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Physical Therapy

Physical Therapy After Total Knee Replacement

April 4, 2016 by Lisa Lafave

Physical therapy is really what it’s all about after total knee replacement. You really have to trust yourself and keep up with your exercises after total knee replacement. You want to get that flexion and extension to where it needs to be and it will only happen with hard work.

After my total knee replacement surgery, I had physical therapy the day of the surgery. I was up and walking the day of surgery. The surgery was in the morning and I was walking that afternoon around 4:00 PM. Heck, no rest for the weary! The next, day I was walking up and down stairs. That was fantastic! I was not going to be limited to one floor post op. On the fourth day, I went home to begin my long recuperation. For the first three weeks, I had a physical therapis come to my home to work with me. Then I had a driver escort me back and forth from treatment and by the fifth week, I was driving myself back and forth from physical therapy.

I am now about three months out and doing fairly well. I am having trouble with a suture reaction, but that will resolve itself overtime. It is seen frequently and is not much to worry about.

So the flexion and extension that is measured at every visit with the physical therapist as a marker of progress has to be achieved before your body shuts down and change can no longer occur. You see you have a certain window during which the exercises can affect your ultimate outcome from the total knee replacement. The more you work it, the greater your flexibility will be for the life of your replacement unit! So don’t forget to work it.

For extension, my primary tool is a rolled up yoga mat with the plastic wrap still on it. I lay in bed with the mat at the end of the bed with my ankle resting on the mat. I flex my quads and hold for five seconds, then release. I do this over and over while watching TV and taking care that my foot does not roll outward, like a duck. If anything, you want the knee to roll in toward the other knee. Then you press downward and try to get that knee as flat as possible. Having a leg that straightens out fully is important for walking.

For flexion, you start with knee slides. You will sit in a chair with a rag under your foot. On a wooden, or tiled floor you will slide your foot out and back. You can do this same movement while laying on the floor with your butt a foot or so away from the wall. Again with a rag or pillow case under your foot, you will slide your foot up and down the wall. If need be, you will use your other foot as a weight to help the operative leg to slide further down and then hold while you count to five. Then release and move leg and foot back up the wall. You can also do knee slides in bed, while lying down. Don’t forget you can use the non operative foot to press Your other ankle back, to give your operative knee a better stretch!

I also like to use my bar chair for flexion. I have noticed that with my non operative leg I can flip my foot around the back of the bar down below. So I feel like I should ultimately be able to do this same maneuver with my foot on the operative side. At first, it was quite a feat just to get my foot on the bar and hold it to stetch out the knee while watching TV. Later the job was to push my foot farther and farther backward; first to heel, then to mid foot, later to toes. The thing about this chair is the bar lets me know exactly where I am at with moving the process forward. I am sure you will find your own favorite techniques, as you approach your own quest toward greater mobility post total knee replacement.

Have you ever been through a round of physical therapy? What tips or tricks did you use? What advice do you have for others who are just beginning physical therapy?

If you think you would benefit from enlisting someone to talk you through the process and hold you accountable, contact me and we can schedule a time to talk.

All my best to you,

Lisa

Lisa J Lafave, PhD, MBA, ACC, BCC
CEO & Founder of Coaching Rocks, LLC
The Wellness Coach from Building Better Bodies Rocks
A Single Mom By Choice Raising Surrogacy Twin Boys
Written in My Little Brick in University Heights, Ohio

Leap Into Action!

Filed Under: The Wellness Coach at Building Better Bodies Rocks Tagged With: Building Better Bodies Rocks, Coaching Rocks, Flexion and Extension, Lisa J Lafave, Lisa Lafave, Physical Therapy, Physical Therapy for Total Knee Replacement, The Wellness Coach at Building Better Bodies Rocks, Total knee replacement

Move it, Move it, Move it!

October 3, 2015 by Lisa Lafave

So I had back surgery, last Spring in May 2015, just 4 months ago and I have been asked to have total knee replacement in March of 2016. I tell you what, that’s a lot to crunch on and absorb. I am a tad worried about how my two little 5 year olds will manage. It’s just so much for them to get through in such a short period of time.

