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Wednesday with WVPT
Author: Ryan Hubbard
April 19th 2017 - Can I golf after a Total Joint Replacement?
Let’s face the facts, as we get older the motions and activities we once would perform with ease can become painful.  I say “we” because I am finding that I can no longer walk out onto the first tee and swing without warming up like I used to.  When the joint aches and pains are not remedied with stretching/strengthening we become more concerned that your joints may be developing arthritis.  However, it isn’t until the more advanced stages of arthritis when you may start discussing potential joint replacement surgery with your doctor or health professional.  This of course being the last resort if other conservative measures such as Physical Therapy, injections or other minor surgeries do not help your pain first.  I do receive a lot of questions regarding return to sport following joint replacement and thought this would be a good topic for this week’s “Wednesdays with WVPT”.
Before we jump into joint replacement surgery we need to talk about the dreaded “arthritis”.  You more than likely have been told in your life that, “arthritis runs in our family” or “that injury will likely result in arthritis”.  But don’t panic, for a few reasons:
  1. Everyone develops arthritis to some degree
  2. There are different stages of arthritis
  3. Just because your joint is painful, doesn’t mean it is arthritic
  4. Not everyone needs/or is appropriate for joint replacement
  5. Physical Therapy can help
Okay that was more than a few, but I had to throw that last one in there. Now, the only way to really diagnose arthritis is through medical imaging such as x-rays.  X-rays can give your doctor a clear picture of the amount of joint space between your bones.  They can also determine the integrity of the bony surfaces.  Arthritis occurs when the bony surfaces are worn down and no longer smooth.  As a result the bones cannot move fluidly together to produce proper joint motion.  Over time the joint surfaces wear down and an inflammatory response occurs.  As this becomes more chronic, BOOM: arthritis.   When I was younger I tore my anterior cruciate ligament (ACL) and meniscus in my knee and had to have surgery.  Both were repaired successfully, but studies show there is 2-3 times more chance that my knee will develop arthritis and potentially need a joint replacement in the future (no need to cry for me).  As someone that has worked with many joint replacement patients I take solace in that this will not be a death sentence for me.  Now I’ll explain why.
The joints that are most likely to be replaced are the knee, hip, and shoulder.  For each joint there are different approaches, techniques, and surgeon preferences.  Going back in history depending on which source you read, the first knee replacement surgery was performed around 1890 in Germany and the first shoulder replacement surgery came after in 1893 in France.  As you can imagine that they have made great strides and medical advances since then.  Even over the past 10 years patients undergoing joint surgery are having a shorter hospital stays (leaving the same day), less invasive procedures (smaller incisions and less tissue to cut through), and implants are lasting much longer (up to 20-25 years).  Now, more than 540,000 knee replacements are performed annually in the United States (Riverview medical). That’s a lot of metal!
I take a lot of pride treating clients with joint replacement because in New Hampshire we are surrounded by some of the best orthopedic surgeons in New England.  I take it as a challenge to maximize the potential of each patient and continue the standards that each surgeon has for themselves.  In reality there is no cookie cutter approach to joint replacement therapy or any physical therapy for that matter.  Each patient and joint is individualized.  I really love it when my patients have set goals for themselves like returning to the golf course for example.  After the proper strength progressions and balance training, I am confident I can get anyone back to the golf course, perhaps with a more stable swing then they even had before.  For anyone who undergoes joint replacement, returning to the golf course is an attainable goal with the proper post-operative care. 
If you have any questions about joint pain, joint replacement or Physical Therapy please do not hesitate to contact us at (603)335-4700 or email me at  Stay tuned for the next edition of “Wednesdays with WVPT” when I discuss exercises on how you can build a better base to your golf swing.

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