Caitlin Woodyard PT, GCS (Geriatric Certified Specialist)
Marcus Daly Rehabilitation Department
1200 Westwood Drive
Hamilton, MT 59840
Do you have a joint that won’t stop hurting, stiffness that limits
your activity, or a limp that leaves you walking at the back of the pack?
Maybe you will be one of the more than one million people who choose to
have a joint replaced each year in the United States. The decision to
trade out your arthritic hip or knee for a new model is not made lightly
by you or your healthcare team. You will likely spend many hours with
your family and physician discussing your options and pondering if it
is right for you. Just as this decision requires thoughtful consideration,
so does the preparation for your own joint replacement journey. Continue
reading for insight and suggestions for a successful experience.
Are you facing a joint replacement surgery at your peak fitness level?
Probably not, years of arthritis typically results in pain with physical
activity, which may have led you to decrease how much you walk, work in
your garden, ride your horse, hike, fish, or go to the gym. Decreased
activity or exercise can result in less joint range of motion, flexibility,
and strength. Maybe you have noticed that your knee no longer straightens
all the way or bends as far as it used to; that is decreased joint range
of motion. If it is difficult to put your shoes on, you are experiencing
limited flexibility. Has your knee ever buckled on you, causing a fall
or a near miss? Do you feel shaky or weak after climbing one flight of
stairs? These are some symptoms of decreased strength.
Physical preparation before surgery improves your ability to move your
body with less pain and more ease after your surgery. While your results
from surgery will improve with preparation, it is important to consider
how your current medical conditions may determine what is safe for your
body. If you’ve recently discussed exercise with your physician
and they have recommended it to you without reservation, there is no reason
to wait. However, if you have a heart condition or difficulty breathing,
if you take multiple medications, or if you have a new concern you haven’t
discussed with your doctor, it would be wise to see them first to discuss
safe types of exercise for you.
Your primary physical goals in preparation for a joint replacement are
increasing the joint range of motion, muscular flexibility, and muscular
strength in your surgical joint and throughout that leg. Your secondary
physical goals are increasing the strength of your non-operative leg,
both of your arms, and your core. Your non-operative leg will be your
workhorse as you are recovering from surgery; it needs to be strong enough
to support you as you gradually are able to bear weight on your surgical
leg. Use of a mobility device such as a walker, crutches, or a cane are
common for weeks to months following a joint replacement; make sure that
your arms are prepared for the work that will be asked of them during
this task. Finally, your core muscles- think primarily abdominal and back
muscles- do work constantly throughout the day for your breathing, posture,
and balance. Preparing them will help you to move better and decrease
your risk of spine injury throughout your recovery.
If you are typically a self-directed and self-motivated individual with
a good grasp on exercise basics, you may be able to prepare yourself for
surgery. However, if you aren’t sure where to start, seek out the
advice of a physical therapist or other exercise professional. Guidance
through specific, safe, and progressive exercises will help you reach
an optimal physical condition prior to scheduling your surgery date. And
remember that your goals are unique to you- while your friend or spouse’s
goal may be walking a couple miles per day, it is ok if your goal is to
walk to and from your mailbox. Your starting point and your goals will
be individual and any progress is a positive result!
In addition to preparing your body for your surgery, it is helpful to prepare
your home. First, consider the entrance to your home; do you have stairs
to negotiate? If so, do you have a rail to hold while you climb those
stairs? Consider installing a basic handrail to ensure your safety and
stability while you come and go from your home- during your recovery and
the coming years of aging. Second, do you have clear pathways in your
home or are you stepping over pet beds, catching your toe on your favorite
throw rug, and stepping around your favorite antiques? If so, consider
clearing your paths and decreasing tripping hazards so you will be able
to navigate between bedroom, bathroom, kitchen, and living areas with
a walker. This will assist you in maintaining your independence and safety
in your own home following your surgery.
Physically preparing for surgery is crucial; your body will thank you.
Mentally preparing is equally important. Have you thought through what
recovery with a newly replaced joint may look like? Your surgeon and nurses
will help you through the details of medication management following your
operation to facilitate good pain control. Physical and occupational therapists
in the hospital will help teach you basic mobility and daily living tasks-
getting dressed, getting in and out of bed and chairs, on and off the
toilet, in and out of the shower, walking with a mobility device, and
balancing while you brush your teeth or feed your dog.
After a few days in the hospital, you will be ready to return home! Aren’t
you glad you put that rail in by your stairs and have a clear path to
your favorite recliner? However, don’t get too comfortable. Just
as you put in many hours of hard work preparing for surgery, there are
many more ahead. You will be discharged from the hospital with your first
set of exercise homework but will need to pursue continued physical therapy
in an outpatient clinic to ensure you meet your long term goals. With
thoughtful preparation, hard work, and a positive attitude, you are on
track to a successful recovery.
This week’s community health column is brought to you by Marcus Daly
Memorial Hospital. For questions and or comments, please contact Caitlin
Woodyard PT, GCS at the Marcus Daly Rehabilitation Department at 1200
Westwood Drive, Hamilton MT, 59840 or call 406-375-4570. Working together
to build a healthier community!