You will have noticed there is a significant opinion here about the potential hazards of PT. You may feel that your therapists are experts and know what you should be doing. However, over the last several years I've been here, I have observed that the more intensive the regimen of exercising, the more problems people get.
These issues can include
A point to note is that it's not the exercising that gets you your ROM, it's time. Time to recover, time for swelling and pain to settle and time to heal. One thing that seems to be missing from all the PT's protocols is that all your ROM is there right from the start, just waiting for all that to happen so it can show itself. In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Exercise as in strength training is counter-productive and does more harm than good. Normal activity is the key to success.
After questioning numerous members, I have observed that certain exercises are more of a hazard than a benefit and have therefore taken to advising members to assert their right of consent and decline to do these.
The worst exercises include these though there are others, in fact, any that cause you undue pain and cause swelling can be included
1. 'assisted' heel slides, often done to the point of extreme pain with stories of patients being given pillows to bite on and to muffle their screams! It will inevitably cause excessive pain and swelling
2. force bending the knee by the therapist - also causes excessive pain and swelling
3. squats and lunges - except narrow squats but even then, not to excess! Can cause generalised tendinitis particularly in quads, glutes and hamstrings
4. steps - up and down on a block - a low number are okay but some have been known to do 30 or more at a time! Can cause generalised tendinitis particularly in quads, glutes and hamstrings
5. high marching. Can cause generalised tendinitis particularly in quads, glutes and hamstrings
6. bridges - can cause generalised tendinitis particularly in quads, glutes and hamstrings
7. clamshells - especially hard on the IT band
8. abduction/adduction exercises - also hard on the IT band (abduction) and psoas tendon (adduction)
9. extension stuff
All these forms of 'exercise' are invariably painful and result in an increase in pain, swelling and stiffness.
WEIGHTS, BANDS and RESISTANCE
There are also another types of exercise which are to be avoided - the use of weights and bands like this
GYM MACHINES
Gym machines are designed for healthy people to achieve improvements in health, strength, stamina and balance. They are NOT supposed to be used during recovery in the first 3 months for a THR or 6 months for a TKR. They place far too much demand on the surgical area and can cause areas of inflammation and loss of ROM, especially with the TKR.
LEG CURL for strengthen hamstrings - should NOT be used to increase ROM
LEG LIFT OR EXTENSION for strengthening quads - should NOT be used to increase ROM
LEG PRESS for strength training of all leg muscles - should NOT be used to increase ROM
TOTAL GYM MACHINE allows the user to do a number of manoeuvres but shouldn't be used post-surgery
ROWING MACHINE
This is an ill-advised machine to use this after a TKR as it can require the use of torsional manoeuvres which could result in loosening of the tibial component.
WOBBLE BOARD another multi-exercise tool which should NOT be used post-surgery
A member left us this valuable bit of info on Dec 17, 2016 - The Mayo Clinic no less!
COMMON SENSE
This philosophy is based upon simple common sense.
- dispelling the dangerous 'no pain, no gain' notion which was promoted in the 80s when keep fit videos were all the rage, fronted by various celebrities who were clearly not experts! Even in the fit and healthy it was soon roundly trounced by a variety of orthopaedic surgeons who went public at the time after being swamped with patients suffering all manner of muscle strains and tears. But the myth persists.
- dispelling the 'window of opportunity' which many members have given the lie to after reporting increases in ROM after 12 months or more.
- ignoring the simple and obvious concept that injured limbs need rest and care, not punishing exercise!
So far, all those who have tried this have reported a significant reduction in pain, improvement in ROM and general mental and physical state.
The 'BoneSmart way' works!
In addition, there have been numerous members who have done no exercises at all and yet obtained excellent results! I am one of them.
