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5 Things you need to know before getting a Hip or Knee Replacement

1. Prehab is just as important as rehab. If you’re considering a total joint replacement chances are you’ve been living with significant pain for at least a year. Because of your pain you’ve probably had to avoid certain movements and have adopted unconventional ways to do things like put your socks on. While these strategies have helped you get through your daily activities they’ve also allowed some muscles to become lazy, required others to work overtime and forced your body to move differently. You may even have noticed structural changes in the alignment of your hips or knees by this point. When you receive your new joint, these compensations won’t be necessary BUT it will take time for your body to adapt to its new normal. This is where ‘prehabilitation’ comes in. Seeing a physiotherapist before your surgery can help you identify and take care of any issues that may delay your post-operative recovery. By doing a thorough assessment of your strength and mobility we recommend a treatment plan and prescribe appropriate exercises to address your specific needs.

 

2. Results are NOT guaranteed. We are always very honest with our patients and they appreciate it. Having a total joint replacement surgery is not like changing a lightbulb. When you put the new joint in, you can’t just flick the switch to have it work perfectly again. Rehabilitation after surgery is an extremely labour-intensive process and without putting in the work there is a chance you will be left with less mobility and more pain than even before your surgery. Between ice/heat application, wound care, exercise sessions and proper recovery, rehab is a full-time job for the first 4-6 weeks. Your long-term results WILL depend on the work you put in at the beginning. In fact, most orthopedic surgeons recommend trying physiotherapy before opting for such an invasive procedure. Working with a physiotherapist pre-operatively can not only give you an idea of what the rehab process will be like, but can also prolong the life of your own joints by providing strategies to manage your pain and maximize your function.

“Having a total joint replacement surgery is not like changing a lightbulb. When you put the new joint in, you can’t just flick the switch to have it work perfectly again.”

3. The booklet of exercises they give you in the hospital is not enough. The exercises will be appropriate for the first 1-4 weeks depending on your progress from the acute healing phase BUT these exercises will not be challenging enough to help you achieve full recovery and get back to your pre-surgery activities. This is why physiotherapy plays such an important role in rehabilitation after a total joint replacement. A physiotherapist will be able to prescribe new exercises as you progress, provide gait training and identify the need for manual therapy. It is important to start physiotherapy early to ensure you are on track and maximize the effectiveness of treatment. Most therapists will recommend scheduling your first assessment within two weeks of your surgery.

4. You don’t have to live with the pain. We want our clients to feel their best, so their pain management is critical. We are not going to sugar coat it; immediately after surgery you will be in pain. Most people report that it is a much different type of pain than what they dealt with before surgery, but it is painful nonetheless. In this stage, it is very important to manage your pain levels to allow you to participate in your rehab program and to prevent central sensitization; a condition where your nervous system is in a persistent state of high reactivity, which lowers the threshold for pain and causes your brain to perceive pain in the area even after the initial injury has healed. There are many ways to effectively manage your pain, such as: taking your medication at the prescribed intervals and timing them with your physiotherapy or exercise sessions, applying heat/ice and controlling swelling, deep breathing and meditation and acupuncture. Be aware that many pain medications can cause side effects like dizziness, nausea and constipation so be sure to discuss options with your doctor or pharmacist if you are experiencing side effects.

5. With the right plan you can return to doing what you love to do. Many people are fearful of returning to sports and exercise after surgery but with the proper rehabilitation there is no reason you can’t return to the activities you loved before your surgery. That being said, if you haven’t run a marathon in ten years, now is probably not the time to take up running again. However, if you’ve been training at a high intensity prior to surgery a physiotherapist can provide a progressive exercise program and education to facilitate a safe return to most activities. Each surgeon will have slightly different recommendations on what level of activity is appropriate in the long term so it is important to discuss what your goals are before undergoing a joint replacement procedure.

Just like every person is unique, so is every body and every joint replacement. Our job is to help you both before and after your surgery to give you the confidence, relief and support you need to get back to experience your life to the fullest.

 

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