Knee Surgery: The Essential Guide to Total Knee Recovery - Softcover

O'neill, Daniel Fulham

 
9780312362935: Knee Surgery: The Essential Guide to Total Knee Recovery

Inhaltsangabe

<p><b>In this age of same-day surgery and do-it-yourself health, <i>Knee Surgery</i> presents an easy-to-do, well-illustrated program of movement for knee rehabilitation - with a special focus on the mind/body connection - and describes the physical and mental rehabilitation process in complete detail, providing all the guidance you need to decrease pain and increase fitness after knee surgery. </b><br><br>Millions of people have knee surgery each year, and in the years to come millions more will head to the O.R. Chances are, you or someone you know has had or will undergo knee surgery. Busy doctors, therapists, and athletic trainers have limited time to spend on quality physical and mental rehabilitation education, yet this is the key to full recovery.<br><br>Written by renowned knee surgeon and Sport Psychologist Daniel F. O'Neill, M.D., Ed.D., this comprehensive and accessible guide presents what you'll want and need the most after knee surgery: a scientifically-based recovery program you can understand that will get you back to work and sports as quickly as possible.</p>

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Über die Autorin bzw. den Autor

Daniel Fulham O'Neill, M.D., Ed.D. is an orthopaedic surgeon specializing in sports medicine and holds a doctorate in Sport Psychology from Boston University. He is director of The Alpine Clinic, his private practice in New Hampshire, and for nearly twenty years has been the associate physician for the U.S. Ski Team. Dr. O'Neill serves as team physician for Burke Mountain Ski Academy in Vermont and is the founder of Coaching Mental Excellence, an organization that helps athletes deal with their injuries and the recovery and rehabilitation processes.

His books include Knee Surgery: The Essential Guide to Total Knee Recovery and Survival of the Fit: How Physical Education Ensures Academic Achievement and a Healthy Life.

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Knee Surgery

The Essential Guide to Total Knee RecoveryBy Daniel Fulham O'Neill

St. Martin's Griffin

Copyright © 2008 Daniel Fulham O'Neill
All right reserved.

