Having Knee Replacement Surgery? Find out if Pre-hab and Aqua Therapy is Right for You.
Living with arthritis in the knees is extremely painful. It impacts your daily life making it difficult to climb up and down the stairs, sit or kneel on the ground and even walk. Everyday tasks, like getting in and out of the car, lifting the laundry, gardening or playing with grandkids becomes a challenge.
After the age of 50 (and sometimes sooner), our knees start to wear and tear as our cartilage or cushion between the knees starts to degenerate. From this, we can develop osteoarthritis. This is especially concerning because older adults living with arthritis are at higher risk for falls, which accounts for the leading cause of injury-related visits to the emergency room. Osteoarthritis can be debilitating and takes a toll on overall quality of life.
Common treatments for osteoarthritis of the knee are anti-inflammatory medications, glucosamine and chondroitin supplements, exercise, physical therapy, hot and cold compresses, removal of joint fluid, supportive devices such as canes and walkers, weight loss and acupuncture.
If you are overweight, losing a few pounds through diet and exercise can help significantly. In fact, every pound lost is equivalent to three to four pounds less pressure on your knees. Losing even five pounds means that you remove an extra 15-20 pounds of pressure off of your knees.
According to the Arthritis Foundation, consuming certain foods can help to manage symptoms and prevent further damage to joints. It is best to incorporate foods rich in antioxidants, like vitamins A, C and E as well as consume foods with anti-inflammatory properties, like fruits, nuts, vegetables and fatty fish. Eating dairy can help to strengthen bones and contains proteins to help build muscle. Try to avoid processed meats, refined carbohydrates and foods high in sugar.
As osteoarthritis progresses, so does pain and traditional treatment options may become less effective. Surgery is often recommended as a last resort. Knee replacement surgery is the most common joint replacement procedure and involves cutting away at the damaged arthritic bone and replacing it with an artificial joint. All of the areas afflicted with arthritis, including the fibia, tibia and patella are replaced. After total knee replacement, patients report being able to do almost everything as before, like dancing, cycling and playing tennis. Most artificial joints are built to last more than 20 years.
However, the prospect of having any surgery is frightful and we know total or partial knee replacement surgery can be painful and involves a long road to recovery. But taking steps to prepare your body for joint replacement is key to a successful outcome. Maintaining a healthy weight prior to surgery, along with exercise and working with a physical therapist can help to minimize pain and stiffness.
Physical therapy prior to joint surgery is known as pre-habilitation, and is generally a new concept. Otherwise referred to as prehab, it is a carefully tailored exercise program, two to three times a week up to six weeks in duration, that focuses on improving balance, strength, flexibility and range of motion. Exercises can consist of both land and water-based therapy, like pool therapy.
For many, aqua therapy is a preferred because helps make the transition for water to land much easier, without placing too much load and pressure on the joints. Water creates a buoyant surrounding, allowing the body to experience weightlessness while providing resistance. The increased resistance of water, when compared to air, enables the body to engage more muscles to create stronger muscle contractions and work much harder to increase cardiac output than on land, without the need for weights.
Prehab prepares your knee for surgery ahead of time. By strengthening the muscles that surround and support your knee, your body is better equipped to handle exercises required immediately after surgery with more endurance and less pain than without prehab. Improving overall strength and increasing range of motion allows the body to have greater control in recovery and improve function outcomes.
In fact, patients who are more fit may experience shorter hospital stays and avoid inpatient rehabilitation, having the opportunity to transition to outpatient therapy and remain in the comfort of their own home. According to a study led by researchers at New England Baptist Hospital, Beth Israel Deaconess Medical Center and Harvard Medical School, researcher found that knee and hip replacement surgery patients who had participated in a land and water-based strength training, and aerobic and flexibility exercise for six weeks prior to their surgeries reduced their odds of requiring inpatient rehabilitation by 73%.
If prehab is something you are interested in, ask your orthopedic surgeon if you are a candidate for physical therapy and aqua therapy prior to surgery. If your physician thinks it’s a good idea, he/she will write you a prescription. Most insurance provides prehab as a covered benefit, but physical therapy benefits may cover only a certain number of total visits per year. However, it is always best to check with your insurance carrier ahead of time. If insurance is cost-prohibitive, ask about cash pay or consider a couple visits with a physical therapist to learn more about exercises you can do at home.
The Basics of Osteoarthritis. WebMD. May 30, 2019. Webmd.com
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Barrell, Amanda. What is the best diet for osteoarthritis? Medical News Today, https://www.medicalnewstoday.com/articles/322603.php
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