Recovering from Knee Replacement Surgery

I’m two months into recovery from total knee replacement surgery. At this writing, it is late June 2018.

While the recovery experience is fresh in my mind, I thought I would share some thoughts on it. Knee and hip replacement is something many of us Boomers will face at some point. But the advancements in medicine today are pretty remarkable.

I had a major surgery 40 years ago. Before things like MRI scans could provide accurate reads on the existing damage. Back then they hadn’t even thought about replacing entire joints with new artificial parts. It was like the stone age compared to now. It’s pretty amazing that medicine can even do this today. In my case, it will eliminate pain in my right knee and allow me to do all kind of things I have not been able to do for the past 40 years — like jog.

The pain from arthritis built over the years and had become unbearable without cortisone shots. It was time.

That’s the “new” knee on the right doing extensions

You can see in the illustrations that this is pretty serious stuff. Metal rods are inserted into shin and thigh bones, connected to your new artificial knee joint. Lots of areas for pain and discomfort.

Remarkably, you’re up and walking with assistance on the same day as the surgery. Of course, you’re also still heavily medicated and in my case, I had the benefit of a nerve block virtually stopping any pain signals.

That stuff wears off pretty quickly, though, and you have to deal with the pain and swelling for several weeks and beyond. I ran into problems here. I can’t handle opioid pain pills. Severe constipation. And the pills seem to make me loopy in the head but don’t really make the pain go away.

So, I stopped all pain meds about three weeks post surgery. Tried arthritis strength Tylenol. But gave that up too.

Ice. Lots and lots of ice is your best friend after this surgery. I’m still icing down after two months and probably will be for a while. They say full recovery can take a year. They also say you might want to take a full two months off work right after surgery. I can see that, for sure.

The first few weeks, you need to use a walker to get around even on short trips inside the house. I graduated to a cane after about 2 weeks, but didn’t walk very far until the 3rd and 4th weeks. I’ve got a temporary handicapped-parking permit, which helps a lot.  I’m progressing faster than normal thanks to a lifelong commitment to working out. My muscles have atrophied a ton on my right leg. But there is still some strength there to build on.

This site is about working out and building muscle, so let’s get to that.

I began upper body – only – workouts, with much lighter weight and far fewer sets as the first month of recovery was winding down. At this time, I skipped my usual lower body day.

During this period, I was in Physical Therapy for my leg. For the first two weeks, a therapist came to the house and we did isometric type exercises for about 30 minutes. Then, once I was cleared to drive again, I was sent to a nearby PT clinic.

That was tough. The exercises were pretty simple: walking on a treadmill for 5 minutes, balancing on one leg for 30 reps, isometric squeezing my quad muscles together and so forth. But the stretching was painful.

I’ll spare you the details, but suffice to say that it includes the therapist forcing the stretch with hands on the wound.

The best part of PT was an ice-down for 15 minutes at the end. Again, ice is your best friend during recovery.

A quick checkup with my surgeon – who did a great job – was all good and he said I could stop going to PT and do it on my own at home.

We discussed my usual workout routine. I told him I have a super smooth Powertec leg sled,  and a Powertec leverage gym with a nice hack squat station, plus a Hoist stack gym with knee extension and a lower pulley for glute kicks, etc. We talked about all the exercises and he cleared me to do any exercise but deep squats. He instructed me to use much lighter weights than usual across the board.

For the past 2 weeks, I’ve been doing my lower body routine with much lighter weight 5 days per week, instead of the usual one day per. I started off doing only a couple of sets per exercise and this week graduated to doing my usual 5 sets per.

Keep in mind, in my usual workouts, I’m focused on using lighter weights and higher reps. So, I’m now going even lighter. In some cases, I’m doing more reps than usual to compensate for the extra light weight.

• Leg Sled — with 50% of the usual weight
• Knee Extensions — with 40% of the usual weight
• Glute Kicks — with 80% of usual weight
• Hamstring Curls — skipping for now because the wound is still sore

I will gradually increase the weight back toward my usual amount as time goes by. Today, for example, I’m going to increase the weight on Knee Extensions because the 70 pounds I have been using X 21 reps in each set has gotten way too easy. I’ll increase the weight and decrease the rep count accordingly to the right balance.

