Naples Orthopedic Surgeon - Dr. Robert J. Zehr » physical therapy

Exercising on your own after total knee replacement surgery

admin — Thu, 24 Jun 2010 12:31:41 +0000

I had a total knee replacement six months ago. After physical therapy in the hospital, I had more therapy at home. Now I’m doing my own exercises everyday. How long should I keep this up?

It might be time for a follow-up visit with your doctor or therapist. Tests of motion, strength, balance, and coordination can guide you. Patients exercising on their own can still show major weakness even years after a total knee replacement. This can put you at risk for falls and other injuries.

Every person is different and has his or her own unique needs for rehab after joint replacement. A closer look at what you’re doing and how you doing can lead to an answer to your question.

It’s likely that some form of exercise will be advised. Regular exercise and physical activity has been shown to keep joints healthy, even joints already affected by arthritis. Make it worth your while to exercise. Find out what’s best for you in this phase of your recovery.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

Baseball injury leaves one shoulder higher than the other

admin — Mon, 14 Jun 2010 19:37:25 +0000

I injured my right shoulder playing baseball last year. It gradually got better, but now I notice my right shoulder is higher than my left. What could be causing this?

The specific cause can’t be determined without an exam by a physical therapist or medical doctor. There is a wide range of possibilities from posture to nerve damage to muscle tear. Shoulder injuries are almost always accompanied by changes in the posture and movement of the wing bone called the scapula.

Once the cause of the problem has been identified, a physical therapist can set up a rehab program. This will restore normal motion and posture.

The best way to rehab a knee after ACL reconstruction surgery

admin — Fri, 21 May 2010 18:37:16 +0000

What’s the best way to rehab my knee after an ACL reconstruction?

Most doctors will send you to a physical therapist who can guide you through this process. Exercises at the beginning of rehab are different from what your knee can handle later. The goal is to get as much motion back as possible without damaging the knee any further.

The healing graft is under increased strain when the knee is in the fully extended position. Closed kinetic chain exercises with the foot on the floor or other surface strain the ACL less when the hip is bent. An example of this activity would be the mini-squats often prescribed in the early phase of rehab.

High demand exercises such as the lunge can be done when the squat is deemed safe to do after ACL repair. Then comes the step-up, step-down, and sit to stand exercises. These can all done on one leg. Each one puts about the same amount of strain on the healing graft.

Can a physical therapist in the U.S. do acupuncture on my shoulder?

admin — Wed, 19 May 2010 16:21:08 +0000

When I had a bike accident in Sweden the physical therapist there did acupuncture on my shoulder. I’ve never seen a PT do that in the states. Is it legal?

Acupuncture schools exist around the world. You don’t have to be a medical doctor to study acupuncture. There is an International Acupunture Association of Physical Therapists. Physical therapists in other countries like China, Canada, and Sweden can do acupuncture.

In Sweden PTs gained the right to do acupuncture in 1984 when the practice was approved by the Swedish National Board of Health and Welfare. Special training is required and only registered medical professionals can learn acupuncture.

In the United States physical therapists are regulated by the practice act of the state in which the therapist is conducting business. If the practice act doesn’t mention acupuncture, then they can do it by exclusion. Most, if not all, states do not permit a physical therapist to do acupuncture at this time.

PTs in the United States can stimulate acupuncture points with electrical stimulation, ultrasound, or direct pressure. This technique is called acupressure.

How late is too late to treat rotator cuff tear?

admin — Thu, 22 Apr 2010 22:17:18 +0000

Years ago, I tore my rotator cuff while lifting and carrying children in a daycare. I couldn’t take time off from work for physical therapy or surgery then. Now, I have chronic pain that’s worse at night. Is it too late for treatment?

Maybe not. Untreated rotator cuff tears can lead to wear and tear on the shoulder joint. A chronic tear with arthritis often results in restricted and sore shoulder motions. Severe pain is reported with daily activities and at night.

Doctors offer several methods of treatment for this problem. The joint can be cleaned out, fused, or replaced. Removing fragments of tissue, scraping off bone spurs, and opening the joint space can help. Fusion eliminates pain, but also restricts motion.

Replacing the joint is a third option. One or both sides of the joint is removed and replaced. If both sides are involved, it’s called a total joint arthroplasty. If only one side is altered, it’s a hemiarthroplasty.

