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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. Local to the Towson, Lutherville-Timonium, Cockeysville, or Hunt Valley area? Friends & Family receive a FREE Discovery Session at Premier! 1. Prehabilitation 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. Wrap-Up 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 References: 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. Local to the Towson, Lutherville-Timonium, Cockeysville, or Hunt Valley area? Friends & Family receive a FREE
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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. Local to the Towson, Lutherville-Timonium, Cockeysville, or Hunt Valley area? Friends & Family receive a FREE Discovery Session at Premier! 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: https://go.premierneurotherapy.com/apply Local to the Towson, Lutherville-Timonium, Cockeysville, or Hunt Valley area? Friends & Family receive a FREE
Discovery Session at Premier! The First Thing That Happens After A Catastrophic Knee Injury (And How It Affects Your Recovery...)2/11/2019 At Premier, we see a fair amount of clients after catastrophic knee events. Whether it is an ACL tear, MCL strain, dislocation, or total knee replacement, the body responds in a very simlar way. When most people think about these types of events and what happens to the body afterwards, they often describe physiological symptoms like inflammation, weakness, stiffness, and pain. But what is it that triggers these events? It's the nervous system. As soon as the nervous system senses that something is "not right" with the knee, it responds by putting the knee in lockdown mode. In lockdown mode, the nervous system shuts down neurological communication to the muscles of the quad (even more specifically the vastus medialis and vastus lasteralis). It refuses to use these muscles, because it fears using the muscles will put too much stress on the knee. And without proper use of the quads, the knee feels extremely stiff and the leg can feel weak. This is a beneficial response for the body, at first. It ensures that you will not continue to participate in activities that can put the integrity of the knee at risk. But what about when it's safe to start using the knee again? Does the brain automatically turn the neurological communication back on to these muscles? Unfortunately, the answer is no. And it's one of the major challenges of recovering from a catastrophic knee event. Even when it's safe to start using the knee, the brain has latched on to the idea that the brain needs to be protected. It continues to lockdown the quadriceps muscle, which actually delays your recovery and puts you at a higher risk for re-injury. In order to addreses this problem at Premier, we combine direct current electrical stimulation of the quadriceps with active range of motion exerecises. By doing so, we re-train the nervous system to relax the quadriceps, which promotes a more efficient recovery and quickly decreases symptoms like pain, inflammation, and stiffness. If you, a friend, or family member are dealing with the after effects of a catastrophic knee event (whether it's been 1 day or 1000 days), make sure you ask your therapy team what they're doing to address this problem - it is the number one reason recovery from these events doesn't always go as well as planned. Local to the Towson, Lutherville-Timonium, Cockeysville, or Hunt Valley area? Friends & Family receive a FREE
Discovery Session at Premier!  “Evan, I’ve tried everything – PT, Chiro, acupuncture, dry needling. Nothing is working for me. The doctor tells me this knee pain is something I just have to live with until I’m old enough to have the knee replaced. The only relief I’ll find from the knee pain is through painkillers. I just feel like my body is too young to be breaking down like this. Can Neuro Therapy help me?” This is a question I received from a 42 year old woman several months ago regarding her chronic knee pain. I’ve heard similar versions over the years from men and women who have basically been told to ‘give up’ the fight against knee pain. “It’s just something you’ll have to live with,” the doctor tells them. What kind of prognosis is that for a 42 year old person (who’s been active their entire life) to hear? I have to live with it? Live without working out? Live without playing sports? Live without being able to demonstrate the importance of exercise to my kids? Live life dreading simple actions like climbing the stairs or walking in heels? I don’t think so. Read more about some of the activities our clients have gotten back to AFTER knee pain The good news is – you don’t have to live life that way. And you don’t need to rely on painkillers. And you don’t need surgery. Neuro Therapy is a little different than other things you might have tried in the past. Through Neuro Therapy, we are able to identify and target the exact muscles that are causing your knee pain. Over time, the brain can develop ‘bad habits’ and start using muscles improperly. When muscles don’t do their job properly, other parts of the body must pick up the slack and do more work than they were designed to do (tendons, ligaments, joints, your knees, etc.). When our knees start doing more work than they were designed for, the result is knee pain. So what muscles are causing your knee pain? The thing is – different muscles may be causing knee pain for different people. In person