Has your Total Hip or Total Knee Replacement been delayed due to Covid-19?

How this isolation period could be your opportunity for an improved surgical outcome (or potentially avoid needing the surgery at all).

Reece Noble, our rehabilitation physiotherapist at our Chelsea and Broadgate (City) clinics discuss how this period of “lock down” could be a big positive for you in your rehabilitation journey.

One of the many consequences of the current Corona Virus pandemic is that priority has been shifted away from “non-essential surgeries” such as knee and hip replacements. The knowledge and medical skills of orthopaedic surgeons and hospital resources are being redeployed to caring for those with Covid-19.

For many of you, this will mean that your hip and knee replacement surgeries will have been postponed for the foreseeable future. And whilst this is a frustrating thing for many, it could actually have a silver lining.

The important role of exercise before and after your joint replacement surgery.

If you have reached the stage in your rehabilitation journey that surgery is your next step, hopefully you have already worked with a physiotherapist  to get you fit and strong, not just around your effected joint(s), but also your body in general.

Unfortunately for many people who undergo joint replacement surgeries, physiotherapy including a well-structured exercise program, have not yet been explored thoroughly, or at all, before surgery is suggested.

This is a real disappointed for a number of reasons. For many people, surgery could be delayed or even completely avoided, by getting fitter and stronger.

“…for many people, surgery could be delayed or even avoided completely, simply by getting fitter

Also, getting yourself fit and strong pre-surgery (often called “prehabilitation”) means that your rehabilitation and getting back to normal life post-operative rehabilitation will be faster and easier. To put it simply – the stronger you go into surgery the stronger you come out!

Furthermore, exercise has a huge array of benefits for arthritic joints, whether they are at the stage of surgery or not, these are outlined in the next section.

The benefit of exercise on arthritic joints

Arthritis of the hip and knee can be very painful, and due to this, the last thing a person with osteoarthritis (OA) often feels like doing is exercising, or questions if exercise is what they should be doing at all?

What we know conclusively is that exercise has many benefits for people with arthritis and their joints.

“stronger muscles around the joint supporting the joint better”

These benefits are;

1/ Pain relief

  • This occurs by the stronger muscles around the joint supporting the joint better
  • Regeneration of the synovial fluid (natural lubricant) inside the joint
  • Endorphin (happy chemical) release

2/ Improved ability to perform daily activities

3/ Stronger muscles allow you to move and perform tasks easier

4/ Improved mental health and sense of wellbeing

  • Due to endorphin release and improved ability to perform daily tasks

5/ Weight loss (In combination with a well-balanced diet)

  • Reduced weight means reduced load/force on the knee e.g. your knee has to deal with 3-4 times your body weight every time you take a step – so losing just 10 pounds could take 40 pounds of force off your knee

Why is the Covid-19 lockdown a silver lining in all this?

The current situation due to Covid-19 gives you a fantastic opportunity to undertake a dedicated and progressive program of exercises whilst awaiting your surgery.

Current estimations of how long it will be before “non-essential” surgeries are recommenced range from 3 to 9+ months. Consequently, what a great opportunity for you to get as strong as you possibly can before your surgery (or potentially even avoid needing it)!

How can exercises be performed at home?

Thankfully, despite the current need to stay indoors, there is some simple ways we can get fit and strong using items around home and basic exercise equipment such as stretchy bands (that can be easily purchased from Amazon), or even no equipment at all.

A good assessment of where you are currently at with your hip/knee is important to set an appropriate program for you, but here are 3 simple exercises you could perform to help with your hips and knees.

Side lying leg lift
Lying on your side, lift top leg up into the air

Make sure your pelvis is still throughout
Repeat 10-12 repetitions, 3 times, with 30 seconds rest in between
To progress, add weight to foot/ankle (e.g. a heavy shoe)

Raised Heel Bridge

Lying on your back, heels up on a chair
Lift hips into the air and hold for 2 seconds
Place hips back on ground
Repeat 10-12 repetitions, 3 times, with 30 seconds rest in between
To progress, move hips further way from chair or go onto 1 leg

Wall Sit

With your back against the wall, feet flat on ground
Move to a position so your thigh is at a 45degree angle (Left picture)
Hold for 20-30 seconds, repeat 3 times
To progress increase the time up to 60 seconds, or increase angle of thigh towards 90 degrees (right picture)

How can you get started with an appropriate program?

Despite currently not being able to offer face-to-face physiotherapy due to the Covid-19 isolation recommendations, Reece (along with all of our team at Complete Physio) is continuing to offer physio services via online video consultations.

If you would like an online consultation to talk about your current needs and to get set up with an appropriate program for your hip and/or knee arthritis, please email Reece at reece@complete-physio.co.uk or call 020 7482 3875.

Book a consultation with us