We know that we need to be active every day to maintain and improve our health; but, lets face it, that gets a lot harder when the days are colder and shorter and we have to battle snow to be outside. I would like to say that it can be good to get out in the colder weather and walk for a few minutes (as long as there are clear, dry sidewalks to walk on); but, assuming you don't feel like donning your winter parka to get your fitness on.... What are some ways to stay active even in the colder months of winter?
If you like/prefer to walk, head to your local mall or recreation center and take a walk around. There are many groups for "mall-walking" around. You can mask up and join a friend or two and walk the mall. Most recreation centers also have a walking track that you can easily keep track of your distance traveled. Some even have walking groups to keep each other accountable.
If you want to venture into a different activity, you can also go to your rec center and meet with a trainer to work on some fitness machines for weight training and cardiovascular exercise. It may seem intimidating, but most trainers are skilled at being able to address your needs and adjust to any specific areas of weakness or pain or you can ask your PT for recommendations of exercise equipment. Plus, everyone was a beginner at some point, right?!
You can also take a dip in the pool and swim, walk/run in the pool, or take a water fitness class. There are usually a variety of classes and activities in the pool. Bonus is that water provides it's own resistance and it is less impact on your joints.
Lastly, in this digital age, there are so many applications available that will give you ideas of exercises you can do in the comfort of your home. Don't worry if you don't have any equipment, many don't require anything - just your body weight; but, if you need weight, look around your house for items that you can use - full water bottles, canned food, babies :) etc. all can be used when lifting "weights".
Don't let winter slow you down and keep you from your goals! Keep moving and look forward to those warmer months when you can take your fitness back outside!
Christina Bateman, PT, DPT
Not to scare you but this is NOT a comfortable surgery to recover from. I frequently tell my patients who are planning this surgery to expect to be miserable for 1-3 weeks. Miserable is a very strong word yet very few of my patients say it wasn't as bad as they thought it was going to be. What surprises many of my patients is how long the knee remains uncomfortable after surgery, many of them think "I am tough" or "I am in good shape going into surgery" so it shouldn't be that bad. Unfortunately this is basically carpentry of the body and it hurts. Toughing it out for a few days isn't enough because it still hurts after week one and two. With that said, the outcomes are EXCELLENT and almost everyone is glad they had their surgery and often wish they had it sooner.
Fortunately the pain gradually subsides and the new complaint is STIFFNESS. If you leave your knee straight too long it hurts and if you leave it bent too long it hurts. Stationary bikes are really helpful at keeping the knee from getting too stiff and it is quite rewarding the first time you make a full revolution on the bike. Most of my patients will struggle to get knee extension (straightening) OR knee flexion (bending), rarely do patients have trouble getting both directions. Knee extension is the priority as it allows you to stand and walk properly. If you are fortunate enough to have your range of motion come back easily, your rehab is much more comfortable. The stiffer you are, the harder/longer it needs to be pushed on by the patient or therapist.
A total knee replacement or total knee arthroplasty is exactly what it sounds like. You are getting a "new" joint. Many patients have two "bad" knees by the time they are thinking about joint replacements. It isn't uncommon that the knee that looks worse on x-ray isn't the more painful knee. Most patients choose to have the more painful knee done first and it isn't long after surgery before your "bad" knee becomes your "good" knee. Your new knee will NOT look like your old knee, not only will you have a nice scar down the front of your knee, the knee itself will appear wider than your non-surgical knee, many of my patients think this is swelling that will subside and are disappointed when I tell them it is actually just the shape of their new knee. If you have both your knees replaced, you will then have a matching set! Swelling and bruising are common and frequently not a concern, if you have concerns about how your incision looks please contact your surgeon or PT. Your knee/leg often aren't too pretty in that first week but will improve quickly.
A Good Outcome
Orthopedic surgeons that specialize in joint replacements do a lot of them, some average 8 or more a day. That high volume allows the surgeon and their entire surgical team to be very good at them. The outcomes are generally EXCELLENT.
Total knee replacements are the most common surgery I see here at Altitude Physical Therapy and myself and our other therapists are very confident in treating patients afterwards. Some of those treated before surgery are able to delay surgery or eliminate the need entirely. Please don't hesitate to reach out to any of the Altitude clinics if you have further questions or concerns of what to expect.
Drew Sowyrda, PT, DPT
Total knee replacements -- or total knee arthroplasties (TKA) have become one of the most performed orthopedic surgeries in the world. According to the Agency for Healthcare Research and Quality, in 2017, more than 754,000 knee replacements were performed in the United States. In the PT clinic I treat as many patients after total knee replacements as any other orthopedic surgery. In orthopedic healthcare, total knee replacements are widely regarded as one of the most successful surgeries. The AAOS notes that over 90 percent of replacement knees are still functioning after 15 years.
Knee replacements are most often done when a person’s knee joint develops severe arthritis. This is when the cartilage in the knee joint -- at the bottom of the femur (“thigh bone”) and the top of the tibia (“shin bone”) -- degrades and the joint becomes painful and usually inflamed. Cartilage acts as padding in the knee joint and to decrease friction as the knee moves. When a person loses most of the cartilage in the knee this can be described as “bone on bone” arthritis and can require a TKA. Most of the time this loss of cartilage is due to wear and tear and is described as osteoarthritis. In some cases this can be caused by an inflammatory condition called rheumatoid arthritis or trauma like a motor vehicle accident.
Knee replacement surgery was first performed in 1968. Since then, improvements in surgical materials and techniques have greatly increased its effectiveness. Recently more and more surgeons are utilizing robotic guided surgical techniques and generally with excellent outcomes.
In a traditional TKA the surgeon uses preoperative x-rays, intraoperative anatomical landmarks, and manually positioned alignment jigs to guide bone cutting and implant positioning. These handheld techniques can lead to less reliable alignment-guide positioning, inadvertent sawblade injury to the knee muscles and ligaments, and limited ability to fine-tune the implant positioning. Suboptimal implant positioning may lead to poor functional recovery and reduced implant survivorship. (At this point I should note that I work with many surgeons who have done hundreds or thousands of these traditional TKAs with great clinical outcomes.)
Robotic TKA uses computer software to convert anatomical information into a virtual patient-specific 3D reconstruction of the knee joint. The surgeon uses this virtual model to plan optimal bone cutting and implant positioning based on the patient’s unique anatomy. An intraoperative robotic device helps to execute this preoperative patient-specific plan with a high level of accuracy. The action of the sawblade is confined to the preoperative surgical plan which limits soft-tissue injury and bone trauma.
A 2019 systematic review about robotic total knee replacement found the following:
If you are considering getting a TKA there is clearly a lot of evidence that robotic TKA are effective and in some ways superior to a traditional TKA. That being said, there are many other factors to consider when looking for a surgeon to do your TKA including:
Once you've made your decision don't forget the importance of rehab! All of our physical therapists are experts in both pre and post op knee replacement rehab. For more information about what to do once you've made this big decision, check out this informational page and reach out to one of our clinics to set up an appointment!
Eric Hanyak, PT, DPT
Bob Cranny, PT