Friday, May 21, 2010

Things i wished my Ortho told me

She had been complaining about her foot hurting, so why was she limping with her knee locked? Then I remembered we ALL do it- we silly human beings tend to compensate for pain- its normal. Abdominal pain? Knees come up, or we bend over to help relieve our discomfort. Sometimes we overcompensate- like locking our knee when our foot hurts- oh well. Let me go back to my original statement-"Things I wish my Ortho had told me!"
I have had knee pain or knee problems for years. Over the years I knew that my ever increasing weight did nothing but add to my problems, but I didn't know how I was increasingly compensating for my pain.
1. When you are walking in chronic pain- you will compensate by using other muscles- and risk inflammation of supporting ligaments, and muscles in your hips, knees, feet, and back. Remind us of this- offer suggestions of how to deal with keeping active
(like remind us to remember to walk with our shoulders over our hips, not with our upper body out in front trying to pull the rest of the body forward)
2. PT is not always the answer- some people have a problem with overdoing it, and not knowing when pain says 'stop doing that' Water Therapy is something that alot of us can do without causing more problems.
3. With increasing pain and with each passing year, you run the risk of losing your core muscle strength- recommend taking Pilates classes- or something that works at maintaining your core muscle strength
4. When it hurts like heck to stand up and walk, it is not unusual for us to hold our breath for the first few steps until we can get into a rhythm and walk with tolerable pain. This eventually leads to shallow breathing- we need to practice deep breathing (something Pilates will also help with )
5. Stretching- is important...when we are in pain, especially with knee pain, our compensating may lead to partial weight bearing, and then to a contracture in the knee, because we don't put full weight in the normal walking posture- which will make for problems when we get our total knee.
6. When we are in chronic pain, we don't always know how to ask for something to help us deal with it- ask how our pain is being helped. If we are taking only over the counter meds,
remind us:
what normal 24 hour dosage is,

to take at least 8 oz of water with ibuprofen.

what the long term complications can be from taking these meds.
7. Don't just tell us to "lose wt" - have someone on your staff to work with us to see where the problems are- is it just diet?, or exercise? or does stress play a factor?
8. After total knee surgery, you will need to get new walking shoes. (not immediately but when you start to resume a pretty normal life). Those walking shoes you had before surgery wore according to your compensating gait and weight distribution- things change when you have no pain.

I guess after it is all said and done- we all want to be healthy, and not just a number with a complaint , and I think experiences at our Orthopedic doctor offices can be improved to help us improve our state of well being.