Lose the Work Ethic!!! Article by Referee54 (Tim) Many of us have a tremendous work ethic---and for several reasons. I can still remember, to this day, my father saying to me on the morning of my first day on a “real job”, “Give them nine hours of work in an eight hour day.” I believe that many of us believe that we are judged sometimes on how hard we work---and that working hard is a good habit---it is psychologically a positive image and deeply ingrained in the societies of many countries. Some of us are athletes. I do not use the phrase, “former athletes”, as I believe that those of us, who have engaged in athletic events, activities, training, etc., are still athletes. We may be a bit slower, not as strong, etc., but we still enjoy the idea of competition---not just with others, but with ourselves, as well. While we are obviously not as young as we used to be, we still like the idea of engaging in outdoor or indoor activities that deal with the physical, emotional, and psychological well-being of our bodies and our minds. For those of us who are athletes, we have gone through, I would imagine, different types of rehabs for minor to significant athletic or orthopedic injuries. We have rehabbed everything from bruises, strains, sprains, fractures, and the like---and, in order to get back doing what we love---participating, we have learned the value of working hard in rehab or PT. I know of a former student who has been treated for shin splints and could not wait to get back into the running scene---she was excited to be racing again---she said, “My PT finally paid off! I can run and race again!” How many of us have felt that way? So, because of all of these facts, we have “three strikes against us” when we set out to begin a TKR or a BTKR rehab. We have been taught to work hard; we have seen the value of hard work; we have been part of a positive process that has allowed us, in former injuries, to successfully resume the lifestyle and the activities that we love and in which we enjoy participating. Now we have had a TKR or a BTKR, and it is time to “win the battle” against the stiff, sore, swollen and dysfunctional knee. We have been taught that, through hard work, success is possible; what we do not realize, though, is this is unlike any other endeavor we have undertaken. But frankly, we will not be successful in recovery unless we change our point of view! Our past works against us. When beginning our recovery/rehab/PT for a TKR or a BTKR, we harken back to when we were 15 or 16 and suffered a sprained ankle. We were diligent in rehab or PT and we got great results---and were back participating in a short period of time (yep, we do tend to forget how fast we healed when we were young…)!! We felt the exhilaration of the successful rehab due to our hard work. Remember getting excellent grades? How did many of us achieve them? I would imagine that many of us would say, “I worked hard for those great grades and for those awards.” How did many of us advance in our fields of work---talent, yes, but we have been taught that there are many talented people---what separates those with talent from those who are truly successful is---you guessed it---the work ethic. And we want to apply this very same work ethic to our TKR rehab. Stop right there---TKR or BTKR recovery is 180 degrees different than anything we have ever experienced---and, because it is, we cannot apply the same set of values to gain “success.” We have to understand that this recovery and rehab are totally different than anything we have undergone, and therefore, our perception and our attitude both toward hard work and about hard work cannot be paralleled to a TKR rehab/recovery. Please consider what has been done surgically to your knee---the cutting, the sawing, the pounding---horribly traumatic---no wonder your knee fights back when you ask it to be pushed too hard, too soon! Therefore, you have to “lose the work ethic” and understand your recovery is totally opposite of anything that you have undergone. Success is not guaranteed by hard work; success in this case is guaranteed more by working gently and by not forcing your knee to do anything it is not ready to do. No amount of "working hard" makes recovery happen faster. In fact, the converse it true---by working hard and striving to out work the knee, our recovery can be effectively halted. What happens? Well, we have seen success with hard work before, and we have been taught to overcome barriers with hard work. The TKR is swollen, stiff and sore---and what do we want to do? We think, “I must not be working hard enough.” And we proceed to work even harder. What we need to do, then, is to lose the work ethic and understand that by treating the knee gently and by being patient (something that is the exact opposite to what we have had ingrained in us), the knee will recover on its own and you will see success. And that is the paradox; In the past, we have overcome obstacles and gained success (and have reaped rewards) by hard work. Now, for what is most likely the very first time, we have to understand that, in order to recover (albeit slowly) we have to value working less---that is---working less than we are used to and less than we would like to. And by dong this, we will actually help the surgical knee along! Is this contrary to what we have been taught and to how we have lived most of our lives? Oh, you bet it is!! I imagine that even with our hobbies, we work hard and are likened in many ways to perfectionists. I would say that in many facets or our lives we push ourselves as much as possible---and now, we are being told to “back off,” “to relax” and “ to quit working so hard.” It is, indeed, a difficult thing to do. But it must be done. Your recovery will happen in your body's own time. A TKR recovery is something that just happens; no amount of hard work that you do will speed things up. In truth, your hard work will most likely slow you down and frustrate you even more. You think that a TKR recover is slow? Consider what many people do, and that is, that they slow it down even further by working hard at their recovery. So, apply the paradox---lose the work ethic that dictates hard work, and subscribe the idea that you just are going along for the ride---Do what you need to do to help the knee along---it does not need hard work, cheer-leading, or pushing. If you push the surgical knee, it no doubt will push back and it will win. So why push at all? The TKR will recover in its time and on its schedule. Do not think that “hard work will speed things up.” Lose the work ethic that dictates hard work; take the exercises gently and keep your knee happy. It will recover, and you will reap the benefits of a better and more pain-free life. But this time the benefits come from NOT working so hard! All you have to do is to lose the work ethic.