Hiking after TKR

Thank you Chico. Yes, Hill walking very much a part of my hiking activities. Currently, I'm on the process of recovering from quite a severe setback from overdoing the walking several weeks ago. My Orthopaedic surgeon was shocked when I told him where I had walked on 26th June with my rambling club on our summer Wednesday evening walks. Then I walked for several miles a few days later along the seafront at Blackpool, England. My problems started a few days after that.

I'm a hiker and I had the same problem as you Gillian as I was always doing too much. I didn't really have a severe setback but I think walking too much slowed my recovery. The thing is no-one can really tell you the correct amount because like Chico says every ones recovery is different. My wife was walking several miles a day after about six weeks and she didn't seem to have any adverse effects.

It's now seven months since my op. and I've been able to do 5-6 miles for about six weeks without much of a problem but I still wonder if my swelling would have reduced faster if I hadn't.

All you can do really is increase your walking gradually and see what happens.

Of course, every patient is different and we all recover at different rates. I was doing really well and was walking for anything up to three miles without I'll effect. Also doing my exercises. The walk I did on 26th June was up Rivington Pike, near Bolton, Lancashire. A few days later, on 30th June, I was dancing at a party - not the best idea in retrospect. However, I'd enjoyed my Zumba class on 18th June (operation was on 11th April) It was my first time back at Zumba. My seaside walk was on 2nd July, not all in one go, but through the day. It was after that I began to struggle with pain and stiffness and difficulty walking. Anyway, after a few days on painkillers, my knee and leg are beginning to feel more flexible now. Also, pain has subsided. I hope it stays that way.

"Of course, every patient is different and we all recover at different rates."

Well it was a lesson I had to learn. I expected my recovery to be similar but not exactly the same as my wife's. I did one of our regular walks after about six weeks and was fine. I struggled then to do similar distances for a while before giving up. My wife had little problem doing the same distances after her op. so I thought my knee would just get used to it but it wasn't ready. That was just from walking, no zumba or dancing 😃. I did have a lot of trouble with scar tissue though and had to do months of aggressive physio to try and improve my "angles". My leg is straight now but only ever achieved around 110 flexion.

I spent a couple of months then trying to increase the steps but easing off again when my knee complained.

Rivington Pike is a walk I've never heard of. I've just had a look and it looks lovely. Will have to add it to my "to do" list. The route I looked at said three miles but steep inclines. Was that the same walk you did?

Yes, up large steps. I realise now that I did too much too soon. I think scar tissue is a bit of a problem as well. Sometimes, I get this tight feeling over my knee. I hope I don't have to have MUA. It sounds like medieval torture!

That's my recovery in a nutshell. Too much too soon and too often.

I get a tight band feeling but I think it's easing. It makes walking a bit uncomfortable but nothing like the pain I used to get.

I think usually a mua is only done for people with a poor angle of movement but I'm no expert, obviously.

Hi Chico

So I didn't realize that at 5 weeks you walked that much. Guess in all your posts somehow I missed that.

And on this thread there are several saying they are walking quite a bit in about a months time.

If that is the case and possible why would one not be able to go back to work ? (assuming that you were able to walk that well in 4 weeks?

Just wondering .

Debbie

First, I didn't intend to walk that much that day. My daughter asked me to go to a mall with her and it just got out of control. Unintentional but a lesson learned.

Walking is not the only criteria for going back to work. You have to have your 0/+120 ROM back plus the strength to do not only working but perform the activities of your job with no resulting pain or swelling. There are a lot of factors at work here: how much the knee has healed, your age, your general state of fitness, the muscle rebuild, your ability to walk normally at other people's speed, ability to do stairs, and more for 8-12 hours.

You also have to be off the opioid meds so you can drive. And then there's the big one: your occupation. There's a big difference between sitting at a desk for 8 hours, being a FedEx delivery person or construction worker, running the halls as a nurse on a 12-hour graveyard shift, etc.

Sooooo many posts on here about people trying to go back to work before they were ready. The timing seems to be between 3 and 4 months....sometimes longer. Closer to 3 months and people report a lot of pain, swelling and sleeplessness every night even for a desk job while 4 months seems to be the threshold where there seems to be a lot less difficulty.

Again, it's all very individual but, IMHO, if you want to go back sooner rather than later, you have to do the ROM and strength work to have any chance of a successful transition. Again, condition of the knee at that point in time, age and occupation are critical factors. We always say "listen to the knee"...it will tell you. If you are doing 10,000 steps a day with no issues and have done the strength work then you might want to consider going back to work, again, depending on your occupation and required duties.

This is NOT an easy call by any means and there is no set time that applies to any one person. I've related to you what I've learned from reading tons of posts on this subject. In the end, your decision needs to be based on the duties of your job and how your knee will stand up to those requirements. Ask the knee if it's ready.

PS: Yes, we've had some people on here who had to go back to work for financial reasons before the knee was able to handle the stress. They had to deal with a lot of discomfort for 1-3 months before the knee strengthened enough to get them past that unfortunate period of time. So that's another factor...you don't want to lose your job. It's a real conundrum to decide when to pull that particular trigger. I would suggest that you do all the prep work to give yourself the best shot at going back to work with minimal knee repercussions.

Good one Chico. I've learned a lot so far.

TKR Rule #3: You cannot push a knee to recovery.

This was a hard one, especially for me. I had a hip replacement, four knee scopes, two shoulder scopes, a spinal laminectomy and a spine fusion (that was horrible...). I totally rehabbed the hip in six weeks (5 hours a day, 6 days a week in a therapy pool and gym). I pushed the hell out of it and the strategy worked. I figured I'd ace the knee too. I even told my bandmates that I'd play a gig the following Saturday night...no problem...

WRONG!!!!!!!!

I hit that brick wall so hard, you could see the marks on my face for weeks. Writhing in pain, drooling on my pajamas, my wife shipping me off to a rehab center when she couldn't take it anymore... I was a walking delusional expectation.

I've been on here for well over 3 1/2 years and have read over 20,000 posts. Everyone has the same identical problem...expectations. Even those who get #2 done "expect" it to be identical to #1 and it rarely is...for better or worse. Can't listen to the docs who tell you that you'll be back to work in 6 weeks or those very rare people whose DNA just seems to generate zero scar tissue and are back to life in two months. No one should ever expect that. The result is pain, depression, anxiety, self-blame and more...all because of expectations.

This is a very slow process that usually takes a full year to go through. Relax, take it one day at a time and listen to your knee. Want an expectation? Here's one: I'll be climbing stairs normally in one year. That's a good expectation and very doable...IF...you get your ROM to at least 0 / +120 and do the muscle rebuild. See? It doesn't happen by itself...ya gotta work for it. But when you get there, it's a great feeling.