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Yoga and Joint Replacements. Steffany Moonaz, PhD, RYT-500. Not too soon. Damage to surrounding tissues Consider lifespan of surgical technique Don’t take surgery too lightly Consider all management strategies Weight loss Strengthen surrounding tissues Pain management. Not too late.
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Yoga and Joint Replacements Steffany Moonaz, PhD, RYT-500
Not too soon • Damage to surrounding tissues • Consider lifespan of surgical technique • Don’t take surgery too lightly • Consider all management strategies • Weight loss • Strengthen surrounding tissues • Pain management
Not too late • Is QOL compromised? • Is posture compromised? • Relationship between fitness and recovery • “Bone-on-bone” • Pain is a subjective, individual experience
Before Surgery • Set timeline with doc • Work around/with pain • Consider fitness for best recovery • Encourage education about options • Ask doc about recovery process
Recovery Process • Get written permission to speak with doc • Get written report of movement limitations • Focus on other aspects of yoga practice • Breathing • Mindful movement • Relaxation • Meditation • Hope and Planning • Support network
After One Year • Get clear about type of procedure • Know the movement limitations of each • They are an expert on how the joint works • Less about pain than ROM, function
Knees • Non-constrained • Most common • Relies on ligaments, muscles • Work on stability • Semi-constrained • More stable • Some/all ligaments removed • Constrained or hinged • Severely damaged knees • Elderly • Revision procedures • Doesn’t last as long • Unicondylar • Only one half replaced • Some surgeons still opt for full replacement
Recovery Exercises- Knee • Quadriceps setting (contraction) • Terminal knee extension (rolled towel under knees) • Heels slides (toward glutes, slight stretch) • Straight leg raising (opposite bent) • Pillow squeezes (adductors)
Hips • Cemented • Age 60+ • Gold standard • Substance between bone and artificial component • Non-cemented • Bone grows into metal • Young, active candidates (loosen components) • Scar tissue acts as cement • Hybrid fixation • No cement on socket, cement on femur • Surface Replacement • Neck of femur is preserved
Recovery Limitations- Hips • For 6-8 weeks: • Avoid bending the hip beyond 90 degrees. (Consider sitting surfaces. Raise hips.) • Avoid bending over from the hip. • Avoid crossing the surgical leg over the non-surgical leg. • Keep the legs three to six inches apart. • Avoid turning the operated leg inward (pigeon-toed)
Shoulders • Standard • One or both components replaced • May be smoothed or capped with metal, plastic • Cemented or uncemented • Reverse • Newer procedure • Not all surgeons will perform it • Ball becomes socket and vice-versa • Allows more ROM (above shoulder height)
Shoulder recovery • No use of muscles for 6 weeks (pulleys, sling, support during sleep) • 3 months of gradual muscle use, stretching, rehab • More intense muscle use after 3 months • 2 years of antibiotics before medical procedures, dental work • Intended for ADLs, not repetitive motion
Important Questions • Why do you need to know about these procedures? • What is your role in each stage (before, recovery, long term)? • Can/should you communicate with medical providers? How? • What is the edge of your scope of work?