You might also gain some insight into what initially caused me to come to these conclusions by reading this PT: the seriously grave consequences of doing too much of it
These issues can include
1. excessive pain
2. excessive swelling and stiffness
3. inability to obtain good pain management
4. poor ROM
5. a slow and worrying progress in recovery
6. general malaise and depression because of prolonged pain and poor progress
A point to note is that it's not the exercising that gets you your ROM, it's time. Time to recover, time for swelling and pain to settle and time to heal. One thing that seems to be missing from all the PT's protocols is that all your ROM is there right from the start, just waiting for all that to happen so it can show itself. In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Exercise as in strength training is counter-productive and does more harm than good. Normal activity is the key to success.
After questioning numerous members, I have observed that certain exercises are more of a hazard than a benefit and have therefore taken to advising members to assert their right of consent and decline to do these.
The worst exercises include these though there are others, in fact, any that cause you undue pain and cause swelling can be included
1. 'assisted' heel slides, often done to the point of extreme pain with stories of patients being given pillows to bite on and to muffle their screams! It will inevitably cause excessive pain and swelling
2. force bending the knee by the therapist - also causes excessive pain and swelling
3. squats and lunges - except narrow squats but even then, not to excess! Can cause generalised tendinitis particularly in quads, glutes and hamstrings
4. steps - up and down on a block - a low number are okay but some have been known to do 30 or more at a time! Can cause generalised tendinitis particularly in quads, glutes and hamstrings
5. high marching. Can cause generalised tendinitis particularly in quads, glutes and hamstrings
6. bridges - can cause generalised tendinitis particularly in quads, glutes and hamstrings
7. clamshells - especially hard on the IT band
8. abduction/adduction exercises - also hard on the IT band (abduction) and psoas tendon (adduction)
9. extension stuff
All these forms of 'exercise' are invariably painful and result in an increase in pain, swelling and stiffness.
WEIGHTS, BANDS and RESISTANCE
There are also another types of exercise which are to be avoided - the use of weights and bands like this
GYM MACHINES
Gym machines are designed for healthy people to achieve improvements in health, strength, stamina and balance. They are NOT supposed to be used during recovery in the first 3 months for a THR or 6 months for a TKR. They place far too much demand on the surgical area and can cause areas of inflammation and loss of ROM, especially with the TKR.
LEG CURL for strengthen hamstrings - should NOT be used to increase ROM
LEG LIFT OR EXTENSION for strengthening quads - should NOT be used to increase ROM
LEG PRESS for strength training of all leg muscles - should NOT be used to increase ROM
TOTAL GYM MACHINE allows the user to do a number of manoeuvres but shouldn't be used post-surgery
ROWING MACHINE
This is an ill-advised machine to use this after a TKR as it can require the use of torsional manoeuvres which could result in loosening of the tibial component.
WOBBLE BOARD another multi-exercise tool which should NOT be used post-surgery
A member left us this valuable bit of info on Dec 17, 2016 - The Mayo Clinic no less!
I had mine done at Mayo Clinic and they no longer believe in the pushing of it. They give you the exercises to do at home and tell you they want the knee to rest and heal. Do what you are comfortable with.you will get there in baby steps.
COMMON SENSE
This philosophy is based upon simple common sense.
- dispelling the dangerous 'no pain, no gain' notion which was promoted in the 80s when keep fit videos were all the rage, fronted by various celebrities who were clearly not experts! Even in the fit and healthy it was soon roundly trounced by a variety of orthopaedic surgeons who went public at the time after being swamped with patients suffering all manner of muscle strains and tears. But the myth persists.
- dispelling the 'window of opportunity' which many members have given the lie to after reporting increases in ROM after 12 months or more.
- ignoring the simple and obvious concept that injured limbs need rest and care, not punishing exercise!
So far, all those who have tried this have reported a significant reduction in pain, improvement in ROM and general mental and physical state.
The 'BoneSmart way' works!
In addition, there have been numerous members who have done no exercises at all and yet obtained excellent results! I am one of them.
You might also gain some insight into what initially caused me to come to these conclusions by reading this PT: the seriously grave consequences of doing too much of it
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