Should You Have Knee Replacement Surgery?

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Some experts question whether the surgery is being done too often or too soon on patients who have not adequately explored less invasive approaches.

For the vast majority of patients with debilitating knee pain, joint replacement surgery is considered an “elective” procedure.

While it’s true that one’s life doesn’t depend on it, what about quality of life? Many people hobbling about on painful knees would hardly regard the surgery as optional. Consider, for example, two people I know: a 56-year-old man passionate about tennis who can no longer run for a bus, let alone on the court, and a 67-year-old otherwise healthy woman with bone-on-bone arthritis who can’t walk without a cane or stand for more than a few minutes.

They have reason to think it may be time to replace their worn-out knees with artificial ones, an operation that is now among the most frequently performed costly medical procedures in the United States. But some leading medical economists are asking whether this surgery is being done too often or too soon on patients who have not adequately explored less invasive approaches to relieve their pain and improve their mobility.

I certainly had done due diligence before opting to have both knees replaced 14 years ago at age 63. I had wanted to wait longer, given that the life expectancy of artificial knees was then 10 to 15 years, and I would have liked Medicare to help foot the bill. I had no weight to lose and had done months of physical therapy that made me stronger but not better. I tried gel injections to no effect, and was living on anti-inflammatory drugs just to get through the day.

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Preventing Muscle Loss as We Age

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Sarcopenia, a decline in skeletal muscle in older people, contributes to loss of independence.

“Use it or lose it.” I’m sure you’re familiar with this advice. And I hope you’ve been following it. I certainly thought I was. I usually do two physical activities a day, alternating among walking, cycling and swimming. I do floor exercises for my back daily, walk up and down many stairs and tackle myriad physical tasks in and around my home.

My young friends at the Y say I’m in great shape, and I suppose I am compared to most 77-year-old women in America today. But I’ve noticed in recent years that I’m not as strong as I used to be. Loads I once carried rather easily are now difficult, and some are impossible.

Thanks to an admonition from a savvy physical therapist, Marilyn Moffat, a professor at New York University, I now know why. I, like many people past 50, have a condition called sarcopenia — a decline in skeletal muscle with age. It begins as early as age 40 and, without intervention, gets increasingly worse, with as much as half of muscle mass lost by age 70. (If you’re wondering, it’s replaced by fat and fibrous tissue, making muscles resemble a well-marbled steak.)

“Sarcopenia can be considered for muscle what osteoporosis is to bone,” Dr. John E. Morley, geriatrician at Saint Louis University School of Medicine, wrote in the journal Family Practice. He pointed out that up to 13 percent of people in their 60s and as many as half of those in their 80s have sarcopenia.

As Dr. Jeremy D. Walston, geriatrician at Johns Hopkins University School of Medicine, put it, “Sarcopenia is one of the most important causes of functional decline and loss of independence in older adults.”

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Roger Federer explains his ‘beautiful’ tennis style

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Roger Federer explains his ‘beautiful’ tennis style

“I play tennis and I try to entertain the crowd. Now, that it might look beautiful to some, I think that comes from having a one-handed backhand.

Serena Williams’ Therapeutic Use Exemptions

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Tandon: A closer look at Serena Williams’ Therapeutic Use Exemptions

But Stuart Miller, the ITF official who runs tennis‘ anti-doping program, … Tennis players play every single week, multiple times a week… they’re not like …. A few weeks ago, Williams and the anti-doping rules were back in the news …

Stop Chronic Injuries

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Tennis can be tough on your body!  Just ask Federer, Nadal and the typical club member at Manly Lawn.  It’s been cold, wet and windy in Sydney for Badge — the perfect recipe for injury!

At some point, particularly as we age, our injuries become chronic — and our recovery time between play becomes longer. The result: we play less and, even more, are less inclined to play!

For chronic injuries, the Guys from Trident may be able to help you like they did for me — and my bum shoulder. Their methodology — small, targeted interventions to keep you moving,  is similar to the Carrolls, the tennis trainers, who used to keep me on the courts in California.  US Nationals are typically five day events on brutal hard courts, so you needed all the help you could get to make it through to finals day — if you were good enough.

