2023-05-02 09:00:00
Anyone who prepares for joint replacement surgery in a targeted manner improves the chances of success. Physio professional Tobias Homburg knows how knees, shoulders and hips heal better.
When they need an artificial joint, most patients value a first-class surgeon. Many also think about their outpatient or inpatient rehabilitation stay in their desired clinic at an early stage. However, what is often not considered: Optimal preparation for the procedure is also important. “Holistic preparation reduces the risk of complications after the operation and you save valuable time in rehabilitation,” emphasizes Tobias Homburg, head of the THerapie.Welt practice in Munich-Bogenhausen.
Joint replacement surgery: improve wound healing and optimally prepare for rehabilitation
The physiotherapist, who also looks after the national biathlon team, has developed a special concept for joint replacement patients. Among other things, it consists of building blocks such as a training program, physiotherapy, tips for nutrition and lifestyle, knowledge about wound healing and Brain Train, an innovative exercise program for the brain. “Our strategy is aimed at improving wound healing and optimally preparing for rehabilitation. In principle, we shift part of the rehab to before the operation,” explains Homburg.
Analysis of muscles, signs of inflammation and hormone status
The program is tailored to each patient. The basis is an analysis of his current state of health. The experts check the condition of the diseased joint with muscles, tendons and ligaments – for example, pay attention to signs of inflammation, mobility and function. In addition, the hormone status, the immune system and the nervous system are also taken into account. Eating habits, lifestyle, sleep and stress levels are also in focus. Based on the results, we create an individual intervention plan. In addition to treatments in the practice, it also includes many measures that the patient can implement in everyday life, including training and nutrition tips,” explains Homburg.
Physiotherapist Tobias Homburg: Patient can influence wound healing
After the operation, the main concern is to stimulate wound healing. Therefore, if possible, all harmful factors should be eliminated beforehand and favorable influences promoted. “We explain to patients how they can influence wound healing themselves. For example, cold can be a means of relieving pain. But if you cool the wound too much, the metabolism is inhibited – and this in turn is very important for wound healing,” explains Homburg and names a few key points of surgical preparation:
Training: Good muscles accelerate rehabilitation after joint replacement surgery
Scientific analyzes show that good muscles around the artificial joint accelerate rehabilitation after the operation and improve the function of the prosthesis in the long term. The rule of thumb is: Before the operation, you should reach about 90 percent of the strength of the healthy opposing joint – i.e. the other knee, hip or shoulder. In rehabilitation, the patient often has to perform exercises and movements that were already difficult for him before the operation. This should be trained intensively in the preparation. This way you can fully concentrate on the operated joint during rehabilitation.
Lifestyle: Increased stress level before joint replacement surgery is poison for the healing process
If the stress level is high, countermeasures should be taken in good time before the operation. You can influence the autonomic nervous system with certain exercises. This controls, among other things, breathing, heartbeat and metabolism. “Specifically, it’s about activating a certain part of the nervous system – the so-called parasympathetic nervous system. “It promotes the healing and regeneration process. On the other hand, when the other part of the nervous system, the sympathetic, dominates, the vessels constrict. As a result, less oxygen and nutrients reach the surgical area. This can have an unfavorable effect on wound healing,” explains Homburg.
Nutrition: Vitamin C helps heal ligaments, tendons, skin and muscle sheaths
Wound healing can also be positively influenced by a conscious diet or nutrients. Omega-3 fatty acids help to end the inflammatory phase. “Among other things, vitamin C is important for the networking of connective tissue fibers, for example in ligaments, tendons, skin and muscle sheaths,” says physiotherapist Homburg.
Brain Train: Training with imagination techniques brings a real effect
The patient should practice this technique before the operation in order to be able to implement it immediately after the operation. This is a mental strategy that uses the imagination of the brain. Similar techniques are also used by professional athletes, such as skiers. Before they set off, they run through the entire route in their heads. The brain train is about imagining certain movements – as if you were actually doing them. “This means that the patient can take the first steps in rehabilitation during the acute phase of inflammation without putting pressure on the hip, knee or shoulder and interfering with their healing,” reports Homburg. “For example, if the patient is not yet allowed to jog, he can already do the first lap in his mind. This training with so-called imagination techniques has a real effect: you get fit faster later when you actually run.”
This article only contains general information on the respective health topic and is therefore not intended for self-diagnosis, treatment or medication. In no way does it replace a visit to the doctor. Unfortunately, our editors are not allowed to answer individual questions about clinical pictures.
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