We've talked about ROM - now what about post op exercise?

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The exercises I was told to do post op are pretty minimal really that don't involve much in the way of strengthening, but concentrate more on THE BEND!:-))))  I know some on here are going to gyms, with instructors, and some feel it's very important to seriously work out after the op.  I can see that we need strong muscles to support the knee but when I went for my six week check the physio was very surprised at the strength I had in my legs.  Now, all I've been doing for a while now is up to ten minutes on the recumbent bike and 10 minutes on the treadmill, leaning heavily on arms.  At the moment I've built up to 7 or 8 minutes on the bike and treadmill, but my intention is not to go more than 10 minutes on each.  I'd like to be able to also do a few minutes or so on the cross trainer when the other knee is done to improve core strength.  I doubt I'll be walking miles every day, ever, but normal walking will do me fine.  I'm not planning on being an athlete, but would like to be able to get up and down from a chair without leaning on arms and also go up stairs and down, without leaning on handrail.  That's my goals.  Something I read in several studies was that one of the reasons they prefer people to be a bit older before knee replacements is because they're not so active, so the knees last longer.  So, the question is, if you don't need the extra strength for work or a hobby you really want to do, can you exercise to the  point of wearing the knee out prematurely unnecessarily?  It was reading the study about the Koreans loosening the glue with keep doing deep squatting that made me think about this.  Reading that obesity wears the knee out faster - the extra weight on it - how good is weight training - pros and cons ????  Questions, questions...

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  • Posted

    Ooh er Chris, you really are into this aren't you?? Lol

    It does seem that the emphasis is on getting extension & flex not strength.

    The net is usually good for those of us who can't afford the exorbitant cost of joining a gym!

    I was also give core strength exercises by my chiropractor, which also have one or two leg exercises. But it does seem to be down to our own want, to be as strong as we can, rather than any physiotherapist driven regime! At least in U.K. Lol

    There is no right or wrong in this it is up to ourselves to be the best WE can be.

    But even just coming down the stairs slowly & without holding on will exercise your quads to some degree. There are a lot of things we do every day which exercises different muscles without picking up a barbell!

    It all depends on what you need for every day life, your job & any extra curricular activities you wish to do!

    XX

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    • Posted

      YES!  This is the conclusion I've come to over the past few days!  I DON'T need to exercise past the point of building up muscles that got weaker with the arthritis and the little bit I'm doing on the bike and treadmill have dealt with that, AND dealt with weakness through the op and given me more strength than I thought I'd have, and doing every day activities probably keeps pretty good fitness when we able to do more after knee ops.  I think we DO have to ask ourselves what we want to achieve from this - that's the important bit!  Normal life will be wonderful:-))))) 

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    • Posted

      Yes - so it will be even more of a void when it's all done and dusted LOL!  Perhaps then we'll think about a holiday!!!!  We've not done anything for years because husband said my knees were so limiting, so then the world will be our oyster!

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  • Posted

    Designed by a pro...

    https://patient.info/forums/discuss/post-tkr-exercising-565527

    Have fun...

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    • Posted

      Sorry Chico, but you and I are just not going to agree on this.  I've no doubt that most people on this group will not need a regime like that to maintain a good quality of life after a knee replacement.  We don't want to be athletes, but just want to have a NORMAL quality of life.  And my personal concern now, having read what I have, is that excess exercise can be detrimental to the knee, wearing it unnecessarily.  .  My physio has already remarked how good my leg stregth was at 6 weeks and that's just doing the recumbent from three weeks post op, working up to 5 minutes (at that stage) and also I was doing about 5 minutes walking on the treadmill, slowly, then too, holding on arms. 

      But how many people have all this equipment, or the time, or the motivation, or the need, to do all that.  It just doesn't happen and truly, why should it happen.  Most people have their knee replacement, do the post-op exercises and their strength comes back naturally as they take up daily life again.  I don't want to think people feel they are failing themselves by not doing excess exercise after knee replacement.  Fine if they WANT to do it - that's their choice, but it can hardly be said to be necessary for the average person. 

      Squats with weights ARE going to wear the knee faster - I don't see that that is even debatable.  Yes, the knee is designed to take the weight of a person, but it's been proven that someone obese will wear the knee faster because of the weight, and the fact that they prefer people to be older when they have a knee replacement because they aren't as active, also has to say something.  It really depends on what someone wants to do or needs to do after their knee op as to how much they want to risk earlier wear of the knee.

      I think your comment about atrophy like an arm being in a cast isn't relevant.  Because up to the op we are, although limited, still using the muscles to walk, and we're walking straight away after the op.  Yes, I know muscles are damaged in the op but from the day of the op we're starting to build them up again, so there isn't that period of lack of use.