The weirdest thing so far… that nobody warned me about? My knee pops and clicks when I walk. Even kind of sounds/feels like a ‘thud’ to me, it’s as if I can hear it and feel it. Freaked me out. Talked to the surgeon about it at checkup. He said it’s normal and that it may do that forever. Apparently the high tech artificial parts will rub against one another. And since there is no soft tissue there any more, there’s nothing to stop the rubbing sound. Guess I need to get used to it. But I’m hoping as I rebuild muscle around the new joint that it will diminish or go away. We’ll see, time will tell.

On the darker side of the experience, I battled depression-like feelings for a few weeks. Constant aching pain, plus mind-fog, plus not being able to get the endorphin high of a good workout… it added up and was hard to deal with for a while. Things might have been better if I could tolerate the strong pain medicine, but I can’t. So, a lot of sitting with the leg elevated staring at TV. Couldn’t manage to do much else.

Fortunately, now I’m in a better place. At least in part due to resuming regular workouts. I feel less foggy-headed, too. My wonderful wife, who puts up with me through thick and thin, and I are heading due south to Canada this weekend. We’re going to be tourists and go to Niagara Falls. Going to be tons of fun.

And yes, we’re driving due south to the Ambassador bridge that connects Michigan to Canada.  That part of Ontario juts down from the mainland and forms a significant chunk of land that is south of most of Michigan.

Meanwhile… It still going to be several months until I’m at full recovery. Till then…

If you haven’t already, grab the 5 Keys to Feeling Stronger — Right Away! Totally free. You’ll get a video by me about the 5 Keys plus some e-booklets. It’s been proven us older folks can build real muscle without punishing ourselves with heavier and heavier weights. Check it out.

The Secret to Feeling Motivated

A Harvard University neuroscientist studied the secret to feeling motivation and came up with a very simple solution — make it fun and stay optimistic.

Hold on! Before you tune out and say that’s dumb, hear me out.

This could be a significant game changer for you. And I will give you some easy, practical ways to actually do it. The scientist, Professor Ron Siegel, points out that our brains are wired to think negatively as a matter of survival.

Goes back to mankind’s early days when being focused on negative consequences often meant the difference between living or being eaten by a nasty predator.

Think about it. You’re sitting around the fire, gnawing on a bone for dinner, and suddenly there’s a loud thrashing noise out in the darkness. Do you think: hey, that’s probably some good friends approaching. Or do you assume: Yikes, where’s my spear, I’m about to be eaten!

If your genes survived the night, you went with the latter. We’re all descended from the survivors.That’s powerful negative motivation and it’s burned deep into our brains.

But sometimes it works against us today. Let’s focus on Working Out. We know logically that exercise is great for us but we still sabotage ourselves out of doing it, thanks to the negative wiring. “It might hurt, I don’t feel so great, maybe tomorrow.” Etc

I’ve written at length on how strength training can reverse aging, Type2 Diabetes, muscle loss, bone loss, genetic degradation and more. But that knowledge alone doesn’t help when you’re fighting the power of negative motivation in the moment.

We all do it to ourselves. I’ve been working out for nearly 50 years now. Every single day, the devil on my shoulder tries to talk me out of it. Every time. So how do you shut him up?

Immediate Reward:

It has been proven undeniably that exercise — especially strength training — releases powerful feel good hormones, including endorphins and dopamine. (Google them)

It is virtually guaranteed that at some point during – and for a good while after – your workout you will feel very pleasantly high. Happens every time for me and the mood shift is dramatic.

I crave it. It’s like a drug with zero side effects. So, approach your workouts knowing that once you get past the devil on your shoulder, you’re gonna feel great as a result of working out.

Of course, you are working out for the purpose of getting toned or even building muscle. That doesn’t happen overnight — so don’t expect it to. But, if you embrace the discipline to do this consistently, it will happen. And you will love the results and feel better about yourself in a lot of ways.

More on embracing Discipline in a bit. Right now, let’s talk about simple steps to feel good about working out.

Supercharge that High: It has also been proven that certain things increase the levels of feel good hormones flowing through us. So here are some easy, practical things you should do to crank it up.

Music:

The reason we love music is the way it makes us feel. It’s also been proven to release feel good hormones even if we’re sitting idle. Combined with exercise, it’s a double-dose of happy.

Combine a Playlist of your favorite upbeat music with your workout, and you will amp up that buzz. Music also helps to take your mind off the mundane aspects of lifting and put you into a groove state of mind.

For many years, I listened to the same Van Halen playlist for every workout. They’re a good example of the type of music you need. Upbeat and driving. The music melted into the background of my mind. I could not tell you exactly what songs I heard or the lyrics, but it really helped fuel my workouts.

