You’ve played tennis for 25 years and love the sport so you were upset when chronic arthritic pain in your left knee stopped you from playing. After consulting a physician, you rested your knee, tried therapy and medications, but the pain didn’t go away. Long story short, you ended up having a total joint replacement. Now what?
First, a little background.
What is a joint and how does it work?
Joints are the movable connections where two (or more) bones meet. Each joint consists of a cavity and the surfaces of the bones where they meet at the joint. These bone surfaces are covered with cartilage, which protects the bones in the joint from rubbing together. Muscles and tendons enable your joint to move.
How does a joint get damaged?
“I tell my patients that they need a new joint because of a life well lived,” says Glenn Burke, a Certified Athletic Therapist and Clinical Director at Advanced Physiotherapy and Sports Medicine in Hamilton, Ontario. “Joint degeneration and osteoarthritis is a common result of a joint being overused in a dysfunctional capacity. Dysfunctional adaptations occur when our body tries to accomplish something that it might not be functionally capable of accomplishing.”
This can damage the bones and cartilage in the joint and it can weaken the muscles that move the joint. The joint becomes unstable and eventually ‘wears out’.
What is a total joint replacement?
It’s a surgical procedure that removes an arthritic or damaged joint and replaces it with a plastic, metal or ceramic device. The new device moves and responds just like a healthy joint, allowing you to move without pain and become active again. The joints most commonly replaced in surgery are knees and hips, followed by shoulders, elbows, ankles and wrists.
Rehabilitation therapy with a Certified Athletic Therapist, both pre and post-surgery is an important part of your total recovery from joint replacement surgery.
According to Glenn, rehab therapy before surgery, or ‘prehab’, is vital to ensuring the post-surgical rehab goes smoothly. “If you know you are having joint replacement surgery, starting a prehab program is ideal,” explains Glenn. “Getting in the best physical shape before surgery can improve your strength, endurance, circulation, range of motion and flexibility. This can decrease the chance for complications and shorten your recovery time after the surgery.”
Post-surgery rehabilitation therapy helps ease the pain and swelling in the area around the new joint, restore normal movement to your new joint, and build up strength in the joint and the surrounding muscles.
You will likely start the rehabilitation phase around two to six weeks after your surgery. “This wait is to ensure the incision is healed and the joint is settling well into the body,” explains Glenn.
Initially the focus of your therapy will be on regaining full, pain-free range of motion and reconnecting the neural pathways to the muscles. These pathways from your brain “tell” muscles to contract or do a particular movement. Then, slowly and methodically, your Athletic Therapist will work on strengthening the muscles around the joint, to correct imbalances and adaptations to make sure no secondary complications occur. The duration of your rehab therapy depends on which joint you had replaced and whether you had complications or not. For a knee or hip, you will likely continue your rehab for about 12 weeks post-surgery.
“The goal is to guide our patients safely back to their activities of daily living,” says Glenn. “There is a saying: ‘You have to crawl before you walk and walk before you run.’ The same concept applies to a safe return to being fully functional after a joint replacement.”
Glenn is the Clinical Director and Athletic Therapist at Advanced Physiotherapy & Sports Medicine in Hamilton, Ontario. He is the former medical manager of the Canadian wheelchair rugby team and was an AT with the Canadian Football League. Glenn is a hockey dad to two boys and husband to a very understanding wife!