      But as I said, you and I won't agree on that, and that's fine - we don't need to agree:-)))))

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    • Posted

      Again, I asked my daughter, the certified pro in this area for over 16 years, to design me a program that would get me my strength back.  That's it.  Nothing more, nothing less.  It's not intended to make anyone an athlete again.  

      When I had my hip replaced in 2009, she got me into a therapy pool and gym, laying out a course of rehab for me.  Yes, I'm a rehab freak so I did it 6 days a week, 5 hours a day.  Back at work completely functional and strong in six weeks.  No pain, pills, cane or any residual effects.  

      I trust her professional judgment completely.  Take it or leave it...everyone gets to make their own choice.

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    • Posted

      Hi Chris, got to agree. I did all the exercises on the sheet given to me by the hospital. I stuck to these for eight weeks and tried one or two more to straighten my leg, bend came eventually at 130d, I'm happy at that. I just continued with daily life, walking and eventually going up and down stairs. Having reached this point pushing myself with exercise only made my leg swell and go stiff and I seemed to go backwards. I'm happy with what I've got, doesn't hold me up in anyway so fine for my needs. Starting all over again with the left knee in 8 weeks time..Eek!!! X

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    • Posted

      Oh you'll be so pleased when you've got the other one done Jackie:-))))  Im waiting for my date to come through now, and it's going to be between 8 and 12 weeks.  I'm excited and desperate but stressed and anxious too LOL!  I'm not anxious about the actual op, or the recovery, but just generally stressed.  But just think afterwards - no pain and being able to walk normally!!!!  It's SO worth it!

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    • Posted

      Know the feeling, up and down, can't complain about this one or though not for the faint hearted, the inactivity nearly killed me. Hope the next one goes well, seems they can differ. Pma having a few days in the sun before to give me Dutch courage😀😀😀

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    • Posted

      A holiday sounds wonderful!  Hope yours goes well too!:-)))))  My surgeon even said I was so lucky with the first one, so not expecting the second one to go just as easily, but still hoping LOL!
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  • Posted

    G'day Chris,

    ?I had a partial knee replacement on 6 Nov 2015, right knee - medial compartment. I was 71 a the time and I work 30 hours plus a bit a week driving a tourist bus and handling passengers baggage. So I don't need pain BUT do need leg strength !

    ?I'm past gym work outs and find the gym activity boring - so never even went there. Hospital and consultant insisted on a 90 degree bend and a fairly straight knee before leaving hospital, along with a demonstrated ability to climb stairs with the aid of crutches. Done within 3 days. Discharged home on 3rd day. Given exercises to do at home, 10 different ones up to 5 times a day. I also used Youtube exercises following knee replacements too supplement my other exercises.

    ?I also saw my sports injury therapist 8 weeks before surgery and she and I worked on getting upper and lower leg muscles in best possible strength condition before surgery as possible. All ready for the butchery to come !

    ?As soon as my dressing was removed 13 days after surgery she went to work on the scar incision line to break up scar tissue - or rather to prevent scar tissue forming and restricting my exercises. As the wound healed she reworked the lower and upper leg.

    Best things I ever did. driving my car at 7 weeks post op and back at work on the bus at 11 weeks post op.

    ?Nowadays (I live in Cornwall, UK ) I can get out on the rugged, challenging South West Coastal Path without any problem. In fact I could do that before the 11 week mark, but only on the flatter sections. the serious gradients were a month or so later. No problems.

    ?My consultant has given me a 15 year lifespan of the new knee. Before surgery he agreed with a partial so long as there was no sign of osteoarthritis in the rest of the knee. There wasn't. Suspects that this arose from sports injuries decades ago. In my youth I used to do Long Jump and High Jump. In High Jump my right leg was my take off leg, so took a bashing over time.

    I'm still driving for the same employer and manage to pass my bus licence holders medical each year.

    ?I asked my surgeon if my new knee was glued - no it was a plastic and titanium joint (I think ?) and it has been compacted into the medial compartment.

    John

     

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    • Posted

      Great to hear John!  You made a very good, and fast recovery!  I have heard that partial replacements can be more difficult to recover from than full replacements?  There was a lady having a partial replacement in hospital when I had my full replacement and when we went back for our six weeks check she was still on one crutch.

      It is concerning just how many knee problems are caused by sport!  I don't think most people give this a thought at the time they're doing the sports.  Recently a friend told me how her son had run a marathon in a longer time than he'd hoped for because his knee started hurting badly  soon after he started, but they were so full of admiration that he kept going, limping through horrendous pain, to finish it.  My concern was what damage was he doing!!!!  I'm glad you've done SO well though - well done!

      I'm hoping I might get 20 years from my knee.  I've read that some even get up to 30 if they look after them well enough!  That sounds a lot though!

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