Walking after a Total Knee replacement

[dazintaz]

I would be interested in hearing from fellow walkers who’ve had a total knee replacement. How long after the operation did you decide to walk a trail and any issues carrying a pack of perhaps even a multi day walk?

[flingebunt]

I talked to someone who stopped bushwalking after their knee replacement, as it reduced their ability to walk comfortably and easily or rough terrain.

Essentially, you want to get up and walking as soon as the doctors recommend which will help recover your knee function. You should probably ease into hiking again though to make sure your knee can handle it. Unfortunately, some people don't recover good knee function after surgery, but I wish you all the best and hope you can get out hiking again.

[commando]

dazintas, myself i would do something different like paddle a kayak from Strahan down to where the Gordon meets the Franklin.
Results are the same.

[matagi]

I would be interested in hearing from fellow walkers who’ve had a total knee replacement. How long after the operation did you decide to walk a trail and any issues carrying a pack of perhaps even a multi day walk?

Have you discussed this with your physiotherapist, so they can target your rehab?

[tjcraig]

I have been walking/camping/thru hiking for about 3 years since my TKR. It has not been ideal as I only have about 90 degree bend in my left knee now.
Life saver has been trekking poles - I use the PacerPoles which are built like tanks and have saved me numerous times. I can cope with most things - I was half way through the Te Araroa when Covid hit - scrambly stuff and climbing over boulders can be challenging. I power up hills but do struggle a little on steep downhill.
I'm a bit slower than I used to be as well but it's good incentive to go lighter and I feel like I'm a better walker gear wise these days.
Go for it!

[johnw]

Reviving this topic as I underwent TKR surgery yesterday on my left knee and I'm interested to know how any others have faired with the same procedure. Long story but I injured my left knee back in the 90s and left untreated to heal on its own not knowing that I had torn the lateral meniscus. So the damage was worse than I had thought. Eventually it deteriorated and I had an arthroscopy in 2010 (meniscectomy/chondroplasty). I was told at the time that I would need a knee replacement within 10 to 15 years, which is pretty much spot on. Very active lifestyle during the intervening period; a lot of bushwalking, cycling and distance running, including a number of full marathons and other endurance events. Visited the orthopaedic surgeon 2 years ago and he said that I need a new knee. I opted for more conservative treatments first, cortisone injection and physio. Worked for a while but last couple of months had really gone downhill. So revisited the surgeon last Thursday, x-ray confirmed that the knee is stuffed. He's about to go overseas for an extended trip and there was a spot available to do the operation at short notice. So I took it up and here I am. Bed rest only post surgery until this morning. Started rehab mid morning. Very painful putting weight on it but managed some walking on the spot with a walker and a very short trip out into the hospital corridor and back. Finished the first sets of exercises about an hour ago and just did another walk down the corridor a fair distance and back. Much less painful and a lot smoother. Of course I am on some pretty strong painkillers, which helps, as well as icing the knee periodically. So all good so far, although some things are very awkward atm. I've been told it will be at least 3 months before I can get back to bushwalking and similar activities. Anyone else gone through the same? And how did you fair in the long-run?

[crollsurf]

Go see a Physio as soon as possible. Don't wait weeks or months. If their good, that'll be your quickest road to recovery. Just beware. They'll want to keep your wallet open for as long as possible

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[johnw]

Go see a Physio as soon as possible. Don't wait weeks or months. If their good, that'll be your quickest road to recovery. Just beware. They'll want to keep your wallet open for as long as possible

Thanks. I'm currently working with the hospital physio team. Once I've done the initial rehab in here and return home (indicatively probably 7-10 days) I may need to return as a day patient for a period. At least that's what happened with my wife's hip replacement a couple of years ago. I've been seeing my own physio every 4-6 weeks for the past 12 months or so to try and avoid or at least delay the surgery. He's aware that I was likely going ahead with the TKR. In the longer term I'll probably go back to him. He's good with pain management (actually PhD qualified) and doesn't push the overservicing angle. I usually suggest the timing of the next appointment. Not cheap but his rates are comparable with other physios I've seen. Only problem is it can be difficult to get an appointment as he only works Saturdays near me. Also lectures at uni which takes up his time.

