Nadine Gregerson – Welia Health
Welia Health Connections
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Nadine Gregerson

The many ways to keep joints working.

When you start feeling joint stiffness or pain in your knees or hips, you might think your only option is surgery. While surgery is one possible path—and sometimes a necessary path—at Welia Health, we work with patients to find the best way forward from multiple choices.

Dr. Thomas Mullin, a Sports Medicine provider at Welia Health has outlined an overview of some of the available options. If you’d like to explore a new approach, call Welia Health at 1.800.245.5671. The sports medicine team can set your baseline and work with you to find a great path to being mobile, flexible, pain-free and active.

It’s all part of Welia Health’s approach to helping you live life well.

It’s time to move

If you’re looking for an easy place to start, the surprising answer is movement. Research shows that getting physically active with regular exercise can reduce arthritis pain. Aim for exercise 30 minutes a day but start with as little as 6-10 minutes. It may take 6-8 weeks to start feeling a difference, so set realistic expectations and have patience with yourself—especially if you haven’t worked out in a while.

In terms of the kinds of exercises to help your knees and hips, avoid anything that causes pain or includes pounding or jumping. Some good low-impact options are yoga, walking, elliptical, pool, biking and Tai chi—basically anything that’s not putting impact stress on your joints. Talk to your primary care provider or the team at the Welia Center—we can help get you started well on your exercise plan.

As for your approach, there’s an acronym from the CDC—S.M.A.R.T.—that offers a handy perspective:

  • Start low and go slow. Exercise for 3 to 5 minutes twice daily and increase as tolerated.
  • Modify activity when arthritis symptoms increase but stay active. Decrease the frequency, duration, or intensity of exercise in order to stay moving.
  • Activities should be joint-friendly. Engage in low-impact exercises.
  • Recognize safe ways (like exercise classes led by a trained instructor) and safe places to be active.
  • Talk to a health professional or certified exercise specialist.

Most importantly, think of exercise as a normal part of the day rather than something daunting. When you’re out and about, park further from your destination and get in a short walk. Engage friends as partners in your exercise goals. Find those exercises you enjoy doing. Soon, you may actually find you’ll miss exercise when you skip a day.

woman doing plank exercise
Talk with your provider about what exercises or stretches might be right for you.

Tip the scales in your favor.

Movement is one part of a solution to joint pain, and weight is another. Put enough pressure on any of our body’s flex points, and we’re bound to feel soreness. So achieving and maintaining a healthy body weight is a great way to keep soreness at bay.

The fact is, losing 1 pound of body weight removes 4 pounds of stress on the knee joints, and that stress from extra body weight is often what causes pain. You can actually reduce your risk of developing knee osteoarthritis by 50% by losing 10-20 pounds—and, as a bonus, you’ll feel more active and energetic. And the benefit is not just in your knees and hips; there are studies showing that being overweight can increase the risk of arthritis in non-weight-bearing bones like your hands.

For any one of us, the weight we carry often reflects years of patterns of living and eating, but the good news is: patterns can be changed. Talk to your provider for the best way to eat well and lose weight to care for your joints—we’ll connect you with the right dietitians, support groups and physical therapists to help you make your goals.

Keep soreness at bay by maintaining or working towards a healthy body weight.

Extra help where you need it most.

Physical therapy—with leading care at well-designed facilities like we have at Welia Health—can be another important tool in your joint-pain toolbox.

There are movements and training you can do with experienced physical therapists to move more efficiently, and our team may be able to help you get healthier faster than you can on your own. We can also address any biomechanical factors that may be holding you back. Working with you, we may even uncover things about your body that you never knew, unlocking the potential for a more active life.

Because of the training our caregivers receive, Welia Health physical therapists can also recommend devices like sleeves and support braces, unloader braces and heel wedges. In the right circumstances, simple devices can make world of difference to get to the life you want to live.

Reduce swelling and pain.

Medications and supplements also might be part of your treatment plan, and the critical word is plan. Consult with a doctor or pharmacist to create the best way forward, especially around medications, because, in addition to the health benefits, there can be risks that need to be taken seriously.

NSAIDS—which are nonsteroidal anti-inflammatory medications (like aspirin, ibuprofen and naproxen and Diclofenac)—help by reducing swelling and pain and can be effective in the right circumstances. There are also medicated creams for areas of concern (like 1% Diclofenac gel, Capsaicin, topical lidocaine) and patches like Salonpas. Tumeric, glucosamine and chondroitin are dietary supplements that can be helpful in reducing pain in certain patients. All medications and supplements carry the risk of side effects and interactions with medications so discuss any medication or supplements with your physician before starting.

In some cases, injections can also work well to provide long-term relief, and these include corticosteroid injections, viscosupplementation injections (Synvisc One, Euflexxa, Monovisc, Gel-One) or Platelet Rich Plasma Injections. Our doctors can discuss with you whether medications, supplements, creams or injections (and the variety of options within each category) would work well for your situation.

Here’s the good news: you have options.

There’s a range good paths when it comes to dealing with joint stiffness and pain of our knees and hips—from stretches and anti-inflammation medications to surgery. The key is finding the path that works best for you. And as time passes and your situation changes, we can help you re-evaluate your approach.

Questions about your knees or hips?

Call your primary care provider or Dr. Mullin at 1.800.245.5671 to schedule a time to talk and discuss the next steps.


Nadine Gregerson

Recovering well from joint surgery

When prepping for hip or knee surgery, it’s important to know that what comes after surgery is just as important. So what can you expect?

