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The Vicious Cycle
The Vicious Cycle

As the temperatures drop and the leaves change colors, we find ourselves in the final quarter of the calendar year. Orthopaedic Associates of Wisconsin is especially busy as many of our patients have met their deductibles and are hoping to have that long-awaited surgery before we greet the new year. Those procedures have BMI (body mass index) requirements that can get in the way of a patient getting a new knee or hip. Such BMI requirements do not exist because we are mean and enjoy depriving our patients of the procedure that will provide relief. They exist to give each patient a better chance at a successful outcome for years to come. A high BMI increases the risk of developing a blood clot or an infection, having anesthesia complications, suffering from cardiovascular issues, or having a slow-healing wound. Sometimes those BMI recommendations come straight from the manufacturers of the prosthetics used in joint replacement surgeries because they know their particular product will fail if subjected to the stress of a high BMI. Regardless, achieving the appropriate BMI can be a challenge. The problem that so many people face is this: at one point in time, they quit exercising because something hurt. The lack of exercise combined with our Wisconsin diet of beer, brats, and cheese resulted in weight gain. That weight gain eventually caused more degenerative changes to the aching body part, which subsequently worsened the pain. The pain got bad enough that exercise didn’t seem to be in any realm of possibility, so the weight gain continued. Now you are left with a degenerated joint that needs a replacement and a BMI that won’t allow us to do so.

So, now what? That can be a tricky question. Don’t you worry-we are here to help! We can help as you find a daily routine that works for you. Our recommendations include a combination of a healthy diet of appropriate portion sizes as well as non and low impact exercises. Diet can be a little tricky. The goal to weight loss centers around the concept ‘Calories in, calories out.’ Ultimately, you have to burn more than you consume. Approximately 3,500 calories equates to one pound of body fat. If you cut 500 unnecessary calories per day out of your diet and change nothing else about your lifestyle, you will lose approximately one pound per week. Foods with greater nutrient density are helpful because they provide the maximum amount of nutrients in the smallest amount of calories to help you feel full and satisfied. Nutrient dense foods include fruits, vegetables, whole grains, seafood, and eggs. Making these foods staples in your diet while avoiding ‘empty calorie’ foods like soda, chips, breads, pastas, and candies will help maximize your nutrition while controlling your weight.

Non and low impact exercises include activities like swimming, water aerobics, biking, elliptical, and weight training. We recognize that not everyone has access to a pool, but for anyone who does, the buoyancy of the water takes the stress off the arthritic joints while still allowing for significant caloric burn. Bikes and ellipticals also allow for excellent cardiovascular workouts with far less stress on the joints than walking or running. We recommend that any walking done for the purpose of exercise be on soft surfaces, such as a track or in the grass, and while wearing supportive shoes. Weight or resistance training doesn’t have to be a combination of complicated exercises. It can be as simple as a ‘Sit and be Fit’ program. Diet can be a little tricky. The goal to weight loss centers around the concept ‘Calories in, calories out.’ Ultimately, you have to burn more than you consume. Foods with greater nutrient density are helpful because they provide the maximum amount of nutrients in the smallest amount of calories to help you feel full and satisfied. Nutrient dense foods include fruits, vegetables, whole grains, seafood, and eggs. Making these foods staples in your diet while avoiding ‘empty calorie’ foods like soda, chips, breads, pastas, and candies will help maximize your nutrition while controlling your weight.

This is not an easy journey. Quite the contrary, actually. These recommendations involve lifestyle changes that can be challenging to keep. We are here to help and provide support along the way. Sometimes we can provide cortisone injections to provide enough pain relief to allow you to increase your activity. Other times, we can prescribe anti-inflammatory medications to control pain caused by swelling. If you find yourself struggling to meet your goals, we can provide a referral for a health coach to help you prepare for an upcoming procedure. Whatever the circumstances, give us a call to find out how we can help YOU!