Thursday, August 22, 2013

Aqua Mixes Pleasingly Into Therapy Mix

Today, the opening day of school, I finally took my knee therapy to the community pool. Oh, I had splashed a few times with the grandkids during the summer, but this was the first opportunity to have the lap lanes -- indeed, the whole pool -- available to me. Bless the children; I am happy to see them playing and swimming on their vacation break. However, it is hard to do much serious rehab when you are constantly dodging tykes jumping into the pool and engaging in other splash-play. There now is no excuse for me to avoid adding aqua therapy to my regular workout routine.

Viewed hopefully, I can do pool therapy on a regular basis almost until Halloween. Yes, the facility is an outdoor pool, but the HOA keeps it open year-round, and last year the grandkids and I were still taking some suppertime dips late into October. Of course, we called the chillier dips "polar bear swims," but we were still in the game. If I do my therapy midday on sunny days of autumn, the temperatures should be a little warmer than in early evenings.

  I was beating myself up a bit for not having taken my bionic knee to aqua exercise before now, but then I read about the various restrictions on getting into the water before full healing of the surgical incision from the total knee arthroplasty (TKA). You should wait at least three to four weeks, allowing time for all scabs to fall off the incision, and by all means you should check with your doctor before starting. You don't want your incision or any portion of your TKA to become infected.

After clearance to start in the pool, my Knee Owner's Manual (Brugioni and Falkel)* offers this helpful perspective:

"Pool therapy is extremely beneficial for all aspects of TKA rehabilitation for the first three to six months after surgery. {That's right in my wheelhouse, at four months and counting.} After six months of rehabilitation, pool therapy is a great modality for a long-term exercise program because of the low-impact nature of the water. Some form of exercise is needed for long-term maintenance of the TKA as well as for cardiovascular health and weight control. If pool therapy is convenient and enjoyable, it is highly recommended as a form of exercise."

So I figure I am set now through my sixth month of rehab (October). I hope I have acquired such a positive addiction to this therapeutic exercise that I will then make the effort to drive to the "Y" pool for an afternoon swim during the winter.

As for exercises in the pool, I today basically just jogged the lap lanes, but with some jumping jacks added along with stretching at the end of each lap. You can find online or in books on this topic dozens of moves to try. From my trusty Manual, I found one I probably never would have thought of: "Walking Backward in Pool" -- "This is a great exercise for strengthening and conditioning the hamstrings. Be careful to avoid running into anyone or anything." This is one aqua exercise that would have been particularly hard to pull off in a summertime pool filled with kiddies. Plus, everyone would have concluded that the old man had gone bonkers.

On Day One, I limited myself to 40 minutes, not wanting to overdo it. I had just reached the point of feeling some cramping on the bottom of my right foot. That brought back memories of my very first experience with aqua therapy -- a decade ago, when lumbar spinal stenosis began intruding on my life. When I experienced cramping during aqua sessions, therapist Michele would halt the instruction and give me wonderful foot massages until all was better. Alas, I am on my own now, but I can heed her advice of drinking plenty of water and eating bananas to keep the hydration and potassium at good working levels.

©  Robert G. Holland

Showing the bionic knee after aqua therapy.

* The full title of the book I have been referring to as my Knee Owner's Manual is: Total Knee Replacement & Rehabilitation: The Knee Owner' Manual, by Daniel J. Brugioni, M.D., and Jeff Falkel, Ph.D., P.T., CSCS, Hunter House, Inc., 2004.

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