7. Prehab
Now you do have time to stop and smell the flowers
“While the healing of a wound is a physiological process, recent research has confirmed the relationship between mental states and the rate at which healing occurs”
Patience
The word Patient has multiple meanings, among them:
A person who is under medical care or treatment (noun) and
Quietly and steadily persevering or diligent in detail or exactness (adjective).
Both meanings apply to a person having TKR. It might sound redundant to advise becoming a patient patient. Still, the truth is, no one is born a good patient, and there is much a patient can learn to help themselves through this difficult period. While healing a wound is a physiological process, recent research on the mind-body connection has confirmed the relationship between mental states and the rate at which healing occurs.
Factors that can delay healing include:
• Fear or significant distress before surgery
• High levels of depression and anxiety
• Other types of mental stress
• Pain—a form of physiological stress
• Poor anger management skills, since anger increases the production of glucocorticoids which slow healing.
In summary, a patient’s mental state can affect the process of healing; increased patience with oneself and one's situation will lessen anger and stress. Knowing what follows post-surgery and how to manage that future discomfort will give the patient choices, and with choice comes a sense of control. Patience is an essential component of the Guiding Hand principle. It provides the patient with space to be both good to, and honest with themselves.
Performance
Think of movement as a form of medicine to
help manage pain and facilitate recovery
Knowing what to do is not the same as doing it. To fully realize the benefits of TKR surgery, the patient must commit to the recommended exercise routine and perform the exercises as directed. This includes both prehab and rehab exercises.
Prehab exercises work to restore as much functionality as possible to leg muscles (within limits imposed by the damaged knee)
Rehab (post-surgical) exercises work to regain range of motion to the fullest extent possible and prevent scar tissue formation.
Because no two knees are alike, no two recoveries will be the same. In some cases, damage to surrounding tissues, muscles, and tendons due to arthritis or previous injuries will limit the extent to which the new knee will recover lost mobility.
Since physiological healing begins immediately after surgery, exercise must begin at the same time. That is why the patient starts walking with support within 24 hours of receiving their new knee. Being “good to yourself” means recognizing the importance of these exercises to your future and doing them as instructed. While these exercises can be painful, there are ways to reduce pain levels.
See link: Managing Pain
Persistence
The last of the 4 Ps may be the most difficult because it directly challenges the human tendency to procrastinate. You can realize Patience and Performance in short bursts of motivated behavior. Persistence—the willingness to endure—is more demanding. It requires stamina, grit, and tenacity. As the happy cousin to Stubborn, Persistence enables you to take charge of your recovery.
Persistence is what leads to gains in flexion.