Orthopedic Advice From An Ophthalmologist

"And Now for Something Completely Different"

In today’s newsletter, I will write about a topic entirely unrelated to eye health, yet an issue I have become all too familiar with over the years, joint replacement surgery. The advice I am giving in this article is strictly my opinion based on my own experiences as a patient undergoing joint replacement surgery. Each patient is different. Do NOT follow any of these suggestions without discussing things with your surgeon first. These suggestions are personal to me and helped me immensely to recover from joint replacement surgery. The purpose of today’s newsletter is to get you to bring up these topics with your surgeon. ASK QUESTIONS!

Wrestling at the college level took its toll on my joints over the years. I’ve had both knees and both hips replaced. No orthopedic surgeon or physical therapist gave me the suggestions I am going to provide you with here. These are all things that I figured out on my own or learned from other joint replacement patients. They might seem simple but made a world of difference in my recovery.

Stand Up Straight

Knee injuries plagued me throughout my wrestling career, so it was no surprise that they were the first to go. I had both knees replaced the same day. The first thing the following morning, a physical therapist showed up in my room and announced, “Okay, Let’s go for a walk.” I gingerly stood up on both feet while clinging to the bed rail. Taking the first few steps had to be one of the most painful experiences of my life. And this is coming from someone very familiar with athletic injuries. The pain was unbearable until I did one simple thing. I stood up straight.

Your natural tendency is to stand up with your knees bent while very gently trying to bear your total weight. You will want to lean on your crutches or walker while slowly shifting your weight from the bed to the floor. The pain was so terrible that I had to sit down immediately. On my third try, I accidentally found the secret and made most of the pain disappear. I stood up straight! Head up, shoulders back, chest out, and knees straight. At first, I was afraid to bear all of my weight on my brand new artificial knees, so I sheepishly tried to stand with my knees bent, back curled, and in a head-down position. I don’t know the exact physics, but I believe this bent knee standing position puts a lot of strain on the knee joint. By standing up straight, you bear your weight on the implants rather than all of the freshly cut and inflamed tissue around your knee. The implants are titanium. They’re not going to break or come loose. Stand up straight. Make the implants do the work for you.

Everyone in the Pool

It takes a lot of work to rehabilitate your knees and hips after replacement surgery, and physical therapy can be daunting. Despite the challenges, there was one part of physical rehab that I wouldn’t have traded for the world: getting in the swimming pool. Once the incision is healed and your surgeon gives you the go-ahead, find a place with a swimming pool. Preferably, one heated for therapy rather than recreation. Shoulder-deep water gives you the buoyancy that allows you to walk around and stretch without full weight-bearing. You can move freely without the worry of falling. In addition, the hydrostatic pressure of the water helps squeeze some of the swelling out of your leg. It felt like walking in a low gravity environment while getting a knee massage at the same time. I couldn’t wait to get in the pool.

Get in Shape Before Surgery

Getting in shape is another big game-changer. Two things in particular: lose weight and strengthen your arms. First, lose weight. Remember, knees and hips are weight-bearing joints. My surgeon told me that 10 lbs. of body weight translates into 40 lbs. of force on your knee with each step you take. That means if you are 50 lbs. overweight, you put an extra 200 lbs. of pressure on your knee. It’s going to be a whole lot easier recovering from knee replacement if you lose as much weight as you can before surgery. I know that is asking a lot since you have limited exercise ability from arthritis in the first place. Work with your doctor and even a nutritionist BEFORE surgery.

The second important part of getting in shape before surgery is strengthening your hands, arms, and shoulders. Since your knee or hip will have limited capabilities during recovery, you will depend a lot on your upper extremities to get around. You might require crutches, a walker, or a wheelchair, all of which require arm strength. It was bad enough that my knees hurt after surgery. I was not prepared for all of the extra discomforts in my hands and shoulders. During my hospital stay for hip replacement, there was a triangular-shaped bar suspended above my bed. I would use this to pull myself up. Can you pull yourself up? Can you walk with crutches? Learn how and develop your upper body strength BEFORE you have to use crutches. After the surgery, it is terrible to learn that you don’t have the upper body strength to use crutches properly. It’s elective surgery. You have time.

Not All Physical Therapist are Created Equal

I assume that you did your due diligence in choosing a surgeon and didn’t just pick whoever was available. Do the same with your physical therapist. You will spend a lot more time with your therapist than your surgeon, and having a great physical therapist can make all of the difference in your recovery. I have experienced the whole gamut. The worst physical therapist I had just sat and read the newspaper while I did everything myself. The best was a world-class trainer for the Chicago Bulls. Like everything else in life, there is a tremendous range of competency among physical therapists. Choose wisely. Ask questions. Do your research. If you’re not happy with your physical therapist, find another. Your new joint will appreciate it.

I hope this helps anyone contemplating joint replacement. Just remember, these suggestions are my own experience and are not considered medical advice. Please consult your surgeon first. The purpose of this article is to get you to ask questions. Stay healthy.

This newsletter does not constitute medical advice. Make sure to contact your healthcare provider if you experience any of these conditions. Do not make any changes before consulting your physician.