Today, I listen to a variety of classic rock, modern pop, oldies, country, etc. Anything and everything that you hear as upbeat and driving along at a nice, constant pace will work. Slow passages are a buzz kill.

Build your playlist. Have some fun doing it. If you want, you can try something like Pandora, with built-in workout playlists. The stuff is out there. Grab it and use it.

Provide yourself with immediate, small rewards: Here are some easy ways to do that, that have a bigger impact than you might imagine:

Drink:

Keep a container of your favorite beverage handy. Mine is plain, cold ice water. Give yourself a reward chug after a hard set. Take a moment and savor how great a cold drink feels when you’re exerting yourself and maybe even sweating.

Go with water, Gatorade, whatever non alcoholic beverage that makes you feel good.

Chew:

Not tobacco of course, but give chewing gum a try. I put a piece of sugarfree Bubble Yum on each side of my mouth. I’m a jaw-clencher by nature. The gum gives my mouth something more positive to do, and it’s another nice little reward cuz it tastes good.

Visualize:

Tons of studies have proven that Visualizing your goals has a powerful effect. Think about how great it will feel to be trimmer, look sexier, feel stronger. See it starting to happen.

Here, you want to combine those visuals with a focus on the Mind/Muscle Connection.

I’ve written before about the Mind/Muscle thing. It’s an idea from the old days of bodybuilding that sounds like New Age baloney, but it’s absolutely for real. And it’s very simple to do.

Think about where your mind goes through when you’re doing a rep of an exercise. It might be thinking, “this is hard, I don’t want to do it.” Or, other negative stuff promoted by the little devil on your shoulder. This is another technique to keep that little shit quiet.

As you’re doing a rep, really focus on the muscle targeted by the exercise. Let’s take bicep curls, for example. As with any exercise, you want to have a smooth, controlled motion as you curl the weight up and down. As you curl it up, laser focus your mind on how the muscle feels. Feel it flexing as you tax it. Feel it tautly releasing the flex as you curl it back down. And so on through the whole set.

Stay with those thoughts till you’ve finished the last rep. That’s all there is to it. That is the Mind/Muscle Connection. It will help you get a good pump and keep your mind focused, while keeping the negative whiny crap out.

But if the Negative Thoughts are Wired in, how do I deal with those?Ok, so if you’re finding yourself saying, “screw screw all that hippie stuff, what’s wrong with being tough on yourself?”

Discipline:

On the other hand: There are those who say forget positive Motivation — “Get Disciplined!”

My wife is the most disciplined workout warrior I know. She gets up at 4 am most weekdays and hits her Peloton bike for an hour. Then she gets ready for work and fights rush hour for an hour to get to the office for 8-10 hours. Then she fights rush hour to get home and hits the weights at home in the evening with me.

I got tired just writing that.

Her main thing is discipline. Starts there for her, and she uses the negative motivations to help her stay disciplined.

We both attended religious schools as kids. Negative motivation was reinforced back then by nuns swinging rulers and reminding you of the consequences of your sins.

So, today, she motivates herself with negative reinforcement. She’s not entirely negative, but it’s how she gets past the devil on her shoulder. When her little demon starts to whine, she shuts him up by telling herself:

• I’ll fall way behind everybody
• I’ll lose all my gains and have to start over
• I’ll wind up skipping the next day, too
• Etc

It works for her. To be sure, she also benefits from all the positive motivations we’ve gone over and loves the workout high. But she also uses negative motivation to her benefit. So if this also fits your personality, how can you use it to your advantage?

Again, here are some practical steps:

• Make a detailed Schedule and stick to it – spell out each day’s specific workout in advance
• Define your workout Goals for each day and the long-term
• Require yourself to make up workouts lost to circumstances you couldn’t control

In fact, you should do those last 3 points whether you’re using negative motivators or not.

The truth is, we need to use both the Positive and the Negative triggers to our advantage.

The key to your success is doing it consistently.

Often, the trick is simply getting past that first rep. However you can get yourself into the workout – and stay with your schedule – is a good way.

Just do it.

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To see more articles on motivation check out this section of BoomerMuscle.com

Build Muscle Fast After 40

It is definitely possible to build muscle fast after 40. In fact, it may be much easier than you think.

However, 40 can be a very tricky age.