For the rest of us, here’s a link to a youtube series of dynamic warm-up and cool-down exercises that were created specifically for tennis players to stop injury or discomfort before it begins.  I have used a variation of Pete’s exercises for many years to continue to play competitively — here’s an example.

I can attest that these exercise, when done regularly, will help you feel more agile, relieve any joint or muscle tightness, and ensure that you are ready for most shots that comes your way — so you can play tennis for life!

Wishing you good health and tennis for life,
Rob
USPTA

The Psychology of Turning Points in Tennis

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Now that we are hot and heavy into Badge, thought the attached IT coaching article might be helpful in managing/understanding the competitive pressures!  Cheers, Rob

The psychological strategies used by players to deal with these turning points will determine how effective players are in using these situations to their advantage.

The purpose of this study was to investigate the concept of turning points and understand more clearly the strategies applied by elite players to deal with turning points during a tennis match. A series of semi-structured interviews was conducted with nine elite professional players from five different countries, followed by a thematic content analysis of the interviews.

The analysis revealed four key themes: positive turning points situations, negative turning points situations, strategies to capitalise on positive turning points and strategies to cope with negative turning points.

On a practical level, strategies are suggested that coaches and psychologists can use to help players managing turning points.

Here’s the link: ITF-PsychologyTurningPoints

This is what exercise/tennis does for your brain

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I’m not shy in my advocacy for exercise as a therapy for mental health. It’s something I talk about often, something I’ve experienced first-hand, a topic I’m passionate about, and over the past few years, something I’ve continued to research and strived to understand better.

This is what I’ve learnt – the human brain is fascinating and we’re continuing to discover more about its capabilities every day. We certainly don’t know all there is to understand about the connection between physical exercise and mental health, but I hope you’ll agree, moving our body is something our brain wants and something our mind can hugely benefit from.

Here’s just some of the reasons why.

It releases feel good chemicals in your brain

Most of us will have heard of endorphins – the ultimate “feel good” chemicals that our body releases when we exercise. Endorphins are what we can thank for that blissful ‘post-exercise high’ that often follows a good sweat session. These chemicals interact with the receptors in our brain that reduce our perception of pain and trigger a positive feeling in the body. Endorphins help to reduce stress and anxiety, but when we exercise, there are other mood boosting chemicals at play as well.

Exercise also increases the production of serotonin in the brain, which works as a natural antidepressant. Lastly but certainly not least important, exercise increases the production of dopamine – the “motivation” and “reward” brain chemical.

With a knock-on production of endorphins, serotonin and dopamine, it’s no surprise regular exercise is linked with enhanced mental health and emotional wellbeing!   

It can improve your concentration

Research supports the idea that exercise improves focus, attention, and the ability to concentrate. But how?

When we exercise, especially at a high-intensity where our heart rate is elevated, our adrenal glands and our brain ramp up production of a chemical called norepinephrine. As more norepinephrine flows into our bloodstream, it increases our alertness and focus. An important reason to prioritise exercise during busy working periods, to improve productivity!

It can boost your memory

A number of studies show that aerobic exercise (aka cardio) promotes brain growth, especially in the hippocampus area, the part of our brain that is associated with memory1,2,3.

And if that‘s not enough to convince you – a new study from McMaster University in Canada found that young adults who participated in 6 weeks of high intensity interval training (HIIT) experienced significant improvements in their memory and recall4.  

It can slow cognitive decline

Keeping physically fit can also help to keep our brain healthy as we age. Exercise stimulates the release of growth factors, chemicals in the brain that affect the health of brain cells, the growth of new blood vessels in the brain, and even the survival of new brain cells. These growth factors help to protect our brain against injury and preserve our cognitive function5,6.

Sources:

  1. https://www.sciencedirect.com/science/article/pii/S0006899310018317
  2. https://www.sciencedirect.com/science/article/pii/S1053811915010721
  3. http://www.pnas.org/content/108/7/3017
  4. http://www.cbc.ca/news/canada/hamilton/exercise-memory-1.4415650
  5. https://www.sciencedirect.com/science/article/pii/S0166223607001786
  6. http://europepmc.org/abstract/med/25455510

Wellness Director, Collective Wellness Group – Dan Conn

Source:  www.anytimefitness.com.au/blog/exercise/exercise-does-mental-wellbeing/