Dr Richard, Quadriceps Muscle, Cosco discussed on Fifty Plus
To appreciate it If you're stuck. In traffic. Today a Sunday. Then that's on you Sunday I love Sundays coming, into coming into the, studio to. Do my outdoor show. Sunday mornings. Nobody. On, the road just nobody. So here we go welcome back fifty plus, thanks for hanging around there are, enough folks in our age demo getting total joint, replacements these days or at least if you're not on that list you. Will be someday probably or you know somebody, already in that boat not that we ought to talk about rehab seven million Americans walking around either with with, aftermarket hips or knees You get, a brand new one you gotta know what to do before and after. That surgery and to find out what we're, supposed to do we're going to welcome with the magical pushable button Dr crystalline Richard licensed physical therapist and member of UT. Health consortium on aging thanks for your time day Hi thank you I appreciate this I have heard that part. Of a successful a big part of successful rehab? After. Joint replacement surgery actually starts way before the. Surgery what step one and when do we take it absolutely so we've coined a term called pre, hab pre basically means that you're getting some form of therapy before you even decide to have these. Surgeries and this is a decision that you can make along with your surgeon or your Arthur pita Dr but. You definitely want to get in for some therapy before you start to consider. Having, one of these replacements and what we know is a lot of. Our patients have great outcomes If they do the pre hab if we're having the surgery done let's talk about. That pre have when does it start we talking about six weeks four weeks two weeks hour and a half. What right so I think pre half start even a year before the Absolutely because, this is, a non what we call a. Non? Pharmacologic. Meaning it's a way that you can decrease taking pain pills Four Yeah, yeah We doing in, pre hab my guess is and I'm, no doctor but my guess is that we're strengthening the muscles around that joint and preparing them to take on a. New. Challenge. Absolutely So you're your quadriceps muscle the muscle right in front of your, your thigh right above the knee replacement and your hip replacements. It's typically very weak in patients who have osteoarthritis general arthritis so if we can get that quad muscle strengthened before the surgery we know that our clients will. Have, better outcomes after meaning they will have decrease pain increase function and just decrease time to return to independence wanna get in their early that muscle up and prepare you for your. Surgery yeah it makes perfect sense, because the people most likely to need near hip replacement probably have been in a lot of pain, and not terribly active for a long, period of time thus they've had their muscles atrophy so we gotta start back over and get back to those teenage. Thighs Close directly exactly in what we know. About some pain is it just stops us from wanting to move, if you're in pain you don't wanna get up you don't. Wanna go to the grocery store as much so we wanna make sure that we're we're just keeping you active in keeping your heart healthy as well because that's. One, of the things that you'll need before surgery is a healthy heart was going to say that's something to keep you off of an operating table is a any kind of an. Issue with your heart that dot. The docs don't want to take on that risk to do they know Blame it all so typically by the way I. Wanted to, ask this question because you'll know the answer and I don't. What's the What is the procedural difference between partial and total joint replacement Right so for a total joint replacement They're basically cutting out both, parts of the bone in your knee and they're putting a brand. New prosthetic me side with the partial we have a lot of new innovative techniques where they, can preserve some of. Your. Own bone some of your own And they. Don't have to take as much of your body parts out when are we going to have. Prosthetic biceps and triceps That's what I need some prosthetic PEX Often by the time. I found sixty Come right out Start over take me back to. About twenty five that'd be. Good right there Part of me wants to think that kind of a partial replacement would require more rehab. Because we're actually trying to get original parts to work with those aftermarket parts but I. Read that it's the total replacements that are going to require the most rehab and. I guess. Because what you were talking about it. Just everything's coming out right Right well it really depends on. The level of. Okay so we we kind of have a grade that we use to determine the severity and the ability that your arthritis is causing you you know if you're in. Pain every single day and you you you've lost function you can't get in and out. Of a car you can't walk more than two to six minutes that's extremely debilitating What most likely require total okay So that's that's kind of the things that we look at with the pre hab and determining if. You're even a candidate. For surgery but that's a decision, you're Arthur doctor with, hips knees both weight bearing joints which wants the toughest to. Rehab Great question Say the knee only because the typically with a total, knee replacement my patients experience a little bit. More. Swelling okay because of the load-bearing versus. The right And I'd have to. See the knee mainly because of the amount of swelling that happens after the surgery and. Our patients ability to manage that ongoing cycle of, pain and swelling I noticed here that your options are rehab as, an inpatient somewhere or rehab at home talk. About. The the ups and downs of both Right so so we have in, a facility an inpatient rehab facility you would stay there on average fourteen twenty days for patients who require more extensive help okay meaning they may not have a family infrastructure where. They have helped with transfers and and walking and getting medication sheet of that nature and. You have to tolerate about three hours a day They're gonna push you aren't they yes. It's it's it's a little bit more aggressive that's an I was gonna, say yes, sometimes if you're sitting around the house and your. Your spouse comes in, and says? Come, on it's, time for rehabs like no wheel. Of fortune Exactly exactly versus versus home are. Outpatient you know that, could, be three to five times a week and then the sessions would be about forty, five minutes, to one hour and that becomes a transportation issue Take you to and from because. Somebody who just got a brand new knee probably isn't going to be. In the mood to drive just So those are floor you know. Our. Patients. Who have, a spouse who can, drive them you know and who's probably retired. And you know has the time to do that okay Dr Richard duty health consortium on aging all sorts of misconceptions about total joint replacement pick your favorite The biggest one is I'll be walking. And no ties What is it how long is no time That's, a great question? So six to eight weeks It's time, line that we give clients snore returned to driving and what we call return to community is a big difference between being able to walk inside of your home versus, walking. Inside of Cosco walking. Inside of you know. Different that's a good point You know. So we usually say six to eight weeks. For return to, community now if you're just walking..