Recipe of the Week

Fun, Facts & Fitness from Mary Morris MSc.

I feel I am surrounded by people who have recently had a joint replacement and so we are regularly swapping stories about our experiences. It's a bit like when we were younger, as a group of new mums, we regularly swapped birthing stories. We oldies do it about our new bits of metal and plastic now embedded in our ageing bodies!

What I have discovered though is that no one story can really compare with another, as we all prepare for and recover from it in different ways. But what I can say without doubt is that those who work really, really hard on their pre and post operation exercises almost certainly come out best.

My father had both knees replaced about the same time as his older sister (clearly a family problem!) and I visibly remember my dad doing lots of exercises, clearly in a lot of pain as he did them, and then had 18 more years of a pretty active life. His sister, however, never stopped using two crutches for the rest of her days and on my last visit to her in a care home she had both legs fully bound in crepe bandages and was unable to walk at all. She always said that "the exercises I should have been doing just didn't work for me and were too painful to do anyway!"

Now, I have to say she was right about that, as all my daily exercises that I am doing religiously (as you would expect!), hurt too! Each and every one of them! The last time I visited the physio it literally felt like he was sitting with all his body weight on my lower leg trying to bend it more, and I found myself begging him to stop! 

Ever since though, in an effort never to be subjected to such torture again, I have used the dog’s lead to simulate the pressure on myself, lying on my front with the lead wrapped around my ankle whilst pulling the heel towards my hip. The difference in just one week of doing it every day, means I can now bend well beyond 90 degrees which means I can now climb stairs normally, because I have the right amount of 'bend' and I can now walk without any hint of a limp.

I also heard that riding a static exercise bike was a good idea to improve the bend but I don't have one, so my husband has set up my road bike in the back garden with it clamped like a static bike. Currently I can only pedal backwards, but each week I ask for the seat to be lowered another couple of centimetres to challenge my knee bending further. Finally, I can now bend the knee enough to use my rowing machine, where most of the energy comes from the 'pull' from my arms, so after more than 8 weeks I am finally getting out of breath again! A great feeling!

I am not telling you all this to impress you but simply to demonstrate to you that more than anything I want to get back to my normal, physically active life. I miss joining my usual walking groups and the other activities that make up such a big part of my life and I am determined to get back to them sooner rather than later.


Rate of Recovery

On my recent visit with my Consultant, eight weeks after the operation, he was impressed with my rate of recovery but I did express my disappointment at the numbness and pain I was still experiencing. It was something of a shock to discover that my knee would not feel 'normal' for another 12 months! Rapid progress can be made in the first three months as I have just been describing, but the feeling that you have a normal knee can take significantly longer. 

My husband has had both knees replaced now and one is much better than the other, which is apparently very common. No two knee or hip replacements are the same and that must be kept in mind and so it is not a good idea to make comparisons with others. However, for him now to be able to play two or three consecutive games of golf still feels like a miracle two years on because he could hardly walk at all before they were done. The result of many years of playing rugby!


Plan your Recovery

If you are likely to need a replacement in the future because you are starting to suffer unendurable pain from either your knees or hips, then a lot of planning is required in advance. One lady I know is really struggling with her knees but lives alone, so she is putting it off due to concerns about who can look after her in the early days of her recovery. Not everyone has family members able to help.

One of our elderly retired doctors was in such a situation, so she booked herself in for respite care in a local care home until she was able to go back home and manage herself. What a good idea!

Also, once you know you are booked in for your op do make sure you are as strong as possible in those important major muscles surrounding the joint that needs attention before the op. This is vital. For a knee replacement (or partial one), work on plenty of strength training on the quadriceps (front of thighs) and hamstrings (back of thighs) and the gluteal muscles that surround the butt and hips. This will ensure that you start your post op recovery in a better place. 

There is a lot of information about this on the Orthopaedic Surgery page of our website. You may find the following videos from physiotherapist Judith Pitt-Brooke helpful:

• Preparing for Surgery
• Preparing for Knee Surgery
• Preparing for Hip Surgery
• Preparing for Foot Surgery

A Few Useful Tips

• Right from day one you will have to get out of bed and move around. It is also very important that in the first few weeks of your recovery you stand up every hour and move around for a few minutes.
• Use your pain medication as prescribed. I always timed my post-op exercise sessions with my anti-inflammatory pain relief. It means you can move more.
• One day I did too much and needed a full day of rest the following day. Be wise.
• Some can get back to driving a car sooner than others. Because mine was my right knee and I have an automatic car it meant it was a bit longer than if it had been my left knee. (Now 12 weeks on I am back in the driving seat – a great feeling (no more supermarket shopping with husband, who spends more than I like!)
• For those who are looking to return to work, I have read differing recommendations. A knee surgeon I heard felt it should be 12 weeks but it can be sooner, particularly if you have a fairly sedentary job. I started teaching classes again after 8 weeks but used my voice more than my body!

Immediately following the op, I thought I would never have the other one done (it is apparently in a similar state of degradation!) but as I am already feeling the benefit of this one, then no doubt I will eventually go for it. The great news is that these modern replacements are good for at least 20 years but I intend mine to last a lot longer than that!

1. On your daily 30+ minute walks revel in the fact if you are able to do it, many people can't!
    
2. Remember, your weekly strength training must always include the leg muscles – they are your guarantee of staying independent. Eg. Sit to stands, squats, lunges if you’re standing, or assorted leg raises if lying down. Go to our Strength and Toning Exercises page and do 3 sessions this week of either the Standing Band / Standing Weights Workouts or the Floor Band / Floor Weights Workouts.
    
3. If you Stretch regularly, you will keep your joints much more mobile.  Check your hamstring length in the Fitness Test 4 ~ Seated Reach from the DIY Fitness Test on our website as that one is particularly valuable for your knee and hip joints.

Did you know... 

Operation is a popular battery-operated game that tests players' hand-eye coordination.

The players compete to perform "operations" on "Cavity Sam" who is lying on the operating table in front of them. The test is to remove various plastic objects from the cavities without touching the sides and causing a buzzer to sound and his nose to light up.

Using the tweezers the "Doctors" attempt to lift the frog from Sam’s throat and the butterflies from his stomach, remove his Adam’s apple and even fix a broken heart. The game is over once all of the ailments have been removed and the player with the most ailments wins!

The game's prototype was invented in 1964 by University of Illinois industrial-design student John Spinello, who sold his rights to renowned toy designer Marvin Glass for $500 and the promise of a job upon graduation - a promise that was never fulfilled. Operation is currently produced by the well-known toy company Hasbro, with an estimated franchise worth $40 million.