Category Archives: Exercise and Health

Home Exercise vs. Outpatient Physical Therapy Following Total Knee Arthroplasty

at-home-exerciseDr. Jeff Stickney, a Kirkland orthopedic surgeon, can help you determine whether outpatient physical therapy or home exercise is better suited for your recovery following total knee arthroplasty. He specializes in orthopedic surgeries and health care including total knee replacement, joint replacement, sports medicine, and more. Contact doctor Stickney’s office today to learn more.

Outpatient physical therapy (OPT) is the practice of visiting a healthcare facility such as a clinic or office to perform exercises to treat musculoskeletal problems. This strategic physical activity with the guidance of a physical therapist is a common means of both injury prevention and recovery from sports injuries, because it helps patients address joint pain and regain range of motion. While OPT has a long history as a fundamental part of proper treatment plans for recovery and maintenance following total knee arthroplasty (TKA), recent studies have questioned the need for OPT following total knee replacement surgery.

A new study, “Home Exercises vs. Outpatient Physical Therapy After Total Knee Arthroplasty: Value and Outcomes Following a Protocol Change”, explored the “health safety, efficacy, and home economics of routine home exercises following TKA compared with OPT immediately afterward”. It compared 251 patients who were prescribed OPT following TKA, and 269 who followed a home exercise program instead after their operations. Ultimately the study found that patients who practice home-directed exercise programs in place of formal OPT have seen comparable outcomes, and can even experience significantly reduced costs. They concluded that while some patients required OPT following their home exercise program, the majority did not.

As the study above highlights, the use of home-healthcare following TKA is increasing. Many other publications have reported the same, claiming that supervised rehab such as OPT may not be necessary for optimal recovery following TKA. However, another recent study explored the association between physical therapy (PT) and functional improvements for patients in home settings. This study also explored factors related to PT utilization, meaning it identified the reasons patients did or did not use their home healthcare.

The study found that lower home-healthcare utilization was correlated with worse recovery. Participation in home-healthcare was generally lower for patients who had the help of physical therapists from rural agencies that came to their home. Medical complexity – such as depressive symptoms or dyspnea – factored into the patients’ levels of participation too.

Comparing the results of both studies, we can conclude that home exercise following TKA is effective, however it’s important that patients actually follow through on utilizing the home practice, performing the necessary amount for an optimal recovery. We can also see that those with medical complexities may need additional monitoring to verify that they perform the necessary amount of home PT sessions to achieve a complete recovery.

How to Avoid Summer Workout Dangers

summerworkoutStaying safe during your summer sweat sessions is important, whether you’re doing laps in the pool, getting in touch with your inner yogi, or logging miles on the road. Read below for a few tips on how to avoid summer workout dangers.

  1. Stay Hydrated. It may seem like a no-brainer, but becoming dehydrated in the heat of summer is easier than you think. If you want to avoid the unfortunate side effects of dehydration, including light-headedness, heat exhaustion, and heat stroke, it’s crucial to properly hydrate. The National Athletic Trainers Association suggests aiming to consume 17-20 ounces of water two-three hours prior to exercise and seven-10 ounces of water every 10-20 minutes during your workout.
  2. Skip Mid-Day Outdoor Exercise. With peak sun and heat hours being from 10 a.m.- 3 p.m., it’s best to move your workout indoors during this time frame. Plan your bike rides, runs, or swims for early morning, late afternoon, or evening to keep cool and avoid exposing your skin to damaging UV rays. If it’s not possible to workout inside, look for shaded outdoor areas instead.
  3. Use the Buddy System. Heat-related illnesses, like heat exhaustion and heat stroke, can be easier to spot in someone else than they are to spot in yourself. Exercising with a friend or group could make all the difference in avoiding an injury or illness. Some signs to look out for include: confusion, headache, nausea, weakness, and blood rushing to the surface of the skin.
  4. Dress for the Heat. Working out in warm weather means wearing clothing that’s breathable. Sweat-wicking fabrics are especially great because they move moisture away from your skin to the outside of your clothing, where it can evaporate. These types of fabrics also minimize chaffing and keep you feeling cool and comfortable.
  5. Be Sure to Cool Down. When it comes to avoiding injuries in the heat, making sure to do a proper cool down after your exercise session is vital. While many of us stretch prior to working out, the best time to stretch is actually after you exercise, when blood is flowing to the skeletal muscles, your tissues are more pliable, and the risk for injury is lowered.

