5 Things You Shouldn't Do Post-Knee Surgery
The Most Important Things Athlete's Shouldn't Do After a Total Knee Replacement
Five years ago, my second-ever patient, after I opened my practice, was 22 weeks post-total knee replacement surgery. Six months before their surgery they had been in a car accident where they fractured their femur and kneecap.
The first time I met with them, they presented simply with knee pain and some mobility limitations.
They had completed their post-surgery rehabilitation with their physical therapist and were back to walking and moving relatively well, they were lifting relatively heavy for their age (37) and were walking up and down the steps with ease.
However, something was off, and they weren’t quite happy with their recovery.
Twenty-two weeks post-surgery their knee mobility was still limited.
Squatting was possible, but only if they shifted their weight to the other leg. Lunges were out of the question. Cycling had started to cause pain earlier throughout the ride they were no longer able to make it past a couple of minutes.
Activities they once loved began to fly the coop. Running hadn’t even been introduced. They were too afraid of it. They were advised to avoid jumping or landing activities. They weren’t told for how long.
It wasn’t until our third visit, that I asked them to tell me everything he was told during his rehabilitation.
At this moment, he laughed, looked at me, and started to list everything he was told during his recovery. From the first day, all the way until he reached the maximum therapeutic benefit:
“Pain can last for several months to about a few years.”
“If it hurts ice it 15 minutes on - 15 minutes off for about an hour”
“At home stay off your leg as much as you can”
“At home avoid going up and down the steps”
“This is as good as your mobility is going to get”
“Avoid lifting anything over 20lbs”
“Avoid squatting too deep”
“Avoid putting too much weight on your knee”
“Complete these exercises at home as long as there is no pain”
“If it hurts stop doing what you are doing”
“Don’t jump or land with this knee”
“Avoid turning with this leg”
“Don’t lift heavy with this leg”
It’s true, pain can last for several weeks after a total knee replacement. Pain can last a couple of weeks after most surgeries.
Full recovery, after surgeries, can take up to a year or more depending on various factors, such as overall health before the injury, muscle and tissue conditioning, and adherence to therapy.
During this time, post-op, it is understandable there may be certain restrictions on activities like high-contact sports or heavy lifting. After all, the human body has a finite capacity to heal, and we can’t accelerate this process beyond its natural rate.
But we can remove things that could slow down it down and we can fuel our body to promote adequate healing.
Now, what they were told isn’t inherently wrong. During the early stages of rehabilitation post-op, there are a few things you don’t want to do. But as they progressed, their therapist recommendations should’ve also progressed.
5 Things You Shouldn’t Do After a Total Knee Replacement
Obvious restrictions after knee replacement include jumping up from your hospital bed, ignoring your pain, and getting right back into the gym.
Refrain from engaging in these high-risk activities during the initial stages of your recovery period:
1. Don’t move too little
While moving too much is certainly bad for post-op recovery, sitting still until everything heals could be worse.
This is what happened to my patient. Afraid of hurting or “making things worse,” they would lounge on their couch the majority of the day when they were not at PT.
Movement and mobility heal. As long as you don’t put the knee joint through uncomfortable and painful activities, we recommend moving as much and as often as possible.
There are multiple ways to get blood flow through the joint in the hospital. From simple muscle contractions to gentle compression machines can help you jumpstart movement in the area.
Once cleared after surgery and during your physical therapy appointments, continue working out the unaffected body parts. Research has shown that exercising the unaffected side helps preserve motor control and muscle mass in the affected side. You’ll still see some atrophy (muscle wasting), but it will come back as you continue to move.
At home don’t just sit still, perform some non-exercise movement on a stationary bike, or gentle range of motion of the knee which can help your body adapt to the new joint, maintain blood flow, and reduce congestion or blood clots.
2. Icing the injury
Directly icing an inflamed joint post-op isn’t good for long-term recovery. No need to avoid it completely, just don’t do it with the idea of reducing the inflammation.
The inflammatory response your body goes through after an injury or surgery is exactly what your body needs to heal. Icing can further constrict already constrained fluid flow in the body. It’s the opposite of what healing requires, which is to improve flow and reduce congestion.
Focus on other methods such as elevation, and gentle range of motion. You can do this for a few minutes at a time throughout the day. Remember, move as often as you can as much as you can without pushing past discomfort, especially the first 7-10 days post-surgery.
Once you’re cleared continue using tissue mobilization techniques. Just make sure you don’t directly affect the surgery area. Attend only to the tissues above and below.
3. Don’t skip sleep
Just because you are recovering doesn’t mean you can go to bed at midnight, wake up at 7 am, or catch up on your sleep by napping throughout the day.
Sleep is the most important part of the recovery process. If you’re not sleeping, you’re not recovering.
Aim for at least 8 hours of uninterrupted sleep during the post-op phase and up to 21 days after. Make it part of your daily habits!
To ensure quality sleep, remove cell phones from your room or put them in airplane mode an hour before bed. You should also make sure to get enough movement during the day. You won’t be able to walk long distances, but spinning on a stationary bike (or an airdyne) at low paces can help increase the movement throughout the day.
For insomnia sufferers, ask your doctor about sleep medications or look into a natural sleep aid.
4. Don’t stop mobilizing
Don’t stop mobilizing.
Move as much as you can, as often as you can.
Don’t stop mobilizing.
Idleness can increase the risk of complications. This is exactly where my patient went wrong during his rehab. They stopped mobilizing as soon as they were home.
As I mentioned before, even mobilizing (exercising) areas not directly affected by surgery can help keep your tissues healthy and conditioned. Mobilize other body areas too like the back, upper body, hips, quads, hamstrings, calves, and feet.
Reminder: Don’t be too eager to get the knee moving back to full range of motion and strength immediately after surgery. Recovery takes time, be patient.
5. Don’t be mindless
Take this time to be mindful and intentional during your recovery.
Be present during your recovery.
This is by far the hardest thing for patients to do. Most just want to get in and get out, get it over with. So many dread going to their physical therapy appointments.
Don’t be like them.
This is the time for you to be mindful of your injury, learn how your body adapts, and be intentional with every movement.
When Setbacks Happen, Plan and Maximize Your Chances of Recovery
That is all for this issue!
Thank you for taking the time to read this week’s The Athlete Spot™ Weekly.
Wishing you and your family a Happy New Year!
When you’re ready, here are 3 ways I can help:
The Anti-Fragile Athlete Framework: When you are ready to overcome injuries, optimize your health, and build a powerful and adaptable physique and mindset, The Anti-Fragile Athlete Framework is the obvious choice. Through ongoing support, prioritize your health, build muscle, and become unstoppable.
Need one-on-one guidance to overcome injuries? Apply for private one-on-one injury rehabilitation.
Promote yourself by sponsoring this newsletter.