ISBN: 9780312362935
Knee Surgery
PART ONE
JOURNEY INTO SURGERY
1
THE ROAD TO KNEE SURGE
The Anatomy and Pathology You Need to Know Before Starting Your Journey
WHETHER WE ARE making our way across an icy parking lot, stepping into a canoe, or just getting out of bed, all of us perform athletic maneuvers daily. When a knee injury becomes part of the equation, the way you get better is no different from the way Tiger Woods recovers. The activity level you return to might be different, but the road traveled is the same.
The knee is a strong, hardworking joint. It helps us walk, get in and out of cars, do yoga, play football, ride horses, etc. Every day we depend on our knees for literally thousands of movements--some that we perform intentionally and others we don't even think about. In spite of their strength, knees tend to get hurt. Whether from arthritis, athletics, oroveruse, almost everyone will have knee pain at some point in his or her life. To complicate matters, the knee has a number of structures that simply do not heal after they are injured. This translates into lots of knees ending up on the operating table. If a knee operation is in your future, you are definitely not alone.
Whether your surgery is for an injury to the cartilage, ligament, tendon, or bone, the goal after the operation (post-op) is to get the knee joint moving fully and for your muscles to regain their functional qualities: balance, flexibility, coordination, strength, speed, and quickness. This is called rehabilitation, or rehab for short. An important part of rehab is having the right mental attitude. As you read the chapters that follow, you will learn concrete, practical steps for your physical and mental rehab that apply to the vast majority of knee injuries and surgeries. The care and feeding of all knees are alike, only the time lines for recovery vary.
Having knee surgery is a big deal and it's okay to be frustrated, angry, even scared. It is okay for now--not forever. Having any kind of physical problem can leave even the toughest person feeling vulnerable and mortal. The good news is that in the twenty-first century, medical technology can make almost any knee useful for most jobs and many sports. But let's not sugarcoat this: Recovery from knee surgery takes work. It's not like brain surgery where you either get better or you don't. Knee rehab involves a physical and mental process which, when performed properly and diligently, helps ensure a good, functional outcome. Another great thing about recovery from knee surgery is you get back more than what you put into it. Each stretch, each exercise, each movement pattern not only improves your knee but also works your back, your hips, your balance, and more. Getting into the habit of caring for your knee translates into caring for total fitness. Thus, with the right attitude, a good doctor, and this book, you will soon be speeding toward a healthier you!
ANATOMY AND PATHOLOGY OF THE KNEE
Before I get started talking about surgery, it will be helpful to develop a working knowledge of the knee's parts and functions. This will help you communicate with your doctor and therapist. As a bonus, this section will also prepare you for future episodes of Jeopardy!
Anatomy
Orthopedic surgeons, physical therapists, athletic trainers, and other sports medicine professionals spend their lives caring for the musculoskeletal system. This system consists of muscles, which provide movement, and bones, which form your body's internal frame. Muscles consist of multiple fibers that get larger and more efficient with exercise. There are more than four hundred muscles in the body, connecting more than two hundred bones. The muscles attach themselves to the bones via tendons.
Ligaments are tough fibrous tissues that connect bones to other bones. Ligaments can be thought of as similar to ropes because they have no ability to change their length. Due to this ropelike quality, we refer to ligaments as "static stabilizers." Conversely, muscles and tendons shorten and lengthen with motion and thus are called "dynamic stabilizers." Luckily, many ligament tears heal naturally on their own with time and activity modification. The medial collateral ligament of the knee is one such ligament (discussed later in this chapter).
Despite reasonable care, certain ligaments do not repair themselves. These include the anterior cruciate ligament (ACL) (connecting the femur to the tibia) and the capsular ligaments in the shoulder (dislocated shoulder). A rehabilitation program for an ACL tear or a dislocated shoulder will attempt to strengthen the muscles and tendons around the joint, but unless these ligaments are repaired surgically, the joint will always be vulnerable.
A joint is where two bones come together. At joints that have significant motion, the bone ends are covered with a smooth layer called articular or surface cartilage. In some joints, including the knee, there is a second type of cartilage called meniscal cartilage. Menisci are pieces of gristle that give extra stability and cushioning to the joint. In the case of the knee, the wrong type of motion can tear this piece of gristle. This typically results in the most common type of cartilage injury--a meniscus tear--but the same event can also injure the surface cartilage. Both types of cartilage have a poor nerve and blood supply and therefore little ability to heal once injured.
In a healthy knee, all of the structures--bone, surface cartilage, meniscal cartilage, muscles, tendons, ligaments, bursa, and skin--work together in a beautiful symphony of motion. Unfortunately, when any part of the orchestra isdamaged, it can affect the function of the entire joint. Damage to a ligament causes instability and undue pressure on the cartilage. A tear of the meniscus can cause inflammation and a sense of locking with some movements. A pulled muscle limits motion and thus can cause scarring of other structures. The list of possible maladies can be long, but the treatment of most is the same: Repair the injured structure and proceed to regain full range of motion, strength, coordination, balance, etc.
Pathology
CARTILAGE INJURIES
As discussed earlier, when you hear about someone tearing cartilage, most often that refers to the meniscal cartilage, pieces of gristle between the femur and tibia that act as gaskets or spacers (see knee anatomy illustration). Their job is stability, cushioning, and protecting the surface (articular) cartilage. Not all meniscal cartilage tears require surgery, but if they cause swelling, catching, and pain, the best chance for a cure is arthroscopy. The surgeon removes the torn bits, or--in a less common situation--throws in some stitches. (A more complete description of arthroscopic surgery comes later in this chapter.)
Damage to the surface (articular) cartilage is called arthritis. The suffix -itis means "inflammation," as in tendinitis (inflammation of a tendon), arthritis (inflammation of a joint), or bursitis (a bursa is a lubricated sac that allows parts of the body to slide...

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