A, we may find the brain has learned to use the calf and hamstring improperly. In person B, we could find issues in the hip and quad that are leading to knee pain. Your knee pain requires an individualized approach. And that is the difference that Neuro Therapy offers. Neuro Therapy finds the exact muscles that are causing YOUR knee pain. We aren’t working from a book (like some PTs) that tells us what causes knee pain for most people. Because you may not be most people - your knee pain deserves an approach tailored to your body. Once we find those muscles, our job is to convince the brain to start using them properly again. I wish I could say it’s as easy as flipping the light switch. But it isn’t – it takes a lot of hard, intense work over a few weeks. We refuse to coddle people with light weight and in-home exercises. We will push you to work at high intensities knowing that the reward is much greater than any temporary discomfort. Luckily, I know the people who read this blog are the kind of people who will put that work in if it means getting back to an active lifestyle. If you are willing to put in the work, Neuro Therapy can help reduce your knee pain and get you back to doing the things you love. To learn more, feel free to shoot us a message on Facebook by clicking this link – m.me/premierneurotherapy We offer a few free knee pain discovery sessions each week, so be sure to ask if we have any available in the upcoming weeks. A discovery session includes a movement assessment, body screening, and introduction to the therapy. You will leave the discovery session knowing what muscles are causing your knee pain and with reduced pain. You can also give us a call at 904-479-0277. to speak directly to one of our team members. Thanks for reading!   When our clients come down with a bad case of knee pain, it restrains them from doing the things they love to do most. Even worse, it can put you on the path to painkillers, possible surgery, and limit your independence. One of the most rewarding parts of my job is helping people to get back to doing what they love without pain. I’ve compiled a list of the 7 most popular things our clients tell us they’re doing again (life after knee pain) since experiencing Neuro Therapy. **I've tried everything. How can Neuro Therapy help my knee pain?** 1. Running A lifetime of pounding the soles into the pavement can be the main culprit leading to knee pain, especially as we get into our 40s and 50s.. In many cases, running induced knee pain can be corrected through examining muscle activation patterns involved with the gait. If just one muscle is not doing its job correctly, the joints can suffer. Neuro Therapy has helped clients to identify which muscles are not working properly and re-train them to relieve stress from the knee joint. 2. Easily climbing the stairs In some of the more extreme cases of knee pain we’ve worked with, our clients had one goal: To climb the stairs without leaning on the handrail and walking with a limp. Sometimes, it’s the little things in life that affect us the most. Not being able to climb stairs is the first sign that we are losing our independence, which is a frightening experience. In our 30s, 40s, and 50s, we are way too young to be thinking about what life looks like without mobility and independence. Local to the Towson, Lutherville-Timonium, Cockeysville, or Hunt Valley area? Friends & Family receive a FREE Discovery Session at Premier! 3. Wearing heels I’m sure this one doesn’t affect a lot of the men in the group (more power to you if it does), but it’s a common one we hear among women. Putting on a nice dress and wearing heels used to be the start to an amazing Friday night, but knee pain forces women to constantly be on the fence about whether the heels are worth the agony that comes along with it. Don’t lose hope – putting on heels can be a worry-free event in the near future. 4. Playing with kids Several of our clients didn’t realize just how bad their knee pain was limiting them until their kids became mobile (how did they get so fast?) One client told us, “I’ve always thought of myself as being the fun parent, but I’m not even able to run around in the yard right now. What kind of parent will my kids remember me as?” Within a few weeks of hard work, we worked together to significantly reduce the knee pain. Now, he is back to playing AND coaching, making sure his kids see the best of him. 5. Squats (Leg Day) What started as resting the legs for a few days to let the knee pain calm down turned into months for many of our clients before they decided Neuro Therapy was right for them. I was once told by a client that it had been so long since his last leg day that he felt his biceps had become bigger than his quadriceps. Knee pain can make it seem like you’ll never get back to experiencing the “Jello” feeling of leg day, but the good news is we can make it happen. 6. Playing Tennis Playing tennis is a great way to stay in shape, compete, and spend time with friends. Unfortunately, all of the starts and stops on hard pavement can wreak havoc on the knees. We’ve heard this from several clients “I used to play tennis, but don’t think I could ever get back to doing that again…I’d be happy to just get around with significantly less knee pain” Little did they know, we were able to get them back to playing pain free (most times within 2-3 weeks). 