On An Even Keel

Paul’s physical therapy program included exercises such as lunges and leg lifts.

Rehab gets boat builder in shipshape after knee replacements

Paul Harrison began building boats in 1999. An engineering graduate from the University of Florida, Paul spent most of his career, almost 20 years, as manager of engineering for a luxury sport yacht builder in the Flagler-Palm Coast area.

“When I first got out of college I was doing mechanical contracting,” Paul shares. “I did some work at the sport yacht facility, got to know some of the folks there and found out they were hiring. I put in my application and got hired.

“My job was in the manufacturing plant where the boats were built. We worked with a group of designers and engineers creating ways to make building the boats quicker and easier for the production people. Today, I work for a different boat builder, MasterCraft Boat Co. I’ve been with them for almost three years.”

Paul enjoys his job. He’s also a huge fan of sports, particularly University of Florida football. But attending games became a challenge the last few years due to severe pain in his knees. The pain is due in part to injuries he suffered during his youth.

“I injured my right knee playing softball and snow skiing when I was a kid,” Paul recounts. “But the majority of my problems stem from arthritis in my knees. I wore out the cartilage in both of them, and they were bone on bone. 

“The pain was excruciating, like a throbbing toothache. After a day of walking on concrete and going up steps at work, my knees were extremely painful and stiff. I had to ice them and rub arthritis cream on them to help ease the pain, but even then, it was still hard for me to get comfortable or get a full night’s sleep.

“The pain was so bad that it also made it very inconvenient for my wife and daughter when we went to football games. They had to drop me off close to the stadium then go find a parking place. Then they had to come back and find me so we could walk in together, and I often had to take breaks and sit down before we got to our seats.”

Paul finally had enough of the pain. He underwent total joint replacement surgery on both knees this year, his left knee in early March and his right in late April. Following surgery, Paul turned to Jacob Barr, PT, DPT, MTC, at Barr & Associates Physical Therapy in Ormond Beach, for rehabilitation assistance.

“I actually went to high school with Dr. Barr and we have some common friends,” Paul relates. “I felt confident going to him for therapy, and I believed I would receive good service at Barr & Associates Physical Therapy.” 

Tailored Plan

“Paul had problems with both knees, but his left knee was worse, so his doctor performed surgery on that knee first,” Dr. Barr confirms. “Paul began therapy with us after his surgery in March and progressed very quickly.

“Within six weeks, Paul decided that since he was already down with his left knee, he was going to go ahead and have surgery on his right knee. After that surgery was performed, he returned to us for physical therapy.”

Paul’s orthopedic surgeon agreed to perform the right knee replacement just six weeks after performing the left, in part because Paul is relatively young – he’s in his early 50s – and is still working.

“In his job, Paul does quite a bit of standing and climbing in and out of boats,” Dr. Barr describes. “He has many working years left and didn’t want to experience downtime later on down the road. He wanted to get it all done now.”

Dr. Barr’s first goal was to restore range of motion to Paul’s knees as quickly as possible. If range of motion is limited or not restored quickly, the muscles surrounding the joint can tighten and become restricted. At that point, it can be difficult to fully restore range of motion.

“Initially, we performed hands-on, or manual, therapy techniques, such as soft tissue mobilization and massage,” Dr. Barr describes. “We also performed passive range of motion exercises and stretching of Paul’s knee and the surrounding muscles and joints of his leg to restore motion.

“We followed the manual techniques with more functional activities to improve his strength. Every patient is different depending on what their ultimate goals are. Paul’s goal was to return to a work setting, where he does a lot of standing, climbing and moving around. In Paul’s case, we focused on improving balance and a higher level of strengthening.”

Dr. Barr developed a physical therapy plan for Paul that included climbing, squatting and stepping exercises. Dr. Barr also had Paul perform balance movements designed to prepare him for activities he would face when he returned to work.

“I’ve got to crawl around the inside of boats, and the spaces can be very tricky to navigate,” Paul explains. “There’re a lot of uneven surfaces, and a lot of stepping is required. Dr. Barr tailored my therapy to those activities, so I would feel comfortable returning to work.”

Paul completed his physical therapy at Barr & Associates in mid-July. Dr. Barr is quite pleased with Paul’s progress.

“He had a great attitude, which helps with recovery, and was very compliant not only with his clinic visits but also with his home exercises,” Dr. Barr reports. “After therapy, his walking tolerance greatly improved; he doesn’t require a cane or walker. He anticipates returning to work at the beginning of August.”

Return to Normal

Before Paul underwent joint replacement surgery on his knees, he experienced throbbing pain that was excruciating. The pain interfered with many of his activities, including sleep, but those days are over.

“My knees are better now than they’ve been in years,” Paul enthuses. “They’re not as stiff as they used to be, and I don’t really have any pain at all. I’m walking close to a mile right now without pain, and I’m building up to longer walks. And now I can sleep at night without any problem.

“The strength in my knees is good, and I’m using muscles I haven’t used in a long time. During therapy, I strengthened muscles I didn’t use in the years leading up to surgery when I didn’t move very much because of the pain.”

Without intense pain, Paul’s life is returning to normal.

“I’m looking forward to this fall, being able to walk with my wife and daughter at the stadium and not being in pain while watching football,” he relates. “I won’t have to worry about how far I have to walk or take breaks before I get to where I’m going because of pain in my knees.

“My knees are very good now. I’m very pleased with the surgeries and the therapy at Barr & Associates Physical Therapy. I’m glad I did it.”

© FHCN article by Patti DiPanfilo. Patient photos courtesy of Barr & Associates Physical Therapy. mkb
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