Bridgetown Physical Therapy = Portland, Oregon

The average person will begin to lose half a pound of muscle every year starting in their middle thirties. As people become weaker, they are more prone to injuries. Reduced muscle mass can also lead to inactivity, which can lead to even faster muscle atrophy. The gym is no longer only for young athletes, seniors should be lifting weights at least twice a week. If a gym is not affordable, there are lots of people trying to get rid of gym equipment on craigslist ads. Some are even offering it for free, just to get it out of their house. So there is no excuse!

10)Apathy - "I don't care"

Everyone should care about their health and their quality of life. We have become a sedentary society, which is developing significant health risks. Our bodies were built for movement.

9)Lack of understanding - "I don't know what to do in the gym"

This may be true. In fact, most fitness experts cringe at the exercises they see some people doing in the gym. The majority of people who join a gym learned how to lift weights from their high school gym teacher 20 years ago. A little education from an exercise specialist will go a long ways in the gym.

8)Discomfort - "It hurts when I start exercising"

Delayed onset muscle soreness (DOMS) is very common when first starting a program. This usually only lasts a few days after your first few workouts. Once you have been consistent with your routine for a few weeks, the DOMS will begin to diminish. The trouble here is that most people only continue a program for 4-6 weeks. So they associate most of their training with pain. Keep consistent and the DOMS will reduce.

7)Chronic Injuries- "I have a bad _____" (fill in the blank with your favorite body part. Usually "back" works well.

There is always a way to exercise, it might just need to be modified. In most cases, you should contact a healthcare professional prior to starting a routine to get proper guidance on exercises to avoid or include into your program.

6)Boredom - "I get bored working out"

Exercise should be fun and interesting or you probably won't continue. Change up your workouts every once in a while. Workout with a friend. Join a league or a local hiking group. There are many different ways to exercise other than being stuck on a treadmill.

5)Inconvenience/Distance - "It takes to long to get to the gym"

You should join a gym that is in close proximity to your house or office. This will increase the chance that you will go to the gym. If this is not an option, then exercise at home.

4)Expensive gym memberships - "I don't have enough money"

Exercise does not discriminate between incomes. Basic walking/running and body weight calisthenic combined with a proper diet can result in great results if done with the proper intensity and consistency. Gym memberships are nice to have, but it is not required to get in shape.

3)It's to hard - "There has to be an easier way"

This is why infomericals prey off our society with get fit quick gimmicks with items that melt away fat. They are making billions off our society that continues to buy items that promise to be the easiest and fastest way to fight our obesity epidemic. Exercise should be hard. If the exercise does not stress the body, the body will never change or adapt. This is a simple physiology principle.

2)No Energy - "I'm to tired"

This is exactly why you should be exercising! Exercise has been proven to increase your levels of energy. Sure the first few weeks are tough and you feel very tired after your workouts. With time you will have more energy throughout the day and you will begin to look forward to the endorphines that are released during your workouts.

1) No time - "I can't fit in exercise with my busy life"

Work and family take up a majority of people's day. If you wait until end of the day to squeeze in a workout, you probably won't be making it to the gym. Workouts should be scheduled into your week and they should be one of the most important items on your "to do" list. This is time you are committing to make yourself a better and healthier every week. I always find it amazing that people can always make time to meet with their personal trainer, but can't find time to workout on their own. It's a matter of scheduling and prioritizing.

Total knee arthroplasty has become a reliable surgical procedure to treat painful degenerative arthritis. Pain relief and functional improvement is excellent and can allow patients to maintain an active lifestyle. Criteria for the type of prostheses selected should include diagnosis, age, functional level, severity of the disease, and patient expectations. Improved instrumentation, attention to surgical detail, including soft tissue balancing of the knee, and the use of polyethylene inserts greater than 8 mm have led to excellent long-term results and low failure rates. Recent improvements in revision total knee systems should significantly improve the long-term results of revision knee arthroplasty. The addition of modular implants has greatly increased the versatility of most systems and allows the surgeon to custom tailor the implant, contingent upon the amount of bony and ligamentous deficiency of the knee. The future goals of total knee arthroplasty include the development of knee systems that mimic normal joint kinematics with improved fixation and decreased polyethylene wear rates. (Scott David Martin, Richard D. Scott, Thomas S. Thornhill. J Orthop Sports Phys Ther. Current Concepts of Total Knee Arthroplasty 1998;28(4):252-261.)

The primary impairments related to osteoarthritis and post-operative total knee arthroplasty (TKA) include a decrease in knee range of motion and loss of strength. One study by Mizner, Petterson, and Snyder-Mackler concluded that there is a high correlation between quadriceps strength and functional performance. This suggests that improved postoperative quadriceps strengthening is important to enhance the potential benefits of TKA. Moreover, intensive rehabilitation should be promoted in the subacute recovery period after TKA to optimize functional outcomes in the first year post surgery. As physical therapists, Josh and I have seen great results in our TKA patients through education, exercise, and manual therapy. We emphasize knee strength and stability, proprioception (where your body thinks you are in space), and knee extension (straightening). Lacking total knee extension could lead to altered gait patterns resulting in low back pain or hip pain. Although rehabilitation is a bit painful, it is a relatively short period of time of discomfort for such long term benefits.

New research out of the University of Delaware (UD) indicates that women, more than men, may wait too long to pursue knee-replacement surgery. "By postponing surgery until they can no longer stand the pain, these women also may risk putting their mobility-and their quality of life-on hold indefinitely," says Lynn Snyder-Mackler, PT, ScD, SCS, ATC, FAPTA, distinguished alumni professor in UD's Department of Physical Therapy and a certified sports physical therapist and athletic trainer. "Physicians typically tell patients to wait to have knee replacements until they just can't stand the pain any longer," Snyder-Mackler said. "Our research shows that may be bad advice-and worse for women than it is for men-because your level of function going into surgery generally dictates your level of function after surgery," she noted. "Osteoarthritis of the knee is the most common cause of disability among Americans. It's a disease of age that affects more women than men on a 60-40 basis," Snyder-Mackler said. "Physicians generally have advised patients to wait as long as they can before pursuing knee replacements, with the thinking that it is a once-in-a-lifetime surgery that should last an average of 20 years."

In consideration of revision arthroplasty, a study in the July issue of Journal of Rheumatology (Vol 31, No 7) explained that physical activity does not appear to be a risk factor. Therefore, individuals undergoing primary total knee arthoplasty (TKA) should be encouraged to remain active after surgery. We have recently attended a seminar on TKA by Dr. Colorito who encouraged candidates for surgery not to wait for new technology, because it could be a very long wait...especially when in considerable pain.

Physical therapists are health care professionals who diagnose and manage individuals of all ages who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. Physical therapists examine each individual and develop a plan of care using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. Physical therapists also work with individuals to prevent the loss of mobility by developing fitness- and wellness-oriented programs for healthier and more active lifestyles.