7. Sitting down and concentrating at work In some cases, the knee pain is so bad that it keeps our clients from focusing. Even though sitting seems like a harmless activity, bending the knee for long periods of time can cause more stress than you think. A client once told us "I'm expected to be a high performer at work, but lately, I'm not able to get in the zone. I'm just always thinking about my knee." If you are someone who can't sit for more than a few minutes without constantly thinking about the knee (sometimes every 30 seconds or so) , it's likely your performance at work may be suffering as well. The most important takeaway from this post is that there are many people out there suffering from knee pain and discomfort just like you. It can feel hopeless at times (aren't I too young for this?), but we've helped many in that situation to overcome knee pain and get back to the activities they love most. To learn more about Neuro Therapy, feel free to shoot us a message on Facebook by clicking this link – m.me/premierneurotherapy We offer a few free knee pain discovery sessions each week, so be sure to ask if we have any available in the upcoming weeks. A discovery session includes a movement assessment, body screening, and introduction to the therapy. You will leave the discovery session knowing what muscles are causing your knee pain and with reduced pain. To learn more about the discovery session, check out our post here- Learn how a discovery session can help you find out what's causing your knee pain If you haven't already, download our free guide. It's perfect for anyone who has had to reduce activity because of knee pain. 7 Tips to Get You Working Out (Again)...even if knee pain has been bothering you for months (pictured below). You can also give us a call at 904-479-0277. to speak directly to one of our therapists. Thanks for reading!  I know what you're thinking. "What in the world is a discovery session?" A discovery session is something that we created because we know Neuro Therapy is probably a foreign term to you. You've heard of Physical Therapy. You've heard of a chiropractor. You've heard of massage and maybe even something like dry needling, but never Neuro Therapy. Simply put, we want you to be able to 'discover' Neuro Therapy - 100% risk free. Each week, we offer a few free discovery sessions for people to come in and learn more about our therapy. It gives you a chance to gather more information and see if it's a good fit for you, and it also gives us a chance to see if we think we can help you. Local to the Towson, Lutherville-Timonium, Cockeysville, or Hunt Valley area? Friends & Family receive a FREE Discovery Session at Premier! The discovery session consists of 3 components: 1. Movement Assessment 2. Body Screening 3. Introduction to Therapy You can expect to leave the discovery session knowing what muscles are causing your knee pain and with significantly reduced pain levels in the knee. A description of each part of the discovery session is given below. 1. Movement Assessment We will take you through a series of movements to gather more information about your knee pain. What movements in your daily life bother you the most? What activities are you restricted from because of your knee pain? What pain levels are you feeling in those movements? We will monitor these movements looking for any abnormal movement patterns that could be contributing to your knee pain. 2. Body Screening (Find out what muscles are causing your knee pain) We scan your body with an electrical signal to identify muscles that are not functioning properly. When muscles in the body don't do their jobs properly, joints (in your case, the knees) are forced to pick up the slack. Over time, the joints have to do more and more work, resulting in pain. You'll find out the exact muscles that are causing your knee pain and what we can do about it. 3. Introduction to Therapy We want you to be confident that Neuro Therapy can reduce your knee pain, so we'll also take you through therapy during the discovery session. Once we find the muscles causing your knee pain, the goal of therapy is to convince the brain to start using those muscles properly again. In order to do so, we take you through exercises while forcing those muscles to work with an electrical signal. When those muscles start doing their jobs again, your knee pain is reduced significantly. Hopefully, I was able to give you a little more insight into what you can expect if you come in for a discovery session. As I mentioned earlier, we only give a few free discovery sessions away each week, so be sure to reach out and see if we have any available in the weeks to come. If you have any questions, please don't hesitate to shoot us a message on Facebook by clicking the link below- m.me/premierneurotherapy or call us at 904-479-0277 Looking forward to hearing from you! -Evan Local to the Towson, Lutherville-Timonium, Cockeysville, or Hunt Valley area? Friends & Family receive a FREE
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About the AuthorEvan Lewis is a nationwide leader in Neuro Therapy and founded the Baltimore area's only specialist Neuro Therapy facility. 
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Premier Neuro Therapy specializes in helping people overcome nagging pains and injuries, avoid surgery and injections, and transform the body to a state of peak performance.
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Our home base is just outside of Baltimore, MD, but we serve clients virtually throughout the United States!
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