In the next several months, in between the two surgeries, I will be exercising to strengthen my core muscles and my quadriceps. In common parlance, I need to strengthen my back and thighs to help the benefits of the back surgery to come to fruition and I need to strengthen the same muscle groups in order to prepare for the total knee replacement.

This morning, I met the physical therapist, Michelle Hribrar, otherwise known as Mickey, at the Cleveland Clinic Foundation’s Sports Medicine department. Mickey was friendly, compassionate, and very knowledgeable. She didn’t miss a beat. I’ve been through physical therapy a several times already. Mickey is a keeper!

I did the typical, and filled out a few assessments, told her some of my story and then she got to work assessing strength and range of motion, and presenting a few exercises for me to start with immediately. The thing that is so amazing about physical therapists is they are just so good at isolating muscle groups and know just what to tell you to do to strengthen what is not working properly.

Moreover, she gave me hope. Mickey reminded me that I am only 4 months out of my back surgery and the body takes at least a year to heal from a surgery such as this. I still cannot walk the way I want to walk, or the distance that I want to cover, but Mickey thinks it will come with time.

So my plan is to continue walking around the block 5 days a week. Do my physical therapy exercises daily and start back at the JCC swimming or more likely moving through the water with the purpose of gently moving my muscles and toning up my core, my gluts, and my quads! I hope to get to the JCC 2 – 3 times each week, likely directly after physical therapy, which should be two times a week.

So that’s my plan. What is up with you? Do you need help too? Can you possibly arrange to see a physical therapist or chiropractor or personal trainer? Or do you want to go it alone? The point is to get moving. When you are behind the proverbial eight ball, you have to start somewhere to pull yourself together.

Why not create a plan that you can stick to today to move a bit more? Can you take the stairs instead of the elevator? Can you park farther away at the office? Can you walk to the corner? You know what your limitations are. You are the expert on you! Can you just reach a little further than you have been? What is one thing you can do, starting today, that would be a symbol of the fact that you have chosen to stop this freight train toward decreasing mobility and diminished quality of life?

Do you have a Fitbit? Do you know what a Fitbit is? A Fitbit is a piece of wearable technology, which can clip to your clothing or be worn like a watch. A Fitbit is an activity tracker that will give you a variety of personal data, like how many steps you’ve taken today, stairs you’ve climbed, and calories you have burned. It can also measure the quantity and quality of sleep you’ve had. A Fitbit can link to the Fitbit website and be used to record food intake, heart rate, blood pressure, and glucose levels.

Are you willing to invest in one? A Fitbit just might be the gadget you need to help you to become more in tune with your body and more on track regarding your fitness goals!

Gadgets not your thing? That’s okay, you can get where you are going, without all this information. It’s totally been done before! Fitbits are just one of the new items out helping people to attain their wellness goals. You can totally go it alone, and do a low tech program!

What are you willing to do to move yourself back in the direction of health? Go ahead give it a try. I swear you don’t even need a professional to get started. Just take one small step. Commit to it and then make it a habit! Then in a few weeks you can consider another one!

Why not take some time to flesh it out with paper and pencil, or should I say finger and tablet? Take a few minutes to create a roadmap for yourself. Write down five or six things that you would implement right now, if you knew, with absolute certainty, that they would become a reality.

Put a star next to the two items you feel are most pressing. Circle the one you are willing to commit to in the next week. Start today, if you think you can swing it. Get out your calendar and pencil in, when you will begin work on the second goal. Time is of the essence! Don’t let the day, the week, or the month get away from you! And don’t forget to move it!

Lisa J Lafave, PhD, MBA, ACC
The Wellness Coach at Building Better Bodies Rocks
CEO & Founder of Coaching Rocks, LLC
A Single Mom By Choice Raising Twin Boys
Written in My Little Brick in University Hts, Ohio

Leap Into Action!

Filed Under: One Woman's Experience Recovering From Medical Challenges Tagged With: A Single Mom By Choice, BBB Rocks, Building Better Bodies Rocks, Coaching Rocks, Lisa J Lafave, Lisa Lafave, Physical Therapy, The Wellness Coach, The Wellness Coach from Building Better Bodies Rocks

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