.jpg)
Most people can't wait to get moving with less pain and reclaim their independence after knee replacement surgery. However, this process can't be rushed. We sat down with Dr. Rory Sandberg, PPG - Orthopedics Carmel, to discuss what patients can expect through recovery and reintroducing activity.
What does easing back into exercise look like after knee replacement surgery?
Immediately after knee replacement, there's usually a lot of pain involved, so most of the initial exercise is physical therapy based. At first, patients are just working on regaining range of motion. Later, it's strengthening the surrounding muscles.
Returning to the recreational physical activities people enjoy following knee replacement really depends on the activity. I have a progressive program that I put people through. For something like golf, at about 16 weeks, patients can start with just chipping and putting, then slowly move up to higher irons and eventually the driver. For an activity like cycling, patients can start that a little earlier on, just as soon as they have enough range of motion to retain good control of the bike.
Are there certain activities that you don't recommend after knee replacement?
Running is the biggest one. The implant is extremely durable and absolutely will hold somebody up to run. However, actions that repeatedly impact the implant have been shown to cause it to wear out more quickly.
Because of that, I try to encourage my patients who are runners to become cyclists. Swimming can be beneficial, but when a patient can start depends on how their wound heals.
Generally speaking, if somebody wants to get back into something and we've completed the physical therapy phase, I tell them to start at about half of whatever intensity and duration they were accustomed to doing beforehand and then work their way back up to it from there.
What alternatives to running would you suggest for maintaining bone strength while supporting implant longevity?
After recovery, patients can walk as much as they want. I don't know if there's a lot of data to suggest that running is necessarily that much better than walking for maintaining bone density as people age.
There's growing evidence to support that resistive strength training can actually help bone density as well. That's something we could all benefit more from doing. However, there are a couple of lower-extremity strengthening exercises that I recommend patients modify as a protective measure against some of the repair work that's done in surgery.
A lot of open-chain strengthening exercises — like a leg extension, a hamstring curl or any movement where the foot is swinging freely — can put an abnormal load across a knee. Patients can swap those for closed-chain strengthening exercises, where the foot is pushing down against the ground or a plate. This can include squats and leg presses. These are fine to do after replacements as they are more natural movements for the body to perform. They are also really beneficial from a bone health standpoint.
How long does it take to fully recover from knee replacement?
Recovery timelines can be different for everyone. Some people recuperate very quickly, and others are slower. I often tell my patients that there are multiple recovery curves, and we don't know which curve they will be on before surgery. It's really important not to approach their procedure making comparisons to someone else's journey.
I would say the majority of individuals are no longer using a walker, cane or other mobility aid by around six weeks. That doesn't mean that they are back to performing activities at full capacity. The literature will tell us that it can take a whole year to be considered fully recovered, but many people can do a variety of activities well before then. The first 3 months post-op are when patients will likely meet most of their recovery milestones, but if they stick with their care plan, they can expect to continue making small gains for the entire year afterward, including building up strength and increasing range of motion.
Not sure where to start?
Our orthopedic care navigation team is here to help. Contact our orthopedic care navigation team at 260-266-4005 or visit our website to find an orthopedic location near you.
