Gaucher Community News - National Gaucher Foundation

Suzanne has been a registered
physical therapist since 1978. She has
experienced multiple symptoms from
Gaucher disease since being diagnosed
in 1981. She is an advocate and speaker
on the subject of exercise and physical
therapy and has written many articles
on its importance for those who are
living with Gaucher disease. She can be
reached by calling the NGF or by email
at suzkrup@comcast.net.
Knee limitations after surgery and
teoporosis in spine
By Suzanne Krupskas
1) Q: Six months ago I had a left knee replacement.
In general, the knee is strong and I am painfree. However,
I’m still not able to fully straighten it. When I was
discharged from physical therapy, (which was three months
ago), my therapist told me that I am lacking 15 degrees
of knee extension. My orthopedist says that I may have to
live with this limitation or possibly be manipulated under
anesthesia to break-up the scar tissue. In lieu of undergoing
this procedure are there any exercises I can do at this point
to help get my knee straighter
S.P. from TN
A: Knee limitations are a challenge, especially six months
after surgery. The soft tissue (muscles, tendons, ligaments)
has become extremely tight and possible adhesions
or scar tissue may develop (as your orthopedist indicated).
Before starting any exercise program inform your doctor. I
would suggest pool exercises if you have access to a heated
pool. The warmth of the water would assist in loosening
the soft tissue surrounding the joint. The following pool
exercises would be beneficial: Place your left heel on a
step with the knee straight and your right leg behind.
Bend forward feeling the stretch in the hamstrings (back
of the thigh) and behind the knee. Hold the stretch for 20
seconds. Rest and then repeat for a total of 3 sets. Walk
back and forth in the shallow end accentuating heel to toe
as you’re stepping for 10 laps. Use a noodle to simulate
biking – accentuating knee straightening for 2-3 minutes
I would also suggest the following exercises: hamstring
stretches on land: Sit on a chair and place a foot-stool in
front of you. Place your left foot on the stool with your foot
facing straight up and your right foot down on floor. With
both hands push your thigh down as you lean your body
slightly forward feeling the stretch in the hamstrings and
behind the knee. Stay in that position for 3-4 minutes.
If the stool is too high, place your left leg in front of you
(heel down) on the floor and push your thigh down with
both hands and hold the stretch for 20 seconds for 3 sets.
Step stretch: Place your left heel on a step, knee is straight
as it can be, right leg on the floor. Lean your body
forward slightly and hold the stretch for 20 seconds.
Rest and repeat 3 sets. Just to remind you, by doing these
exercises it does not guarantee full and normal extension.
However, you still would benefit from doing them to assist
in elongating the muscles, tendons and ligaments with the
possibility of gaining more flexibility and more range of
movement.
******
2) Q: I have osteoporosis in my spine. What exercises
would be beneficial for me I sit in front of the computer
most of the day approximately 7-8 hours. I am sedentary
and need guidance on what to do. Thank you. I’m looking
forward to receive your expert advice.
M.T. from VT
A: Osteoporosis is definitely a disease that requires
immediate attention. If you lead a sedentary lifestyle (as
you say you do) the skeletal system is going to be more
compromised and more at risk for further bone resorption
(breakdown). Bone is living tissue that is constantly being
broken down and rebuilt. This balance leads to healthy
bone. However, if there is more breakdown than rebuild
the result is osteoporosis. To prevent further breakdown and
to assist in strengthening the bones, it is medically proven
that bones need loading type of exercises to become denser
such as weight-bearing and weight-resistance exercises.
Although I suggest you start with the following three exercises
4-5 times weekly, it is a necessity for you to discuss these
exercises with your physician. The following routine hones
in on the erector spinae muscle group; this long muscle is
responsible for stabilizing the entire spine. 1) Stand Shoulder
Blade Pinching: Stand with legs shoulder-width apart, knees
slightly bent, stomach tight (tuck your navel towards your
spine), hold onto 3lb. dumbbells in each hand, elbows bent
90 degrees, palms facing each other, with both hands reaching
out in front of you (do not fully straighten elbows), then
pull arms towards chest as you pinch the shoulder blades
together. Hold the contraction for 3 seconds – repeat for 10
times / 3 sets. 2) Modified Standing Military Press: Standing
position as #1, with both hands start at your shoulders,
palms face forward – elbows are bent, push both arms (at
the same time) up above eye level extending your elbows
then return to starting position. Repeat for 10 times / 3
sets. 3) Trunk Extension: Lie on your stomach (either on your
bed but preferably the floor). Place a small pillow under
your pelvis, head down (face is parallel to the floor), arms
by your sides, raise your head (face is still parallel to the
floor) and chest off the bed/floor and hold that position for 3
seconds – repeat for 10 times / 3 sets.
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