[crollsurf]

Don't expect much from the outpatient Physios. Their job is to get you out the door. If money is an issue, run with them, but your own Physio sounds better.

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[johnw]

Don't expect much from the outpatient Physios. Their job is to get you out the door. If money is an issue, run with them, but your own Physio sounds better.

The hospital I'm in outsources the rehab to a local physio practice that I've used before when I was running marathons. They were good back then, sorted out an issue I was having with ankle and metatarsals in my right foot. Rehab is included in the private health insurance I've already paid for so may as well use it. I'll go back to my own physio after that. Exercise program they started me on yesterday seems to be having some positive effect but it's only day 2, long way to go yet. Pain is better but a nurse just told me days 2 and 3 are the worst then it gets better.

[crollsurf]

Ok, that sounds better. The few times I've been in rehab, even though they called it physio, they really only seemed to care about how the wound was healing.

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[johnw]

Ok, that sounds better. The few times I've been in rehab, even though they called it physio, they really only seemed to care about how the wound was healing

Yes quality of health care can be variable. I can't complain so far. Wound care is mainly looked after by the nurses in here. My surgeon turned up early this morning to see how it's going and was really happy with progress. Told me not to try doing too much. Reckons there will be some level of pain for up to 6 months, but different to pre-surgery and much less severe. I had a long discussion with the two physios that visited yesterday. I think they're here again this morning so expect they'll see me in due course. Nurses recommended to start icing the knee again today so I'm doing that now. Will do the first set of exercises after that. Two more during the course of the day. Hopefully this is the solution. I remember virtually crawling up from Lake Albina to the main range track a couple of years ago. Was in so much pain even driving back to Jindabyne. Improved for a while then progressively downhill.

Below for anyone contemplating TKR. Pretty long scar. Not sure if they can do a keyhole surgery, there's a fair bit of gear to stuff in there. I believe they can do keyhole for hip replacement now though.

[Walk_fat boy_walk]

Ah jeez! Good luck with the recovery.

[johnw]

Ah jeez! Good luck with the recovery.

Thanks WFBW. Probably looks worse than it feels, although pretty stiff and sore until the meds kick in. I'll be hobbling around for a while though, probably with a stick initially. But I'm happy I made the right decision. Did a volunteer remote bushcare trip a couple of weeks ago with an older bushwalker than me. He had the same op a couple of years back. We had to descend about 100 metres into a gorge, rock hop, scramble and wade for about 1 km along a creek then climb out again and do maybe another 2 km back to the cars. All off track apart from the last bit. Anyway I followed him out and while he was slower than me, my bad knee notwithstanding, he coped really well, even on some awkward climbs. He then walked smoothly back to the start while I limped most of the way. That made up my mind.

[johnw]

So far the recovery is progressing better than I hoped. Worked with the physio yesterday and graduated from the walker in the afternoon. Within half an hour or so I got my L plates then P plates on crutches . Did some easy up and down stair work and standing squats. Wants me to do 3 or 4 walks down to the practise steps and back today on crutches and do the stair work again. Probably 50-70 metres walk from my room. Also keep up the sitting/lying down exercise program I was already doing. Knee is still very stiff but meds are keeping a lid on that so I can get on with it. Very happy, I might even try an exploratory walk with the crutches later on today .

[johnw]

Astonished how quickly my recovery is progressing. My surgeon called in last night and was surprised at the range of movement in my leg. Wasn't sure I really need to do much rehab. Today the physio came and started me on just a walking stick. Possibly don't even need that but probably best for safety, and so I don't knock anyone else over! Been signed off from the initial post op physio program. I feel very confident walking around with the stick, not sure if prior use of a hiking pole/s helps. Now need to focus on as much walking as pain tolerance allows, plus easy stair work, knee bending and flattening to get full extension back (eventually). I won't pretend I'm pain free but it's liveable (will likely need some level of medication for a while) and should continue to improve in line with my own efforts. I think the key will be to have the discipline to continue at home. Also believe I have probably benefited from doing regular physio to build up quads etc pre surgery.

