My husband complains to me all the time, “Don’t you ever slow down?” It was yesterday morning that I was up at 7 a.m. to do an online yoga class hosted by a yogi from the East Coast. Granted it was an easier class than I would have done pre-op, but it was getting me moving again towards that goal of strength with flexibility which then always drives my hopeful attitude. Today, I got on my elliptical and will be doing another relaxing yoga class later today.
I have also been reviewing an article suggested by Dr. Jacob Templar entitled, “Physical Activity and Exercise Therapy Benefit More Than Just Symptoms and Impairments in People With Hip and Knee Osteoarthritis”. As someone who believes in physical activity and the power of exercise for healing and strength, I do also know that there are some that don’t really understand the significant benefit of strengthening. There may be an attitude that surgery will fix me and therefore why waste energy getting stronger before surgery.
There are reasons that you should remain steadfast in undertaking an exercise program. Now, I am not talking about running and jumping - high impact exercises are not for me and I know my body well enough to know that those will only be a hindrance. However, the article, although focused on hip and knee osteoarthritis, does state that at least 10 random controlled trials, “support the efficacy of land-based exercise therapy in reducing symptoms and impairments” (Skou, Pedersen, Abbott, Patterson, Barton, 2018). The authors also state that “like analgesic medication, exercise therapy needs to be taken at a sufficient dose and duration to be effective and ensure optimal and clinically relevant effects on symptoms and impairments.” The authors also suggest that there are three key areas that patients may have deficits in that can be remedied with exercise therapy. These are proprioception, strength and the ability to “stabilize the joint”. Regardless of whether you have hip osteoarthritis or not, the same principles should apply to most hip patients. Strengthening is good. So what if this exercise hurts? Well, here is the thing. Pain does not always mean tissue destruction. (See blog on Pain Science). The authors continue to state, “Pain during exercise is allowable, as long as the individual finds it to be of an acceptable level, and any increase to normal pain and symptoms following the exercise session has reduced to the same level or lower within 24 hours” (2018).
Skou, Pedersen, Abbott, Patterson, Barton also discuss that when “the potential benefits and harms are compared, it is difficult to argue against the implementation of physical activity and exercise therapy for people with OA. However, some barriers and potential contraindications do exist. Key barriers to physical activity and exercise therapy in people with OA relate to fear of movement and pain flares. Fear avoidance beliefs are common in individuals with OA and relate to impaired physical function.A substantial number of people with OA fear that they may injure themselves as a result of physical activity participation.Therefore, assistance in addressing fear of physical activity is essential to addressing physical inactivity and improving long-term adherence to exercise therapy. In most cases, reassurance to patients who may be fearful that exercise therapy can damage their joints should be provided” (2018).
Exercise therapy does not only address your orthopedic issue, but it also can greatly minimize any other health problems such as diabetes, high blood pressure, depression. Give it a try!
Exercise therapy, in my opinion, has been my lifesaver. I have pre-habbed for each of my surgeries (hip, knee, ankle, spine) as a way to strengthen and prevent ineffective compensation patterns that the body may use to adapt to worsening joint issues. One such faulty compensation pattern is the Tredelenberg gait. This gait is caused by weak hip abductors. This type of gait “can be seen when one leg swings forward and the hip drops down and moves outward” (Healthline, 2019). When compensation patterns develop, they can also wreak havoc on other parts of the body.
You have heard the old song…
Your knee bone connected to your thigh bone
Your thigh bone connected to your hip bone
Your hip bone connected to your back bone ....
This is incredibly true. Our body is very complicated and miraculous and interconnected. It needs to be given the right supports in order to heal. Exercise can be that support. It is especially effective when overseen by a Physical Therapist or Personal Trainer. A PT or Personal Trainer can help you modify and individualize your exercise program based on your specific needs. So, do I ever slow down? Of course, I do, but I also believe that the motion of my body is the lotion I need for healing and improvement. It is the lotion called Empowerment and Hope.
References
Jewell, T. (2019, August 9). Trendelenburg Gait: Causes, Treatment, and More. Retrieved May
17, 2020, from https://www.healthline.com/health/trendelenburg-gait#outlook
Skou, S. T., Pedersen, B. K., Abbott, J. H., Patterson, B., & Barton, C. (2018). Physical Activity
and Exercise Therapy Benefit More Than Just Symptoms and Impairments in People With Hip and Knee Osteoarthritis.Journal of Orthopaedic & Sports Physical Therapy,48(6), 439–447. doi: 10.2519/jospt.2018.7877