To knee or not to knee, that is the question!
September 18, 2017
Many people view having a Total Knee Replacement in a similar way to running the Great North Run. They know that may people do it therefore it can’t be too bad. Well the reality of the Great North Run is that 13 miles is a really, really long way. One thing for sure training makes it a lot easier and a lot more enjoyable. In the same way, any orthopaedic surgery provides challenges to the patient, this is certainly the case for Total Knee Replacement surgery.
Top tip 1: Start early with your pre-habilitation!
The main reason why people have a Total Knee Replacement is for Osteo Arthritis (OA). With this condition the knee can become stiff, sore and painful. Walking can become increasingly sore and muscles around the knee can “switch off”. If this happens for one week, you may not notice any major problems. If this occurs for longer than this it can be a massive problem. More and more patients are arriving at Physiotherapy Matters 2-3 months before their surgery. We carry out a full assessment and provide them with some critical exercises to do before their surgery. We have a saying at Physiotherapy Matters, “the better condition the knee is going into surgery, the better the results will be after the surgery”. Our focus will be on maximising the amount of movement you have in your knee before you go under the knife. We will be given you some very specific strengthening work to do right up until the surgery. So why is this important? After the operation, knees are generally hot and swollen. Swelling has a definite effect on the ways muscles can operate leaving the muscles weak and sore. Our weak will aim to gain as much strength as possible in order to achieve the best results when you come out the other side.
Top tip 2: Rehabilitation needs to start straight away and continue
Unfortunately at Physiotherapy Matters we have seen a definite trend for people recovering from knee surgery. As you can image, that trend is not a particularly positive one. We saw someone yesterday who had been discharged from hospital based physiotherapy after just 2 sessions of physiotherapy. He worked as an engineer and had a particularly manual job. At his last appointment at the hospital he was walking with crutches and still struggled fully straightening his knee. We have a saying in Yorkshire “It’s as bent as a dogs hind leg”. Well that was how this unfortunate chap’s knee presented at Physiotherapy Matters. Any know can image that if your unable to fully straighten your knee, it’s not going to lead to a particularly functional walking pattern. At his first appointment he struggled to bend his knee past a right angle and was walking with crutches. After a long chat we devised a plan to sort him out which involved a couple of sessions per week for the first two weeks. So what’s happened since then I hear you ask? Well, his knee can now fully straighten his knee and his is now in a position to return to work.
Top tip 3: Do as we ask and you’ll be fine!
Our staff at Physiotherapy Matters know that you are central to everything we do. Yes our fantastic hands will do some fantastic things to get joints moving better and we can do a great massage if this is required. But, the minute our patients leave our clinics, it’s up to them to work really hard and carry out the exercises that we prescribe. Exercise are not about one size fits all. They are specific, tailored and specifically formulated for you. Toward the end of the session we will talk you through exactly what we want you to do at home. Exercises may focus on range of movement, strength, balance or methods which will help to reduce the amount of swelling. It’s vital that your happy with the exercises and you can complete them as we say. Our staff will often give you a specific printed programme which details exactly what to do.
Top tip 4: Ice is a grossly undervalued piece of kit
From the word go, our physiotherapists will probably advise you to get going with ice. After a while, ice leads to a term we call “reactive vasodilation”. By applying ice, the vessels which transport blood around the body open more which helps to limit the amount of swelling around the knee joint. The physiotherapist will talk you through the best ways to apply ice and also will assess whether it is safe to do so. Certain conditions and situations mean that it is not appropriate to apply ice to an affected area.
The above gives you a whistle stop tour of how we manage Knee Replacement patients. If you are about to embark on a journey of Orthopaedic surgery please ring 0191 285 8701 and speak to one of our experience physiotherapists.