You’re not old yet, but you’re not young, either. Our bodies start to lose muscle mass around your age due to sarcopenia, which can accelerate dramatically as the years go by especially if you’re inactive.

But you’re not too far removed from your glory days and peak condition, so you should be able to amp up your workouts relatively quickly compared to someone a couple of decades older than you.

Even still, you are far enough from your peak that it doesn’t make sense to pretend you’re still in high school and able to recover quickly from a ton of physical abuse.

Resistance training has always had a bit of a competitive edge to it. How much you can lift equals how strong you are compared to others. Right?  

Clear Your Mind, Start Fresh

Try to clear your thinking on this score. How much weight you use really does not matter — except that it is enough to bring you to failure in 8-12 reps.

Nor does it matter how you create the resistance. Free weights – great. Machines – great. Body weight – great. Resistance Bands – great. It’s all good. You’re muscles only feel the tension, they don’t care how you made it.

Studies have shown definitively that lifting light weights in the 8 – 12 rep range is superior to trying to push around super heavy weight — if your aim is to build muscle tissue.

Our egos tend to tell us that more weight equals more strength equals more muscle. Wrong. Unless you’re trying out for the Olympic team, forget about your weight totals.

Muscle grows in response to tension placed on it that does microscopic damage to the tissues. With proper rest and nutrition, the fibers are repaired a little stronger and thicker than before. Hypertrophy is the process. You feel it as a “pump” while you’re working the muscle and perhaps after. It’s NOT pain. It’s a satisfying pumped up feeling as blood rushes in with nutrients, flushing out toxins, and starts building the muscle up.

To those points above there is general agreement.

Focus on Failure

Where I diverge a bit from others is that I believe in focusing on a specific muscle group with enough sets in order to take it to “failure” — rather than mixing up various muscle groups on each workout day. Again, our primary goal is to build muscle tissue.

Failure occurs when you cannot complete another clean rep without cheating. Don’t cheat on any rep.

If you’re focusing on biceps, for example, I would stay on biceps until you’ve reached failure. In my case, this equates to 5 sets each of 3 separate exercises. Bicep barbell curls x 5, bicep dumbbell hammer curls x 5 and bicep rope curls on a machine x5.

NOTE: If you’re just starting out, start slower with fewer sets. See articles below for more details on how to get going.

Keep a Mind/Muscle Connection

It really is all about the feeling.

You want to focus on the muscle being targeted and feel the tension in that muscle as it moves through the range of motion. It’s easier said than done.

Too often, people will focus on throwing the weight around to finish the rep, as if that’s the ultimate goal. Or, they will strain and use body english to move a weight that is too heavy.

We want to cause “hypertrophy” in the target muscle. That means putting a controlled strain on it that causes blood to flow in bringing nutrients and flushing out toxins. You can actually feel this happening if you concentrate. Back in the day, they called this “The Pump.”

The amount of resistance is key. You are going to focus on getting 8 – 12 clean reps for each set you perform. If you can do 12 in the first set and need to drop to 8 by the last set that’s ok. In fact, if you can only get 5 reps in the last set, that’s ok, too.

Your focus is on the feeling not the numbers.

Add resistance whenever 12 reps becomes too easy on that first set. It’s that simple, numbers wise.

But finding the ideal resistance can be challenging because our minds get involved. It is key to really get your head into this process and focus on how the target muscle feels as you perform the reps.

Beware! There is a little devil on your right shoulder who will call you names for using weight that is too light. And there is another one on your left shoulder who will tell you whatever weight is just way too heavy.

Ideally, you can tune those devils out and find the ideal weight range that takes you to genuine failure on each set. Tune them out by really focusing your mind on the target muscle. Feel the motion. Feel for the pump. When you feel it, you’re there.

More Detail on How to Do It:

Also, see the article below “Building Muscle After 60” for more on how you can build muscle regardless of your age: 40, 50, 60 and up.

And see below “A Workout Routine: Resistance Training to Build Muscle, Lose Fat” for a sample workout to get you started now.

Also see “Lifting Light Weight vs. Heavy Weights” bottom below for more details on the benefits of lighter weight/higher reps.

If you’re a woman concerned about “bulking up” please see this on women building muscle. This method works for men and women.

Building Muscle After 60

Resistance Training to Build Muscle & Lose Fat

Lifting Light Weights vs Heavy Weights

I’d love to hear your thoughts on building muscle after 40. Please share them below or drop me a line at Brian@BoomerMuscle.com