[michael_p]

Great to hear your recovery is going well. You'll be back out and about before you know it.

Michael.

[johnw]

Great to hear your recovery is going well. You'll be back out and about before you know it.

Michael.

Thanks very much Michael. Still going well. A few bumps with nausea and other side effects from strong painkillers, but nurses are helping me to try and ditch those and see if I can do it with milder meds. Leg and foot is now very swollen, which is normal. Still wandering around the wards and doing physio exercises, not painful but feels very tight. Looking forward to going home but don't want to make the mistake of leaving too early.

[madpom]

I once shared a ward with a number of men fresh out of knee replacements.

The only lesson I learned from the experience was "take earplugs".

Good hearing how you are going with it. Suspect I'll be there myself in a few years so it's good information.

[johnw]

I once shared a ward with a number of men fresh out of knee replacements.

The only lesson I learned from the experience was "take earplugs".

Good hearing how you are going with it. Suspect I'll be there myself in a few years so it's good information.

Thanks madpom. Thankfully mostly everyone in here has their own room. Although I have met some fellow knee replacements and we seem to be a fairly quiet bunch. Or maybe suffer in silence. I did bring some in ear headphones just in case .

[GregR]

Great to hear your recovery is going well. You'll be back out and about before you know it.

Michael.

Thanks very much Michael. Still going well. A few bumps with nausea and other side effects from strong painkillers, but nurses are helping me to try and ditch those and see if I can do it with milder meds. Leg and foot is now very swollen, which is normal. Still wandering around the wards and doing physio exercises, not painful but feels very tight. Looking forward to going home but don't want to make the mistake of leaving too early.

I feel your pain John. sounds eerily like my scenario except (a) yours was planned and (b) different body part. Same end result though- laid up and going stir crazy trying to win "Where is it on.." this forum to stay sane...

I'm now back to nearly normal after my recent hospitalization and 3 months in, I'm walking day walks again to a similar distance and times to previous. Bike riding again, albeit in a limited fashion, and next month or so hoping to strap on a O/N pack and head out for a night or 2 to gauge how the body copes.

good luck with the recovery but I'm still going to try and keep you honest on the Competitions!!!

[johnw]

I feel your pain John. sounds eerily like my scenario except (a) yours was planned and (b) different body part. Same end result though- laid up and going stir crazy trying to win "Where is it on.." this forum to stay sane...

I'm now back to nearly normal after my recent hospitalization and 3 months in, I'm walking day walks again to a similar distance and times to previous. Bike riding again, albeit in a limited fashion, and next month or so hoping to strap on a O/N pack and head out for a night or 2 to gauge how the body copes.

good luck with the recovery but I'm still going to try and keep you honest on the Competitions!!!

Good to hear that you are almost there Greg and back to some walking and cycling. Pre surgery I made a Q&A list for my ortho which included "when can I get back to more strenuous activities like bushwalking, cycling" and so on. His answer was 3 months. So it sounds like you are on track. I've now transferred to the rehab ward for a few days then hopefully go home by Tuesday. I actually found a little floor pedal bike in the cupboard of my room last night so will give that a workout. Had a bit of a rough night though. Change of location, bed and avoidance of strong painkillers meant I couldn't find a comfortable sleeping position. My knee complained most of night. I feel brighter today albeit just had a bout of nausea from the zinc tablet they gave me earlier. Just taken something to counter that then I'm off to find the physio. Yes playing "where is it" games helps keep your sanity. At least my brain still functions normally (my wife will argue otherwise). And you are right to keep me honest, I expect nothing less .

[madpom]

we seem to be a fairly quiet bunch. Or maybe suffer in silence

It was more the snoring. A whole ward of men forced to sleep on their backs. Impressive!

[madpom]

Bike riding again

Again, cant talk for knee replacement but for other knee injuries / op.s cycling is wonderful. Building strength without any impacts. Until you find yourself 40km from anywhere, with a flat and a bust bikepump & incapable of walking more than 100m! Thank god for random, generous farmworkers out for a bevvy & spotlight in the farm ute! That was 1st knee op after a big fall.

