Having seen Eamonn Homes on Twitter up and about on crutches after a hip replacement (good work), I thought I would share a few tips that I give to people undergoing orthopaedic surgery. Hip replacements and knee replacements are common nowadays but there is always a person going through the procedure with his or her hopes, dreams, fears and past experiences. As one of my greatest influence’s, Oliver Sacks, would always say, it is as much the person as the condition. Each person’s experience is unique to them and necessitates validation and respect.
- Pre-operatively, understand your pain so that you have a working knowledge to enable you to deal with it effectively. The pain is normal, not to be feared, instead to be overcome with the right actions post-operatively. In many, many cases the operation results in pain relief and a much improved quality of life.
- Post-operatively the pain needs to be well controlled. Conversely, a predictor of on-going pain is poorly controlled pain at the outset, so keep talking to your doctors and nurses and inform them if you are suffering. On another level, the pain can dissuade you from that early movement and mobilisation that is important for recovery.
- Relaxing and calming techniques help your body to focus on healing. If you are unnecessarily stressed, anxious or fearful, important resources are diverted to protection and survival rather than healing. Common methods that I teach people are to use their working knowledge of their pain to reduce the threat and choose the right healthy action, mindfulness, visualisation, sensory exercises and breathing.
- Using motor imagery activates and exercises the areas of the brain that plan and execute movement. When movement is limited, these are great exercises to keep the higher centres working for you. The quality and precision of the way we move depends upon these representations and they need to be accurate. Some of this accuracy is lost when we are in pain or not moving normally. Imagine moving your hip, knee, foot and walking; all these are simple and you can do them as often as you like. Visualisations are also a great way of creating calm and motivating you to take the right action. Remember, when you think about something, your brain and mind are very active but with your body — our minds are embodied, in other words an extension of, and part of our thinking (embodied cognition).
- If you are anticipating that a movement will hurt, visualise the end position (e.g. standing up) and then imagine the act of standing up over and over (10-15 reps) and then do it.
There are many other sensorimotor execises and techniques that a person can use over and above the standard movements and post-operative exercises (and pre-operatively), to get the best outcome. In essence, it is about creating the right conditions for healing and recovery, holding a vision of how you want to be and then work towards that vision (dealing with distractions on the way — e.g. fears, worries, negative messages) of health and a meaningful life.
This is the way of the Pain Coach Programme | t. 07518 445493