Dr. Stickney, a Kirkland orthopedic surgeon, is an expert in exercise and healthjoint replacement surgerysports medicine and more. Contact Dr. Stickney and return to your healthy, pain-free lifestyle!

Middle-Aged Women Who Exercise Could Delay Dementia

exerciseFor middle-aged women, physical fitness may do more than give the heart a boost; it may also benefit the brain in a big way. Recent findings out of Sweden show that middle-aged women with a “high degree” of cardiovascular fitness are 90% less likely to develop dementia later in life than those who had just a moderate fitness level.

The study, published in the journal Neurology, also discovered that if the middle-aged women who maintained a high fitness level did develop dementia, the symptoms tended to emerge 11 years later (on average) than they did for the women who had a moderate fitness level.

To conduct this study, a team of researchers from the Center for Aging and Health at the University of Gothenburg studied the health data of 191 local women, ages 38-60, from 1968-2012. At the beginning of the trial, the participants were given an exercise test in which they cycled on a stationary bike until they felt exhausted.

After tracking the health of the women for 44 years, the researchers found that the initial fitness test scores helped predict whether the participants would be diagnosed with dementia later in life. The results showed that 32% of the women with a low fitness score developed dementia during the study period, compared with 25% of women with a moderate fitness score and just 5% of the highly fit women.

The highest dementia rates were seen in women who started the exercise test but couldn’t complete it: a whopping 45% of these women went on to develop dementia later on in life.

Though this singular study doesn’t fully prove a direct link between exercise and a lowered risk of dementia, it’s clear that exercising frequently (aim for 150 minutes per week) is extremely beneficial for both the body and brain. In years to come, studies like this one will allow researchers to provide clearer recommendations for exercise and other lifestyle modifications to reduce the risk of dementia and more.

 Dr. Stickney, a Kirkland orthopedic surgeon, is an expert in exercise and healthjoint replacement surgery, sports medicine and more. Contact Dr. Stickney and return to your healthy, pain-free lifestyle!

How to Prevent Falls in the Winter

walkingonsnowThis time of year, outdoor walkways more closely resemble skating rinks, as they become slippery hazards obscured by leaves, rain, ice and snow. Though many falls are more embarrassing than they are painful, injuries and even deaths caused by falling are common and more prevalent in the winter months (though it’s important to be cautious of trip hazards year-round).

Senior citizens, being less agile and more fragile, are especially at risk. Unfortunately, falls are the number one cause of injury to seniors, one in three of whom will fall each year and too often, the result is a debilitating fracture, loss of independence or death.

So, how to avoid outdoor slips, trips and falls this winter? The New York Times offers a few tips:

  1. “Check your footwear. Shoes and boots should have slip-resistant soles (rubber or neoprene, not plastic or leather). Or equip them with external traction cleats, sold under brand names like Yaktrax.
  2. Take smaller steps, bend forward slightly, go slow and walk as flat-footed as possible when it’s icy or snowy. Check the steps and sidewalk for black ice before going out in the morning, even if only to pick up the paper or mail. Do likewise when stepping out of a vehicle. Although the air temperature may be above freezing, dew or fog can freeze on a colder surface.
  3. Always use a handrail when going up and down stairs. Consider installing a railing on stoops that lack them. If an item you want to carry is too big to hold in one hand or arm, ask someone to help.”

Along with these tips, it’s vital to maintain your physical strength and balance as much as possible as you age. Higher levels of physical activity have been shown to protect against falls, so keep active or consider sessions with a personal trainer or physical therapist if you aren’t sure where to start.

Even after taking all the precautions, falls are bound to happen, and when they do, it’s important to be prepared. Some experts recommend learning “the right way to fall” which involves trying to stay relaxed as you fall, tucking your head when falling backward to avoid hitting your head, rolling onto your back upon landing and more.

