Now every person is different and the causes that have led to them needing a knee replacement can vary hugely. However there are a few key factors that will make a huge difference to how quickly a person will recover from knee replacement surgery, and how well they recover.
For over 10 years I have run 'Knee & Hip Classes' for people with knee and hip pain who are waiting for replacements, recovering from replacement surgery or even just trying to avoid or put off needing surgery. Those who do go to have surgery are often back in class within a couple of months, not always doing as much as they used to because they may still be waiting for some of the swelling to go down. However within a couple of weeks of being back in class they are almost all able to push the pedals around on a bike and go up and down steps.
Now you maybe thinking that I keep talking about them being back in class or back doing things.
Well this is the biggest secret to recovery - not rehab but 'prehab'!
Doing the physio exercises before surgery. The greater the ROM (range of movement) in the joint and the greater the strength in the muscles and the better the balance in strength between the muscles that control the movement of the knee pre surgery the better the post surgery outcomes will be*.
At this point you might argue that you are in pain when you try to do certain movements, therefore you couldn't possibly do exercises before you have the surgery. You will be in pain that is why you need the surgery, but that pain can actually be reduced by doing exercise pre surgery. Tight muscles place more tension on the joint leading to increased friction between the surfaces which is generally increased further by poor muscle balance meaning that the tension in some muscles lead to poor joint alignment creating increased friction in the joint (in many cases the cause of the problem in the first place). By teaching you how to do daily movements with good joint alignment we start to correct those imbalances and reduce some of the friction within the joint reducing the pain on those movements and more generally in life. Post surgery this leads to better recovery because there are no/less forces acting in the wrong direction on the replacement knee joint, aiding recovery and helping your new knee joint last longer through less friction and therefore less wear and tear.
Many of my clients have come to me several months post surgery having had there first knee (or hip) operated on and awaiting (or expecting to need) surgery on the other leg as well. They usually feel that they need to build more strength in the leg that has been operated on so that they can cope whilst the other leg is recovering. What they find is that there recovery from the second operation if and when it becomes necessary is much quicker (weeks instead of months) than it was from the first operation because they did the exercises first. They not only built strength and improved their ROM but learnt how to do movements correctly with good alignment reducing the stress on the joint(s).
Takeaways:
Prehab - do appropriate exercises before you have the surgery.
Pain - it may hurt, there maybe some pain or discomfort.
This will usually reduce the more you get used to doing the exercises.
The pain is trying to stop you damaging the joint further - that damaged area is going to be replaced.
There is likely to be a lot less pain in the long run.
Good Alignment is the key! - It is absolutely the most important thing in your prehab and rehab! If your instructor is not emphasising good alignment in your exercises find a different instructor or even just watch my 30 minute knee and hip rehab video**.
The image below shows a good exercise performed badly - the knee is coming across the body and the foot is not in alignment with the knee.
*There are always exceptions usually as a result of complications during/post surgery although these are a lot less common than they used to be 10-15 years ago.
** Please excuse the background but the video was shot in my garage
during the first COVID lock down.