The road to mobility following a hip replacement or knee surgery is not a short one, but with the right post-surgical care and support, full recovery is something to look forward to…with a little help from the experts.
A big operation for any one, at any age, hip and knee replacement and repair surgery is extremely commonplace, with doctors in the US alone replacing more than one million hips and knees every year.
If you’ve been living with chronic pain and stiffness that makes everyday tasks difficult or affects your life on a day-to-day basis, or if you have a deformity where the joint is swollen or the leg bowed, then surgery can be life changing.
Many people focus primarily, and naturally, on the surgery itself, but it is the post-surgery period and your personal recovery plan that is key to resuming full mobility and the ability to enjoy life to the max.
Doreen Setenane, Clinical Manager at Emirates Home Nursing heads up the team responsible for looking after patients once they come out of hospital and has taken care of hundreds of hip and knee replacement clients.
Before leaving the hospital, the patient should generally be able to get in and out of bed unassisted or with minimal help; be able to eat, drink and use the bathroom; walk with an assistive device such as a cane, walker or crutches; and ideally be able to climb up and down two or three steps.
After an average three to four-day stay, they are then ready to begin the healing process at home and Doreen recommends that the family’s first consideration is the home environment.
“Limited initial mobility means that you may need to have a ramp installed for easy access, especially if there are entry stairs. We also suggest installing an adjustable toilet seat so less bending down is required, and grip mats are a must to avoid falls,” she says.
“Other home and mobility aids help reduce the stress on surgical areas and also ensure personal safety; and these include crutches, walking sticks, shower chairs and commodes,” she adds.
NURSE KNOWS BEST
The UAE’s hospitals usually provide patients with a helpful ‘stages of recovery’ information brochure that is designed to work hand in hand with any specific doctor/hospital recovery plan.
“Other areas that we need to be aware of include complications or common post-surgery issues such as bleeding, infection and the prevention of blood clots; and this is where having home nursing support adds value – both in providing practical expert help and as emotional support as the patient goes through the recovery process,” notes Doreen.
If you translate this into actual hands-on care, the Emirates Home Nursing team cover the full gamut of medical and other support services including ensuring that the hospital’s discharge plan is followed to the letter, general assistance with daily living activities, pain assessment and monitoring, removal of stitches post-operation (usually after 14 days), as well as being that all-important connection between the family and doctor/hospital for facilitation of follow-up appointments.
Says Doreen: “Our nurses are a great resource for family members who may be a little overwhelmed or unsure regarding their loved one’s care; and we take time to educate both the patient and family about the recovery process.
BEND IT LIKE BECKHAM
Emirates Home Nursing is also a go-to resource for physiotherapy and Doreen works closely with the specialised in-house team to develop customised home exercise programmes designed to get you moving and back to full independence within a reasonable timeframe.
“We think it is really important to involve the whole family in any exercise programme, and this is a great motivator for the patient who doesn’t feel that they simply have to ‘go it alone’,” she explains.
Starting with a comprehensive assessment, Emirates Home Nursing is able to tailor individual programmes for its clients using ultra sound, electrotherapy, TENS, hot and cold therapy, weight training, passive movements, active movements, stretching and strengthening, rehabilitation exercises, and balance and coordination exercises…all in the comfort and security of your own home.
IN THE SPOTLIGHT
Emirates Home Nursing’s clinical manager recently took to the lectern as an invited speaker at the 6th International Congress for Joint Reconstruction Middle East 2018. Addressing a packed audience on the topic of post orthopedic surgery home care and associated nursing challenges, her presentation focused on the patient’s journey and how home nursing care and physiotherapy are vital for post-surgery recovery success.
The cooler winter temperatures we enjoy in the UAE are a great incentive to head outside and get active, whether it’s rollerblading on the Abu Dhabi Corniche, a bike road along Palm Jumeirah Boardwalk or pounding the pavements as a Dubai Marathon participant.
It’s also the season of competition with the calendar brimming over with aquathlons, duathlons, triathlons, half marathons, marathons, cycling challenges and wadi races. But whether you are a newly enthused exerciser or seasoned athlete, injury is something we all face at one point.