Do you have questions about staying active in the winter or preventing dangerous falls? Dr. Stickney, a Kirkland orthopedic surgeon, is an expert in joint replacement surgerysports medicine, exercise and health and more. Contact Dr. Stickney and return to your healthy, pain-free lifestyle!

Stay Active Outside this Winter

winteryogaWinter weather can make it a little too easy to ditch your outdoor exercise routine, but hibernation is not the answer even when you live in the chilly Northwest. Research shows that taking your workouts outside not only keeps your physical health in peak condition, but also helps to boost your mood and your immune system and can even play a hand in preventing long-term chronic illness. Read below for fun ways to remain active outdoors this winter.

  1. Get Walking. Or even go for a run! Don’t let the rain or snow stop you from getting your cardio in. Dress appropriately for the weather and consider doing a 5-10 minute warm-up indoors to get your heart pumping and blood flowing. That way, the cold air won’t be nearly as jarring when you open the door.
  2. Enjoy Winter Sports. Do you enjoy skiing, snowboarding or maybe ice-skating? Winter is the ideal time to perfect your favorite winter sport skills or even try your hand at a new one. Bundle up, get your heart racing and have fun while you’re at it!
  3. Take a Hike. Exploring nearby hiking trails in the winter allows you to see your favorite landscapes in an entirely different (and sometimes more beautiful) way. You’ll also enjoy a unique solitude you won’t find other times of the year. Just remember, winter backcountry exploration can be dangerous. Take the right precautions before hitting the trail. 
  4. Say Namaste. Everyone knows how great hot yoga is, but why not enjoy the amazing benefits of this mindful exercise in the cold? Many yoga studios offer outdoor classes, but you can also do it yourself. Be sure to engage in a warm-up before you head outside so your muscles are loose, dress in warm layers, then choose a few poses you’re comfortable with and give it a go.

Dr. Stickney, a Kirkland orthopedic surgeon, is an expert in joint replacement surgerysports medicine and more. Contact Dr. Stickney and return to your healthy, pain-free lifestyle!

Why Exercise Is Best Done Outside

outside-exercciseIt’s not secret that one of the essential components of a healthy lifestyle is exercise: from lowering the risk of physical disease or the need for joint replacement to improving your emotional and mental wellbeing, exercise is critical for longevity and a higher quality of life. However, dragging yourself to the gym isn’t always appealing, and exercise that isn’t enjoyable can become exercise that isn’t done.  A new study by the University of Innsbruck in Austria has found that the best way to exercise is by heading outdoors, whether for a vigorous walk in the woods or a casual stroll near your house.

In the past, experts believed that a successful exercise regimen boiled down to two factors: intensity and duration. They figured that the secret to getting people to exercise was short, high-intensity workouts: this ensured that busy professionals weren’t strapped for time, though the intensity and effort could become off-putting. 

The new study, published in PLOS One,  believes that a workout’s emphasis should instead be on duration and enjoyment. To test this, they recruited 40 volunteers from Innsbruck to complete several prolonged workouts, completing mood and anxiety tests before and after. 

First, a guide took them around the surrounding mountains for a brisk, but not strenuous, three-hour walk.  Next, they were required to complete a similar workout on a treadmill within a gym, working out next to other participants and encouraged to converse. Finally, they spent three hours in a room at the university where they could spend time on the computer, read magazines, or chat with each other.

Analyzing the results, the scientists found that the mountain hike was the most taxing of all the activities and heart rates had risen more, although participants noted it felt less strenuous than the treadmill exercise. Happiness scores were significantly higher after the outdoor hike, although those after the treadmill walk were more elevated than just sitting and talking. 

Long walks outside may be a healthy alternative to intensive gym workouts, and the study is a reminder that even for those who can’t compete interval training, there are plenty of options to exercise and optimize your health. Consulting with an orthopedic surgeon can help you determine the best regimen.

Is joint pain impacting your ability to lead a healthy, active lifestyle? Interested in learning more about walking and exercising after joint replacement surgery? Dr. Stickney, a Kirkland orthopedic surgeon, can help advise you of the best