Is hip joint replacement the answer for dysplasia?

admin — Tue, 13 Apr 2010 13:09:37 +0000

I was born with developmental hip dysplasia. Physical therapy and a hip operation at age six have kept me pain free. Now at age 46, I am having constant pain. My hip dislocates from time to time. Would a hip joint replacement help me?

Studies of hip replacement for developmental dysplasia show a wide range of results. A recent report from Japan shows the results after hip replacement for this problem. Some patients were followed for 26 years. Besides the new joint, each patient had a large bone graft used to form a deeper hip socket.

They found that problems are more likely to occur in patients under age 50 with this operation. The authors suggest that other operations can be tried first before removing the joint and replacing it. Patients must be advised about the right level of activities. This will help preserve the hip before surgery.

Pace of rehab after total knee replacement varies

admin — Thu, 01 Apr 2010 12:45:52 +0000

I had a total knee replacement six weeks ago. I’m a young (65-years old), active athletic-type. I’d really like to push my rehab ahead and get more aggressive. Is this possible?

Most patients have a fair amount of pain, swelling, and stiffness the first eight weeks. They aren’t always able to advance their rehab program. The first two weeks are usually focused on warm-ups, specific exercises to strengthen the muscles, followed by a cool-down exercise period.

From two to six weeks more time is spent on functional skills like walking and stair climbing. Exercises get harder and last longer starting at five minutes and moving up to 20 minutes. By the end of six weeks the knee joint is ready to handle more demanding activity and exercise.

You’ll want to check with your doctor about how far and how fast you can go now. Having a physical therapist to supervise your home program is often a good idea.

Best form of surgery for torn rotator cuff depends on location

admin — Thu, 15 Oct 2009 10:45:33 +0000

I have a moderate rotator cuff tear. I haven’t had relief from physical therapy and medications. Now we’re talking about surgery. My doctor says there are a couple of ways to approach surgery for tears like mine. What type of surgery is best?

There are a few ways to operate on rotator cuff tears. The most extensive surgery is open repair of the rotator cuff. With this procedure, surgeons use a large incision to operate. During surgery, they suture the tear to help the shoulder function properly. This approach is the best option for severe tears, or those that affect more than half of the rotator cuff tendon.

An alternative for minor tears is called acromioplasty. With this procedure, surgeons shave part of the acromion bone on the point of the shoulder. A ligament over the top of the shoulder is cut, and injured tissues are removed. This takes pressure off the injured rotator cuff and promotes healing. For patients with tears that affect less than half of the tendon, this procedure usually have good, lasting results.

For patients whose tears go through about 50 percent of the tendon, repair of the rotator cuff may offer better results than acromioplasty. This choice also depends on where the tear is located. Ask your doctor which surgery is best, given the size and location of your injury.

The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. For more information on this subject, visit www.zehrcenter.com.

Why do I need physical therapy before knee surgery?

admin — Fri, 09 Oct 2009 10:53:46 +0000

I am facing knee surgery for a torn anterior cruciate ligament (ACL). When I went to see a knee specialist, I felt rushed. I was told I needed surgery right away. My family doctor thinks I should have some physical therapy before surgery, but the specialist is adamant that I have surgery right away. Is it usually helpful to have some PT before having surgery?

Some doctors prescribe up to 12 physical therapy visits before scheduling ACL surgery. Doing some physical therapy first can help prepare you for the surgery. The visits help by getting control of the swelling, restoring knee movement, and improving knee stability. Getting the swelling down before surgery may keep scar tissue from developing after surgery. Improving knee movement and joint stability before surgery can also affect your progress after surgery. Your physical therapist can use the visits before surgery to answer your questions. He or she can train you to use crutches, and go over the exercises you’ll do after surgery.

Too busy for physical therapy? Rethink surgery!

admin — Tue, 22 Sep 2009 11:14:37 +0000

I recently dislocated my shoulder. I’ve heard about a new surgery available to fix it. Does that mean I won’t need to go through physical therapy? Frankly, I don’t have the time.

The surgery you are talking about is arthroscopy surgery, and it’s not all that new. However, it is being looked at more closely as an improvement over the traditional approach of simply placing the shoulder in a sling. Physical therapy is an integral part of the recovery process, regardless of the treatment approach. Since it’s your body, you need to have a say in how it is cared for. That said, many surgeons prefer not to operate if the plan for rehabilitation afterward can’t be agreed upon. Discuss your concerns with your surgeon.