Progression Strategies

by Chuck Wolf

I have been privileged to work with a diverse population with different ailments, including knee and hip replacement patients. I typically started with them about 6 weeks post-op. This experience has given me a deeper empathy for those that have undergone surgical procedures. All too often we take for granted the simplest movements. As health and fitness professionals, we often use the term "gait re- education" quite judiciously. To use it haphazardly is one thing, to truly experience it is another. Having been very active, I cannot tell you how upsetting, frustrating, and humbling it is as to try and do a simple knee extension and not be able to do it.

When rehabbing my new knee, I would be sitting with my knee flexed approximately 25 degrees. I my mind I thought extend, but nothing was happening. No matter how hard I tried, that joint would not budged. I realized I had to start with a more basic approach, isometrics. After 2-3 weeks of straight leg raises, muscle energy techniques, and assisted knee extensions, I finally was able to lift my foot off the floor....only about an inch, but it felt as if I had accomplished a 1000 pound lift. I began to cry as my wife smiled, laughed and told me how proud she was of me.

The process I have used with post-surgical clients/patients in the past has included isometric techniques, progress to muscle energy techniques, then isolated, uni-planar exercise, and lastly followed with integrated, tri-plane movement patterns. I have used this approach for years and now can say, from my personal experience, it works very well! More to come...

To your good health!