For typical cases, your doctor will want you to start walking short distances within the first day of surgery. In 3-6 weeks, you should be able to resume normal activities, and, within 3-4 months, you’ll feel completely yourself again—except better.

Here are some ideas to make your recovery process smoother and faster.

Tips for easier rehab

There are three things you can do before surgery that make a world of difference.

  1. Do prehabilitation—the pre-surgery recommendations for strength, flexibility and endurance. Getting your body ready for surgery is not hard, and it helps you heal faster. Learn more >
  2. Get support. Talk to a few people you can rely on. Meal prep is helpful, but also think through any shopping, errands and cleaning you might need. You likely won’t be able to drive for 3-6 weeks, so plan accordingly.
  3. Ready your space—and your schedule. Don’t expect to be able to do much at first. Empty your schedule and ready your house accordingly. Put the things you’ll need within easy reach (without bending or stretching), like phones, remotes, books, tissues and medicines. If you have a low toilet seat, consider adding an elevated seat.
Woman eating healthy
Eating healthy after surgery can increase your healing and energy.

Post-surgery recovery

Once you’re home from surgery, you’ll have instructions to help you with your care. Here are some of the things you can do to help recovery:

  1. Care for your incision. We’ll provide you with steps on keeping the incision site clean and healing appropriately. Call right away if you see redness, drainage or get flu-like symptoms, like chills or fever.
  2. Pay attention to your body. You will likely have swelling, so keep your legs elevated 4-5 times a day for 30-45 minutes. Ease pain by applying ice packs for 15-20 minutes at a time. Take anti-inflammatory medicine as recommended by your doctor.
  3. Move your body early and often. Movement is the best way to prevent blood clots, so getting up and around on your crutches, cane or walker is very important.
  4. Pay attention to what you eat. Healthy meals can keep you from gaining weight during those times you can’t move as much. Make sure you eat plenty of fruits, vegetables and protein. And drink lots of water as it helps incisions heal.
  5. Start your home exercise routine. Start slow and easy—even a few minutes at a time—and gradually increase what you can do. You will have scheduled appointments with Welia Health’s physical therapists several times a week, so we’ll help guide you. Your home exercise program will help you get back your strength, flexibility and mobility, and starting while you are on the mend is a great way to build a habit.
  6. Follow up with your doctor. For the first year after surgery, it’s important to check in with your surgeon at the scheduled follow-up appointments to see how your recovery is progressing.

Recovering well from surgery isn’t hard. It just takes intention. So plan ahead for the best post-surgery recovery.

Additional resources

Nadine Gregerson

Prehabilitation makes hip rehabilitation easier.

Hip or knee replacement surgery on the horizon? What you do today can help you get back on your feet faster after surgery.

It’s called prehabilitation—or, as it’s commonly called, prehab—the idea that the prep work we do before surgery makes a big difference on how we bounce back. The right prehab can make post-operation rehab shorter, smoother and less painful.

The best part about prehab is it’s easy to add it into your daily life. Just a few minutes each day can make a big difference.

How do you begin? If you haven’t already, consult with your primary care provider about your joint issues. Or, if you’re on the schedule for surgery, talk to Welia Health physical therapists for the best advice.

Simple prehab for faster rehab.

Prehab includes a few things that can help make post-joint-replacement rehab easier. Good prehab routines suggest you:

  1. Move. Try to stay as active as possible while keeping painful symptoms at a manageable level. Constant and frequent movement—as you’re able—is the easiest shift you can make for smoother recovery. Simple things like walking everyday (even through winter at Welia Center’s indoor track) or choosing a parking spot from where you shop are simple steps that add up and get your body ready for change.
  2. Do brief, daily exercises. If you can strengthen key muscles, improve flexibility and extend your range of motion, it tends to dramatically improve your recovery from surgery. Our Welia Health physical therapists will give you specific prehab stretches and movements to make rehab easier. Each plan is specifically built for you based on your particular needs and symptoms.
  3. Eat well. It’s no surprise that weight stresses joints. In fact, when we lose a single pound of weight, we take 4-5 pounds of pressure off our joints. Small changes like switching a portion of mealtime carbs for vegetables or fruit are things you can do right now, or consider engaging a Welia Health dietitians who will customize a plan just for you. Losing any excess weight means your muscles have less work to do as you recover after surgery.
  4. Improve balance. Good balance goes a long way toward a healthy, active life. When you talk to our physical therapists, they will also help you with exercises for balance, which is important during rehab and beyond.
  5. Hydrate. Healthy cells, muscles and organs start with hydration—and hydrated cells heal faster, which can reduce scar tissue. As an extra bonus, hydration will also reduce your muscle soreness, help maintain body temperature and improve digestion. Download our Guide to Healthy Hydration
Small, 8oz cups of water throughout the day is a great way to get the water you need.

The best benefit of prehabilitation is it reduces stiffness and pain, and sets the stage for a faster recovery. Not to mention, a healthy and active prehab path will help you feel better mentally. So, as you consider knee and hip replacement surgery, adding prehab into your routine can improve recovery, but also sweeten life today.


Additional Resources

Considering joint surgery? Here is how to know when is the right time >

Preparing for joint surgery >

Joint surgery recovery >


Nadine Gregerson

If you’re wondering when (and if) to get hip or knee replacement surgery, you’re not alone. That’s the number one question our doctors at Welia Health hear when a joint starts to influence what someone can do comfortably.

The question’s a good one. There are lot of things you can do before surgery—maybe even to avoid surgery all together. At the same time, wait too long and you might not get the full benefit of a new joint. Gradual inactivity and bone wear can actually make surgery less effective.

The great thing is, the first step is easy: it’s just a conversation.

Read more >


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