2nd op (cartrlege tear) years later physio advised cycling. So having the 3 winter months off work I got the missus to drop me at Bluff and cycled the 3400km to Cape Rienga. Specialist was quite impressed at that level of muscle recovery I'd achieved. Sadly ACC (injury insurance) wouldn't cover the costs!

[johnw]

we seem to be a fairly quiet bunch. Or maybe suffer in silence

It was more the snoring. A whole ward of men forced to sleep on their backs. Impressive!

I can't usually hear the other patients but have caught myself out, waking myself up with some loud snoring .

[johnw]

Bike riding again

Again, cant talk for knee replacement but for other knee injuries / op.s cycling is wonderful. Building strength without any impacts. Until you find yourself 40km from anywhere, with a flat and a bust bikepump & incapable of walking more than 100m! Thank god for random, generous farmworkers out for a bevvy & spotlight in the farm ute! That was 1st knee op after a big fall.

2nd op (cartrlege tear) years later physio advised cycling. So having the 3 winter months off work I got the missus to drop me at Bluff and cycled the 3400km to Cape Rienga. Specialist was quite impressed at that level of muscle recovery I'd achieved. Sadly ACC (injury insurance) wouldn't cover the costs!

Cycling is also good post knee replacement. I've already had some discussion with physios about that. I've been using the small floor pedal bike in here under their instruction. It will be about 3 months before I can get back to proper cycling on actual roads or trails but any form of cycling seems to be considered positive as a recovery tool. I'm glad you found some assistance with your predicament! Pre surgery I had been doing some shorter rides near home. In the interest of going light and keeping it simple I wasn't carrying pump or tools etc. Always a bit concerned about what happens if I get a puncture, lose the chain and so on. I would have struggled walking the bike back with my bad knee.

[johnw]

Going home tomorrow, yay! Will come back likely 2 days a week as a day patient for physio up to the limit included with my medical fund. Probably about 6 weeks. Any follow up needed I'll do with my own physio after that. Had assessments this morning with occupational health therapist, physio and my rehab doctor. All good to go, just need a Doppler x-ray and blood test before I leave. Hopefully get those done later today or first thing tomorrow. Had sessions in the hospital gym yesterday, this morning and going for another this afternoon. No problem handling the exercise routines so far. Range of movement is much better than expected. Still a long way to go but at least I'll be able to do the balance of recovery in my own environment.

[johnw]

Well I've been home for over a week and generally coping very well except that I haven't had a decent night's sleep in weeks. If I get more than 2 hours straight I'm over the moon.
It's not possible to find a comfortable sleeping position and I'm told by other patients and rehab staff that will go on for some time yet. Still experimenting.
2 1/2 weeks post surgery and I'm walking quite easily and confidently with no aids around home, up and down steps, and find a stick more of a nuisance than benefit in most situations.
I do take one when going out, to day therapy etc, just in case. It's surprising how quickly people get out of your way in shopping centres etc!
There is incremental improvement each day in the range of movement in my operated leg, and I'm being pretty disciplined about doing the relevant physio exercises at home and day therapy.
Just swelling, stiffness, no sleep and some occasional med related stomach upsets being the main hurdles atm. All normal apparently.

[Tortoise]

Hey John. It sounds like you're progressing very well indeed. I have no doubt that your commitment to doing the exercises is contributing to that. Bummer about the sleep issue. Easier to cope with at home than in hospital.

[johnw]

Hey John. It sounds like you're progressing very well indeed. I have no doubt that your commitment to doing the exercises it contributing to that. Bummer about the sleep issue. Easier to cope with at home than in hospital.

Thanks Tortoise. Yes, even though I had really good care in hospital I was so glad to be home. It's a long road but I have the tenacity to get there.
Unfortunately most of the healing takes place at night when your body is typically resting, and that's what causes the discomfort.
Looks like I'm going to get used to getting up at 1 am and 3 am to ice my knee .