Knee replacement surgery can hugely improve quality of life for recipients. Especially when knee replacements are typically given to folks who are in a debilitating amount of pain. Regaining mobility and living without pain are the goals of your entire care team when you go through knee replacement surgery. Which is why it’s so important to stick to the plan for pre- and post-op activities to make sure you reach those goals.
Pre-Op
Before you undergo knee replacement surgery, you will likely participate in a pre-op class, which will prepare you for the procedure and help you think through what needs to happen before and after your surgery so you can focus on recovery. These are some of the things you’ll want to consider:
- Your environment after surgery:
Is your bedroom up or down stairs? Is there clutter obstructing any paths in your home? - Your plans for your household obligations:
If you usually do the laundry, meal prep, shopping, or yard work, do you have a plan for someone else to take over until you’re back in business? What can be put on the back burner? Are there stairs between you and anything absolutely necessary? - Driving:
If you’re prescribed pain medication, how soon do you want to be able to stop taking it so that you can drive? Is it your right knee or your left knee being replaced? If it’s the right knee, are you prepared for how long it will take before you can drive again? Who will drive you around in the meantime? How will you get to physical therapy rehab appointments? - Your goals:
What do you want to be able to do after knee replacement?
All of these are things you’ll want to discuss with your care team and your family before surgery to ensure that everyone is aligned and you can focus on your recovery. If you have questions or concerns, write them down and bring a list with you to your appointments to ask your surgeon. It’s better to over prepare, and you definitely can’t just have a nebulous plan to “wing it” when you’re out of surgery. Hopefully, your surgeon wouldn’t allow that!
Post-Op
After surgery, you’ll have some amount of physical therapy rehab prescribed for you to complete per your surgeon’s directions. You’ll want to work with a physical therapist who is experienced in assisting knee replacement surgery patients in particular.
Recovery and rehab timelines can vary, but have gotten shorter in recent years. This is at least in part thanks to medical science advancements and component improvements. Most patients are out of the hospital after surgery within a day or so, sometimes going home on the same day. Then outpatient rehab programs can be as short as three to four weeks. After that, the direction is usually to return to normal activities as tolerated, with a home program of some sort provided by your therapist to continue on your own.
After knee surgery, you can continue to make gains in range of motion and strength for a year. And with knee replacements happening earlier and earlier, patients on the younger end of the spectrum can be left feeling a bit adrift after being released from their three-week formal rehab program. It’s highly unlikely that they will be where they want to be in reaching their mobility goals in three short weeks. So how do you continue to progress yourself when rehab is ended?
Progressing Function
Strength, mobility or range of motion, and stability all combine into function. When recovering from total knee replacement surgery, most folks think about their range of motion, like how many degrees they need to be able to bend their knee in order to get in and out of a chair, up and down the stairs, etc., but you also need strength and balance to control that motion. Beyond range of motion, you need to consider how your knee will perform when you put it into function.
For example, if we look at a football player recovering from an ACL injury, they may have done all their rehab, can balance on one foot, do exercises in practice, etc. but then when they put it into function and they’re running down the field and look over their shoulder to catch the ball, they injure themselves again. In a less athletic example, it might be rushing across the room to pick up a ringing phone. You may have been cleared by your care team and can walk without an assistive device, but if you haven’t regained proprioception, which is your body’s ability to sense action, movement, and location (where your body is in space), then you are at risk of injuring yourself when you put your recovering knee into function.
Progressing in the factors that make up function beyond range of motion is important for ensuring you reach your ultimate goals. But after you’re discharged from your formal rehab program either per your physician’s or insurance company’s protocol, it’s crucial that you continue working on regaining function on your own.
Home Programs and Beyond
Your physical therapist will likely send you home with exercises to do on your own after their time with you has ended. It can be really easy to let that print-out gather dust and coffee stains on the corner of your kitchen counter where mail goes to languish. Or to find that they’re too easy and feel like they’re not worth doing at all. That time after your formal program ends is critical for habit formation so that you continue progressing in your recovery.
And when you’re struggling to find the motivation to do your exercises, it’s time to think back to what your life was like immediately before your surgery. Remember the pain you were in, the activities you wanted to do but couldn’t, the effect living with chronic pain had on the rest of your life. Remember why you did the surgery in the first place, and let that be your motivation for getting the absolute most benefit out of that surgery by doing something to get stronger every day.
Set small achievable goals for yourself, starting with where you are and what you can do, and as you hit one goal, make a new one that’s a little harder. Use your pre-surgery abilities and activities as your baseline (not your activity levels pre-pain; it will take time to get back to those days!). Think about your goals in terms of function: what daily-life activities are you struggling with? For example, maybe you want to be able to balance on your surgical leg so you can reach up into a cupboard on that side. Or perhaps you don’t feel like you have control when you sit down in a chair. Noticing those functional limitations can guide you in where you want to improve your strength, mobility, and stability.
Keeping up with a whole body exercise and strengthening program is the best thing you can do after knee replacement surgery and rehab. It can be difficult to find and stick to something on your own, but if you can keep your goals in mind and make small steps forward every day towards them, you’ll have a far greater chance of regaining the knee function you need to live the life you want.
The Restart! app was created to help people get moving starting from right where they are and can be a great way to access progressive full-body workouts that adjust to your abilities and limitations without the cost of going to a gym or hiring a personal trainer. Always consult with your physician before beginning any exercise program, especially if you are recovering from something like knee replacement surgery. Download the app here:
