As I have gotten older, put my body through a multitude of injuries sometimes out of sheer carelessness and stupidity, I wish I could just replace things that don’t work perfectly anymore. Like changing the carburettor of your car or changing the seats for some fancy bucket seats! I mean why not? Sounds so easy…!

Now I’m not saying that our parts, more specifically joints can’t be changed for newer and shinier metal ones, but that’s more of a last resort situation that frankly none of us look forward to. What I am hinting at is joint replacements due to degenerative changes or even undergoing surgical repairs for muscle and tendon injuries.

Every joint, muscle and tendon is designed to perform a specific function and with injuries and degenerative changes and other factors that may result in diminished function, we may require repair or replacing it altogether. Seems pretty logical right? But what we forget it, this also results in weakness and loss of specific function that cannot always be regained a 100% even after replacing or repairing it.

‘Pre-operative muscle strengthening’

This is the in between step that none of us pay attention to and skip out on thinking that anything new will adapt and fix itself within our bodies to make us 100% again. Sadly, that’s not always true.

Might sound like gibberish right now, but I do have a sound explanation with an example!

I love knees, so this is my example!

From the time we learn to crawl, our knees take the weight and brunt of our antics as children and later on the weight of our upper bodies as adults. No matter how much you try, your knees will always be used and sometimes not treated very well. No matter whether you’re running all day or sitting all day, your knees will be used. Might be you injured your knee playing a sport or osteoarthritis is a genetic gift to you.

Why would your joints and muscles require replacing or repair?

• After an injury which may result in a partial or complete tear of muscles or ligaments.
• Age related degenerative changes within the joint.
• Long standing chronic pain due to bone deformation or degeneration.
• Weakened joints or muscles due to overuse and recurrent injuries.
• Chronic subluxating or dislocating of joints like shoulder or knee cap.
• What actually happens?

Due to one or more of the above mentioned reasons, our muscles and ligaments weaken and cannot sustain the strain and give out under the pressure. This results in loss of their ability to perform functions of holding joints together, loss in range of motion due to stiffening up of joints, calcification of tendons and within muscles, etc. This may require attention from a specialist and couple scans to figure out what exactly is happening within to decide the next step.

If you do need surgery, you also need pre-operative physiotherapy.

More often than not, we only pay heed to rehabilitation after the surgery, but very few of stop to think the advantaged of developing strength and conditioning before we go into surgery. Think about it, wouldn’t it be easier to start strength and conditioning before your surgery to re-educate muscles and joints into performing their duties and help them adapt to the functions early on?

Research says that people undergoing knee replacements or ligament repairs benefit and heal better with early return to sport and activity when rehabilitation of strengthening and proprioceptive exercises are started 6-8 weeks before they are scheduled for surgery.

This has resulted in return to their pre-injury levels of activity almost 3 weeks before their counter-parts who refused pre-operative rehabilitation. Starting early rehabilitation before surgery resulted in increased muscle strength and tone which in the longer run post surgery results in faster gains in muscle tone with better outcomes for functional tasks with faster return to activity.

Don’t let the fear of surgery stop you from achieving your goals.

If you are due for surgery or think you might need surgery, don’t delay starting an exercise program early on. Book and appointment with one of our physiotherapists for a comprehensive and customized exercise program to help to tone and re-educate those muscles and put you right on track for a faster recovery!

We wish you an active, healthy and pain free life!

References:

Huber E, Roos E, Meichtry A, de Bie R & Ferrari H 2015, ‘Effects of proprioceptive neuromuscular training (NEMEX-TJR) on functional outcome after total knee replacement: An assessor-blinded randomized controlled trial’, BMC Musculoskeletal Disorders, 16:101.

Wallis J & Taylor n 2011, ‘Pre-operative interventions (non-surgial and non-pharmacological) for patients with hip or knee osteoarthritis awaiting joint replacement surgery- A systematic review and meta-analysis’, Osteoarthritis and Cartilage, Vol 19, pp.1381-1395.

Ibrahim M, Khan M, Nizam I & Haddad F 2013, ‘Peri-operative interventions producing better functional outcomes and enhanced recovery following hip and knee arthroplasty: an evidence based review’, BMC Medicine, 11:37.