Tag Archive for: rehab

What Your Body Needs for Bone Repair

/in /by

Note: As this email hits your inbox at 6:15 a.m., Paula and I are already at the surgery center where she’s getting her right knee replaced. She had the left one done six months ago, so the recovery routine is familiar. We know we need to concentrate on bone repair, and since it’s slip-and-fall season here in the North, I thought this would be a good time to remind everyone of the nutritional requirements for bones. That’s why we’re rerunning this Memo from last February.

When it comes to broken bones, especially in adults, what can be done to help the healing process? Pain management is always paramount because of the second reason: joint rehabilitation. If any movement is too painful, no one wants to rehab the muscles and tendons surrounding the joint, especially with a dislocation that stretches them beyond their normal capacity. Putting the bone in place is one thing, but getting the tendons and muscles to repair is another. There’s no being brave or gutting it out; rehab is necessary to restore complete joint function.

That raises the question: are there any supplements that can help with the healing process? The research is virtually non-existent, as outlined in a recent article, but there are some nutrients that make sense:

  • Vitamin C: an additional 1,000 to 2,000 mg per day. Vitamin C is involved in building connective tissues; bone, tendon, and ligaments are all connective tissue.
  • Vitamin D: an additional 50 to 100 mcg per day. Vitamin D is known for helping build bone, so it makes sense to increase the amount.
  • Glucosamine: 1,200 to 2,400 mg per day in total. Glucosamine, like vitamin C, is used in making all connective tissue. This appears to be important within the first two weeks after the injury, based on animal studies.
  • Calcium: 500 to 1,000 mg/day in total. The formation of the callus and conversion to bone requires calcium. Taking an extra amount, providing stone formation is not an issue, is important.

The final part of bone repair is patience. We all progress at our own pace. If ever there was a time to be consistent, this is the time.

Manage the pain, perform the rehab once you’ve been given a program, take some nutrients that can benefit bone growth, and don’t stop until you have full function. That’s the bottom line on broken bones.

What are you prepared to do today?

        Dr. Chet

Reference: J Orthop Res 38:695–707, 2020.

What Your Body Needs for Bone Repair

/in /by

When it comes to broken bones, especially in adults, what can be done to help the healing process? Pain management is always paramount because of the second reason: joint rehabilitation. If any movement is too painful, no one wants to rehab the muscles and tendons surrounding the joint, especially with a dislocation that stretches them beyond their normal capacity. Putting the bone in place is one thing, but getting the tendons and muscles to repair is another. There’s no being brave or gutting it out; rehab is necessary to restore complete joint function.

That raises the question: are there any supplements that can help with the healing process? The research is virtually non-existent, as outlined in a recent article, but there are some nutrients that make sense:

  • Vitamin C: an additional 1,000 to 2,000 mg per day. Vitamin C is involved in building connective tissues; bone, tendon, and ligaments are all connective tissue.
  • Vitamin D: an additional 50 to 100 mcg per day. Vitamin D is known for helping build bone, so it makes sense to increase the amount.
  • Glucosamine: 1,200 to 2,400 mg per day in total. Glucosamine, like vitamin C, is used in making all connective tissue. This appears to be important within the first two weeks after the injury, based on animal studies.
  • Calcium: 500 to 1,000 mg/day in total. The formation of the callus and conversion to bone requires calcium. Taking an extra amount, providing stone formation is not an issue, is important.

The final part of bone repair is patience. We all progress at our own pace. If ever there was a time to be consistent, this is the time.

Manage the pain, perform the rehab once you’ve been given a program, take some nutrients that can benefit bone growth, and don’t stop until you have full function. That’s the bottom line on broken bones.

Super Bowl Webinar Tomorrow!

The research is done, the presentation is ready, and I’ve practiced as much as I can. At this point, I can’t guarantee you’ll be on the live webinar, but if you’re not, you will still get the opportunity to watch it later in the day or whenever it’s convenient. Taking Back Your Muscle is the kick-off for Aging with a Vengeance 2023. I also think it’s the one that can benefit us the most. Hope to see you tomorrow!

What are you prepared to do today?

        Dr. Chet

Reference: J Orthop Res 38:695–707, 2020.

Rehabilitation Becomes Prehabilitation

/in /by

After giving some thought to the discussion I had with our physical therapist, I’ve scheduled my knee-replacement surgery. I’ve already been doing everything he recommended to rehab the knee: avoiding any high-impact exercise, using an exercise bike, stretching. His verdict is that none of those will help the problem. The compounding issue is that my lower right leg is roughly 14 degrees off center; if I wait much longer, it becomes more difficult to make the leg straight with knee replacement.

It helps that the surgeon my PT recommended happens to be the surgeon I’ve already been seeing. While the decision is made, the work is now moving to another level. Having been an advocate of surgical prehabilitation for a few years, I get to test it firsthand; I’ve already seen how much it helped Paula before her foot surgery and hip replacement years ago.

I have three prehab goals: to increase my fitness level, to increase the strength in my right leg, and to reduce my body weight a reasonable amount before the surgery. Concurrently, I want to train myself to endure more pain, because it will surely be needed after the surgery.

Prehabilitation Goals

Fitness

Due to localized muscular fatigue, I haven’t been able to push myself as hard as I want during high-intensity interval training (HIIT). As a result, I don’t feel I’m in the physical condition I want to be in, surgery or not. It’s time to double down. That requires cycling adaptive training and HIIT with longer intervals.

What do I mean by cycling adaptive training? It’s spending more time at a higher resistance—higher than normal but not as high as during intervals. The energy systems have to be trained to adapt to higher lactate levels. Fortunately, I’ve been doing that a little bit anyway. Now I’m on a mission.

Strength

Part of the problem is the muscle mass I’ve lost. My right thigh is just over an inch smaller than the left. I know I’ve been compensating because of the perceived muscle weakness in my right leg, and I’ve been limping more than I should.

I’m increasing my effort in leg-strengthening exercises. Nothing fancy, just squats, leg extensions, and leg curls. I’m using as much weight as possible and focusing on overcoming the natural inhibition arthritis pain causes. I’ve already noticed a difference in just a couple of days.

Body Fat

You’ve heard me complain about the fat we all gain due to aging. I can’t lose all of it, but I’m going to bump up the effort a little. Less weight going into surgery and rehab means less force necessary to overcome gravity later.

The Bottom Line

This is not the outcome I wanted, and I still think that the ideas around knee replacement could use some major innovation. However, we play the hand we’re dealt when we’re dealt it, not five years from now. I have things to do, and being mobile is important to those objectives. I’ll provide updates as time goes on as well as provide details on the prehabilitation program.

What are you prepared to do today?

        Dr. Chet