The Strength of Therapy

When Reid needed to build strength before his knee replacement surgery, he received a new type of therapy.

At 78 years old, Reid Ethington has always been an active guy. He enjoys playing sports, gol ng, and walking. In 1969, he had his knee operated on. After the operation, Reid says, “It’s been bone on bone since then and I’ve had no trouble.”

“In this case, ‘bone on bone’ means there is no cartilage in the knee, and cartilage is what helps the two bones in the knee move together,” says Katie Darkow, a physical therapist with Boone erapy.

Reid was having no problems with his knee until he and his wife Betty took a vacation to the Gulf a few years ago. Turns out walking on the sand really irritated his knee, and it was very painful to get home.

Over the years, Reid would “tweak” his knee, but it wasn’t anything that he thought needed surgery.

Reid started playing pickleball with his friends, one of whom happens to be a nurse. After several games, Reid really started having problems with his knee, so his friend introduced him to Benjamin Holt, MD at Columbia Orthopaedic Group.

After discussing options with Dr. Holt, Reid determined the best option would be to replace the knee. So, surgery was scheduled, and Reid was headed o to prehab.

Prehab is therapy done before an event, like knee surgery, with exercises to provide strength, avoid injury or decrease pain.

When Reid met Katie, he told her he was going to have a knee replacement and wanted to get stronger. Katie saw how active Reid was and wanted him to build as much strength in his knee as possible. She recommended Blood Flow Restriction erapy. is type of therapy is used often to build strength in a limb without having to add weight to the limb during activities or exercise. As Katie explains: “It is essentially like a blood pressure cu that you can put on any area of the body. So with Reid, because we’re working on his knee, we put the cu on his thigh to measure total limb occlusion. Treatment is then completed at partial limb occlusion.” Limb occlusion safely reduces the blood ow to the limb being treated.

“I would have Reid relax while the cu pumps, similar to a normal blood pressure cu , and the machine safely determines when the total loss of blood ow occurs. From there, I can set the machine to a safe occlusion percentage, always starting o at a lower range and with patient tolerance in mind. Limiting the blood ow within a safe range creates a situation in which the muscles are required to work harder to complete the exercise. is allows for increased strength gains in a shorter amount of time than traditional exercise.”

Without the blood ow restriction therapy, Reid might have added an ankle weight to his leg lifts, which could have added more pressure to his knee. “Blood ow restriction therapy was the easiest way to get that strength from him without causing more knee pain,” Katie says.

Before prehab, Reid had problems going up and down the stairs of his house. Living in a house that doesn’t have a bedroom or complete bathroom on the rst oor required him to use his stairs often. With his knee pain, Reid wasn’t able to take the stairs very quickly, and it was painful.

After a few sessions with Katie, Reid could tell that his leg was indeed getting stronger. “By the time we were done, I could go up and down the stairs at a normal pace without pain in the joint,” Reid recalls. e drawback of blood ow restriction therapy is that the therapy can feel uncomfortable. Imagine your arm in a blood pressure cu , but you’re wondering if it’s every going to stop pumping and getting tighter around your arm.

Reid quickly learned that he couldn’t wear his normal Bermuda shorts because they were too uncomfortable in the cu . He wore a pair of gym shorts made of a thinner material, which made all the di erence. “You’re doing exercises with the leg while it’s restricted, and that can be uncomfortable, but it does get easier, and it’s just a part of therapy,” Reid says. “You have to look towards the end goal, which is to improve the strength in the leg, and you have to grin and bear it.”

Reid was able to do blood ow restriction along with his more typical therapy exercises, including leg lifts, sit to stand, and stair steps.

Blood ow restriction therapy can help a patient build strength both before or after surgery. After Reid has his knee replacement surgery, he will return to Boone erapy and Katie for rehab and more blood ow restriction therapy.

Reid has nothing but positive things to say about his experience. “I was pleasantly surprised by this type of therapy and I can recommend it to people, and it does work”. By Erin Wegner