By Dan Hellman
Sometimes I think we should walk around with shirts imprinted with “Spare Parts Enclosed.” People today are having parts of their bodies removed or replaced with alarming frequency, so our body parts are becoming disposable. I hate to think that we will soon be shopping for body parts just like we shop for car parts. All “progress” aside, the best joint replacement is the one you don’t need.
As a physical therapist, I have rehabilitated many people with joint replacements, some as young as 40 years old. But my favorite clients? They’re the ones who come to see me before they have their joints replaced and are willing to do whatever it takes to avoid the knife.
Healthy tissue is the key.
Ever since I started looking at the human body through the eyes of tensegrity (fascial links), and not just muscle and bones, I have become a more thorough therapist. I am now capable of assisting more people with more issues than ever before. Medical science is gradually coming around to recognize the importance of fascia for general good health, flexibility and pain-free movement.
Age is not the major factor in determining if a person can avoid joint replacement surgery. The critical factors are the health of the tissues and the dedication of the individual. Period. It should come as no surprise that people who maintain a healthy diet and manage negative lifestyle factors tend to respond very well to corrective exercise. Exercise is obviously critical, but it’s not enough. If the tissues are dehydrated and of poor quality, exercise can actually cause more damage.
Movement is also key to joint health because it improves the synovial fluid in the joints, the fluid that keeps the joints lubricated. This is particularly important for people with arthritis. For all these reasons, I prescribe specific movements for my patients with joint pain coupled with advice on nutrition and controlling important lifestyle factors like sleep and stress.
Create space for the joints.
It has been my experience that joint-replacement surgeries can be avoided with the proper manual therapy, segmental strengthening, myofascial stretching and specific ELDOA exercises. Since all muscles have internal, external, middle, total and extreme ranges, it is vital to know the proper range within which to train each muscle. That’s where the quality and experience of your therapist comes in.
My client Sandi came to me for a consultation on a hot and sunny July 4 a few years ago. She was scheduled for hip-replacement surgery the following month, but decided she wanted to try a course of treatment that might help her avoid it. So I worked with her. Sandi was very diligent with both her nutrition and her exercises, and within one month she had put her cane away and cancelled surgery.
I would like to take full credit in Sandi’s case for being a brilliant physical therapist, but Sandi’s case is not unique, and we should hope to see more like it. Fast-forward a few years to 2019, and we see the case of Lynn Burt, a 74-year old Utah woman suffering from arthritis who spared herself a double knee replacement. She questioned her doctor’s advice and instead enrolled in a program designed to help arthritis patients manage their condition through exercise.
Lynn Burt now sees a physical therapist twice a week for aerobic and flexibility conditioning. She still has the knees she was born with and is moving freely with much less pain–and she is talking about playing sports like badminton.
Take responsibility: Get a second opinion.
It may be tempting to go for spare parts today, because it seems so easy. Joint replacements happen every day and are becoming a new normal as people age. But you really don’t have parts to spare, so please try to keep the ones you have. That one and only body that you received at birth is a precious gift. If you are dealing with orthopedic pain and your doctor tells you that you need to have a joint replaced, please seek out a second opinion from a professional other than a surgeon. Sandi and Lynn did, and they will never regret taking responsibility for their own health care.
I have great respect for surgeons, of course. I work with them, consult with them and receive referrals from them. But surgery is what they do, not rehab. So get a second opinion from someone with a different perspective—an osteopath, an experienced physical therapist, a non-surgical physician or a chiropractor, for example. Sometimes joint replacement surgeries are truly necessary, but removing the joints you were born with and replacing them with prostheses should be a last resort, not the first option.
I don’t know about you, but when I meet my maker, I want to have everything I was born with, just to show that I took care of the gifts he gave me.