open. 2016;6(2):e009857. Published 2016 Feb 2. doi:10.1136/bmjopen-2015-009857
2. O'Neill SC, Butler JS, Daly A, Lui DF, Kenny P. Effect of body mass index on functional outcome in primary total knee arthroplasty - a single institution analysis of 2180 primary total knee replacements. World J Orthop. 2016;7(10):664-669. Published 2016 Oct 18. doi:10.5312/wjo.v7.i10.664
3. Same-day Mobilization following Total Hip and Total Knee Arthroplasty. Alberta Bone & Joint Institute. Published 2009 Oct 1.
This week's blog was written by our Clinical Director of Neuro Therapy, Leah Zinnert. It's a really fascinating piece!
National Geographic recently came out with a documentary called “Free Solo,” about how Alex Honnold became the only person in the world to climb the 3,000 ft wall El Capitan without a rope or other safety gear.
An article written about the climb stated that:
“Elite climbers have pointed to Honnold’s unique ability to remain calm and analytical in such dangerous situations, a skill that Honnold has slowly developed over the 20 years he has been climbing… There are other climbers in Honnold’s league physically, but no one else has matched his mental ability to control fear.”
His ability to remain calm in these high-risk situations intrigued scientists. So much so, that they actually conducted a functional MRI of his brain.
This type of imaging shows changes of blood flow that occur in the brain when a person is performing a certain task or exposed to a certain stimulus. Essentially, what is activated (or not activated) will light up during the scan.
The amygdala, the part of the brain they were especially interested in studying in Alex, is a part of the limbic system. It helps us to interpret and process emotions. It helps us to identify threatening stimuli and regulate our fear response.
What they discovered in Honnold was interesting. When they exposed him to stimuli that, in you and I, would most likely cause a fearful response, it generated nearly no response in Alex’s amygdala. His brain remained in the parasympathetic (rest and digest) state instead of being driven into the sympathetic state that would occur in the typical person.
But how? One hypothesis could be genetics. Some people are just wired to be more ‘chill’ than others. Some of us are better at remaining calm in stressful or scary situations.
Or perhaps it’s a result of his training?
Has the repeated exposure to scary situations given him the ability to actually train and control his responses even at the deepest levels of the nervous system?
Maybe it’s a combination of both.
On the opposite end of the spectrum, what if your amygdala was the opposite of Alex Honnold’s? What if it was OVER active (which studies have suggested would cause the amygdala to be larger than normal)?
Could it signal a fear response in a situation that may not be appropriate, which would increase anxiety, fear, and even pain levels?
And what if we have the ability to train our brains to interpret stimuli differently?
Here are 5 tips that have been proven effective at training (and shrinking) your amygdala, so you can be more in control of your fear response.
1. Face your Fears
Avoid Avoidance. Is there something that your fearful of? Often, repeated or controlled exposure to these things can help decrease fear, help you to manage anxiety, and stress. If you’re unsure of how to do this, talking to a professional can help.
It all starts with the breath. Ever been stressed out, feel like you can’t control anything happening around you? One thing you can always control – your breath. Try this exercise to drive your brain in to chill mode:
The goal here is to increase focus and calm. There is a lot of information you can find online about best strategies to initiate a meditation practice if you are unsure. https://www.wikihow.com/Meditate or App’s such as Headspace or Calm can be helpful.
It has long been proven that regular aerobic exercise helps to release endorphins, which naturally stabilize mood, decrease anxiety, and decrease stress. Not sure where to start? Pick something simple that you know you’ll enjoy doing!
5. Why are you fearful?
Take some time to explore why you may react or be more sensitive to certain stimuli. Once you are more aware of the WHY behind certain behaviors, they are easier to manage.
Do you know someone who would benefit from training their amygdala?
Send them this article!
There's not much in the world that can be accomplished in 30 seconds. But there is a simple self check you can do to assess whether or not your knee pain has a strong correlation to the nervous system.
Around 40% of the clients we see have neurologoical communication issues in the quads and hip flexors that are contributing to their knee pain.
The quads and hip flexors play an extremely important role in everyday movement. When they aren't functioning properly, they don't absorb force properly, and can cause problems in the joints below the waist, including the knees.
So how can we tell if the quads and/or hip flexors are causing your knee pain?
It's as simple as laying on your back and rasing your leg. And grabbing a friend.
The self-check for the quads (see first picture below):
Lay on your back, keeping the back flat against the surface you are laying on. Raise your left leg off the ground. Once the leg is up, ask your friend to push down with moderate resistance on the leg. It's important to understand this isn't a strength test to see who is stronger. It's designed to see how quickly your quad can respond to a little bit of force going into it.
When your friend pushes down, resist and don't allow the leg to drop.
If you're able to resist, switch to the opposite leg and repeat.
If you're unable to resist or the leg drops for a moment before you're able to resist, it means that activation of the quad is not occuring efficiently.
This problem is almost definitely contributing to your knee pain, and needs to be examined further.
The self-check for the hip flexors (see picture below):
This test is very similar to the first test. The only difference is that in the previous test your back was flat on the table. In this test, you need to arch your lower back (think about lifting your ribcage to the ceiling).
Once you're in the correct position, raise your leg, have your friend push down on the leg, and see if you're able to resist.
If you're unable to resist or the leg drops for a moment before you're able to resist, it means that activation of the hip flexors is not occuring efficiently.
Similar to the quads, this is almost deifnitely contributing to you rknee pain and needs to be examined further.
These two assessments are two of the easiest tests we run to determine whether or not a neurological problem is contributing to your knee pain.
If you've passed both of these tests, but are still dealing with knee pain, we can run a host of other asssessments during your Initial Evaluation at Premier Neuro Therapy to get to the bottom of it.
The Initial Evaluation (or Discovery Session as we like to call it) is a free way to learn more about what's causing your knee pain and whether or not Neuro Therapy is a solution for you.
Just click the link below to apply:
About the Author
Evan Lewis is a nationwide leader in Neuro Therapy and founded the Baltimore area's only specialist Neuro Therapy facility.
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