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Staying active after a total knee replacement

5/9/2019

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knee pain
If your arthritis was so severe that it resulted in getting a total knee replacement, you should know there are several ways to reintroduce activities that were too painful and difficult for you before surgery.

Assuming you are in physical therapy and cleared by your doctor to resume activities (in most cases after about 12 weeks), you should be ready to start a new sport or physical activity. Staying active will also help you strengthen your knee and make it more likely to function well for many years.

Even if you're not hurting anymore post-surgery, it's completely normal to feel nervous that you’ll damage your new knee joint if you participate in physical activity. However, knee replacements have improved quite a bit over the last few decades and artificial replacements are designed to mimic a natural knee. This means that, like a natural knee, it needs exercise to function properly.

The American Academy of Orthopaedic Surgeons (AAOS) recommends up to 30 minutes of exercise two to three times per day during the early recovery stages, in addition to daily walks. In general, low-impact exercises are best so you don't cause undue stress on your knees.

Aerobic Exercises
  1. Walking
    Walking is one of the best exercises you can do to build up strength in your knee. Start with smaller steps and shorter walks as you work your way up to longer distances. Keep track of how long you walk every day so you can monitor your progress.

  2. Swimming
    Swimming is not a weight-bearing activity, so it’s a great way to exercise without putting stress on your artificial knee. Many people with knee replacements can resume swimming within three to six weeks after surgery. But check with your doctor or physical therapist before diving into the pool.

  3. Cycling
    Cycling is a good way to regain strength in your knee. Whether you use an actual bicycle or an exercise machine, stay on a flat surface and increase your distance slowly. As weird as it might sound, the AAOS recommends peddling backward on a stationary bike as you gradually gain your strength back.
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  4. Elliptical machines
    As with cycling, your knees move in a circular motion, which means you can go for longer distances. An elliptical machine is a great alternative to running because you can move faster than walking, without the impact.

  5. Dancing
    Ballroom dancing and gentle modern dancing are great ways to exercise. Dancing is a good way to use leg muscles and engage in light aerobic activity. Just be sure to avoid a lot of twisting, abrupt movements, and jumping that could put your knee out of alignment.

Strength and Flexibility Training
  1. Yoga
    Gentle stretching is a great way to avoid stiffness, improve your flexibility, and boost the overall health of your knee. Like with dancing, it’s important to avoid twisting movements. Remember to also protect your knees by keeping them aligned with your hips and ankles.

  2. Weightlifting
    Lifting weights helps build strength and diminish knee pain. Your bones will also grow and become stronger if you practice resistance training. Remember to start light and work your way up in weight. Always use weights that are appropriate for your size and strength. Consult with a physical therapist or trainer to develop a workout that is right or you and your body.

  3. Calisthenics
    These basic exercises rely on simple, rhythmic movements and build strength while increasing your flexibility. Exercises in this category include crunches, pushups, and lunges.

At Staszak Physical Therapy & Wellness Center, we want to make sure you are able to heal and get back to doing what you enjoy. Between our therapists and the instructors and trainers at Evolve Fitness Studios, we have a great team here to make this happen for you. For physical therapy, give us a call at 541-505-8180.

For workout support with trainers focused on injury prevention, call Evolve Fitness Studios at 541-844-1295.
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5 Ways to Ease Knee Pain

10/25/2016

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Knee Pain
Chances are that if you asked those around you, nearly everyone would admit that they have experienced knee pain to some degree. Whether it’s caused by arthritis, excessive foot pronation, or overuse of the muscles that protect these vulnerable joints, our knees take a beating. In fact, did you know that knee arthritis is the single greatest cause of chronic disability among U.S. adults ages 65 and older?

Here’s the good news: most chronic knee pain is avoidable. Research published in the New England Journal of Medicine suggests that exercise and physical therapy can be just as effective as surgery for relief from chronic knee pain related to arthritis. By strengthening and stretching key muscles and by learning ways to protect and take care of our knees, we can ultimately prolong the health of our knees.

Here are 5 ways you can prevent and ease knee pain:

  1. STRENGTHEN YOUR BUTT
    We know from research that knee injuries, including common ACL tears, can occur when large hip muscles are weak. ACL tears, which are eight times more likely in women athletes, have been shown to lead to other cartilage tears and are correlated with knee arthritis later in life.

    As a society, our butt muscles are weak. When the main butt muscle (gluteus maximus) is weak, it causes the pelvis to drop and the upper thigh bone (femur) to fall inward. This imbalance creates painful downward stress on the hip, knee, and ankle every time you take a step.

    Hip extensions are helpful exercises to strengthen the glutes.

  2. STRETCH THE MUSCLES THAT SUPPORT YOUR KNEES
    When butt muscles atrophy or become imbalanced because we sit so much of the day, the hamstrings and hip adductors (inner thigh muscles) also overwork — to compensate for the underdeveloped gluteus maximus — resulting in compressive force on the knee joint. By stretching out these support muscles, you decrease the chance that they’ll get tight and cause muscle imbalances. So remember the complementary two-fold process: as you strengthen naturally weak muscles like the glutes, also stretch supporting muscles like the inner thigh muscles.

  3. TONE YOUR CORE
    Abdominal weakness will cause your pelvis to tilt forward, creating excessive low-back curvature and shifting the leg bones inward. You can experiment with this yourself: Over-arch your back and notice how your legs and knees want to roll in toward the midline of the body. Then flatten your back and notice how the opposite movement occurs in the legs.

    Strengthening the core helps to keep your back in a neutral spine position and places the lower extremities — specifically the knees — in the best possible position for movement without joint compression.

    There are so many ways to strengthen your abdominal muscles besides doing crunches. Consider Pilates workouts; Pilates was created with a strong emphasis on improving core strength to improve the function of the entire body. Or try fun core workout options like ball exercises, an abs routine on a fitness ball, or a core workout with elements of dance, yoga, or kickboxing.

  4. MAINTAIN A HEALTHY WEIGHT
    Being overweight makes men five times more likely (and women four times more likely) to develop knee osteoarthritis. New research shows that a ten percent decrease in weight will result in a 28 percent increase in knee function (such as for climbing stairs and walking). Another study found that for every 11 pounds a woman loses, there is a remarkable 50 percent decrease in the risk of knee arthritis.

    Why? Fat decreases muscle strength, and excess body weight adds strain to knee joints. In fact, there’s an inverse relationship between body weight and quadricep muscle strength: the higher your body weight, the weaker your knee muscles.

    To start burning those extra calories required for weight loss without adding additional impact to the knees, try water aerobics, an elliptical trainer, or cycling (making sure you have proper seat height).

  5. MIND YOUR FEET
    You may look great in three-inch stilettos, but keep in mind that high-heeled shoes increase the compressive force on your knee joints by 23 percent. Wearing heels also encourages tight calf muscles, another common cause of knee pain. A tight calf can pull the foot inward to a position called pronation, which essentially collapses the arch of the foot and causes the lower leg to roll inward, placing stress on the ankle and knee.

    So embrace the flat shoe fashion trend and stretch out those calves. On the flip side, replace your workout sneakers frequently — every 300 miles, which could be three months or a year depending on your level of activity. This is a safe way to avoid wearing a shoe with poor cushioning support for your arches and joints.
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