STRAINS, SPRAINS AND SPORTS INJURIES
The continued growth and appeal of endurance sports is a fact. Marathon running, which registered a 13.25% increase in participation between 2009-2014, led by female runners with 26.9% growth (according to research commissioned by runrepeat.com) is just one example. Triathlons, and the ultra-distance Ironman, are also hugely popular thanks to international media coverage and other high-profile events like the Reebok CrossFit Games.
A 2013 study by the British Journal of Sports Medicine on injury types among triathletes is still relevant today. Over-use injuries affecting the shoulder, lower back, thigh, knees and lower leg all made the list. Tracy Evarola, a physiotherapist from the Emirates Home Nursing specialist services team, agrees, and says that the most common exercise-related injuries or problems she sees in her clients include anterior and posterior cruciate ligament (knees), pulled muscles, strained back and plantar fasciitis (heel) as well post-operative sports injury recovery.
THE BENEFITS OF PHYSIO
“Physiotherapy is important because it supports the healing process of these injuries through pain management, strengthening programmes, mobilisation exercises, and prevention of further damage to the affected parts,” she remarks.
For runners, Tracy stresses the importance of implementing a gradual training programme that will allow their body to develop strength and endurance, improve skill levels and confidence. “It’s also important to have rest days to give your body time to recover from intensive training and to prevent overuse and fatigue. And it’s always a must to start and end with flexibility exercises,” she adds.
The intense nature of the triathlon discipline also calls for physiotherapy, but at a much earlier stage. Tracy elaborates: “Injury is present in almost all body areas as a result of triathlon training. Physiotherapists play an essential role in preventing injuries during a triathlon training. We ensure that the athlete’s muscular, cardiovascular, and respiratory systems are capable to efficiently work in a given period of time required for all three disciplines. Specific exercises are given to develop muscle strength to provide control, stability and direction to each plane of motion and to prevent unwanted movement and injuries.
“Physiotherapists work with the athlete to help improve their endurance and reach to a point where they can exercise comfortably for the period of time required in the race. We also give stretching programmes to prevent or overcome the effects of muscle pain and tightness.”
PHYSIOTHERAPY 365: A TAILOR-MADE APPROACH
The UAE, with its ambient winter season and incredibly hot summers also has an impact on our bodies when we train or when we are injured. “Heat and humidity affect people with pain as they have difficulty regulating their system with extreme changes of temperature and moisture in the air. The level of fluid that lines and lubricates the joint may undergo possible changes and this may somehow increase pain and inflammation,” explains Tracy
“Extreme hot weather has a number of effects on the body’s system, but people should also be aware of the symptoms in their own bodies as high heat and humidity also can exacerbate ozone levels, possibly causing additional distress and pain in those who have asthma, fibromyalgia, multiple sclerosis or chronic fatigue syndrome.”
Emirates Home Nursing’s physiotherapy team offers a broad range of treatments for sports injuries plus orthopaedic, neurological or respiratory conditions. Clients undergo a comprehensive assessment that allows the physiotherapist to design a personalised evidence-based treatment programme.
EXPERT ADVICE FROM EMIRATES HOME NURSING
So, what are the best and worst sports to practice in terms of high risk of injury? Tracy recommends swimming as one of the safest sports to practice with a low risk of injury. “Competitive swimming does require the ability to swim a variety of strokes, which can lead to common shoulder injuries, but with coaching and use of the proper techniques, it’s a safe and rewarding sport,” she says.
Football is one of the UAE’s most beloved sports, but is one that comes with a higher risk of injury, as she explains: “The high speed and full contact nature of football means that players are seven times more likely to be injured during a game than a practice. Ligament sprains account for more than 30% of all injuries, with the lateral ligaments of the ankle and the knee’s medial collateral ligaments most commonly affected.”
Sport is accessible to most, if not all of us, so whether you’re keen to get the family involved with an evening walk, cycle or rollerblading session at TrainYAS or Train Dubai or thinking about signing up for your first 5km run, Tracy has a few expert physio tips to share.