Recovery from any type of surgery, especially something like a total knee replacement, is a matter of consistent effort to improve your overall function. Is it a “routine” or a “job”?
The Difference Between A Routine And A Job
Doing both a routine and a job takes effort. One you don’t really have to think about to do it and the other, you hate thinking about and you probably hate having to do it.
There are a lot of misconceptions of what life will be like after you get your new knee (skip to the bottom if you had a TKR awhile back). Right after surgery, some think that “resting” is the best approach to recovery. “Waiting until the pain goes away” to get moving is one of the most common misconceptions.
And this is understandable. Only the uninitiated cannot fully understand how painful having a knee replacement can be. And with that much pain, you want to make sure that you’re doing the “right” thing because you don’t want to make matters worse!
On the other side, some have the misconception that a “boot camp mentality” is needed. Here the notion of “No Pain, No Gain” rules. People think that they need to do as much as their body will let them before losing consciousness is how they’ll get “better”.
In order to avoid these two traps in your knee replacement recovery, it’s a good idea to take a step back and consider what is really going on.
Recovering from a knee surgery is really like recovering from any physical injury, like stubbing your toe or even breaking one your fingers in an accident. It’s a matter of 1) avoiding anything that makes it hurt worse, and 2) allowing nature to do the healing.
After stubbing your toe, you don’t stop walking do you? However, you’re careful not to stub your toe again. And, you’re not going to go on a 100 mile trek either. You basically nurse your injury with moderate movement and wait until it feels better to do more demanding activities.
And even if you have broken a finger or even your arm, there is an unconscious understanding that “I won’t be able to use this thing the way I want to until it’s healed”. The doctor may put a cast on it for several weeks so it will heal in a normal alignment. But, you basically have an understanding that “nothing is really wrong with it and it’ll heal in a matter of time”.
The same can be said in your recovery or rehabilitation period of your knee replacement. Healing will take place over time. All you have to do is not injure it again.
So What Should I Be Doing While Recovering From A Knee Replacement?
Having a good outcome from your knee surgery is a matter of developing a consistent daily routine of working on your range of motion with and managing any swelling that may be going on.
You want to look at your recovery and rehabilitation as a “routine and not a job”. A routine is something that you do without much thought. You just go about it and move on to the next thing in your day. A routine usually is a matter of habit and is done at relatively fixed times.
Typical daily routines are things like brushing your teeth, washing your face, eating your meals. Routines like these are important to healthy living. And, they all take effort and you want to do a good job at it. But, you don’t really have to put much thought into doing them.
All the routines mentioned above generally take place at regular times. And, indeed, they usually need to take place before you head to your “job”.
So a good routine for your knee recovery should take place at regular times. And the routine needs to take place before you do any “work”.
A job on the other hand is something that takes some determination to do and is more likely a “burden”. It’s something that you do, but, to be honest, you’d probably like to be doing something else. You put up with it. But, it’s not something you live to do.
What Is The Recovery Routine?
In short, exercising and elevating at fixed times everyday.
If you’re like most people, the whole point of having your knee joint replaced is to get rid of the arthritis pain so you can move normally and enjoy your life again, right? The real objective is to “be and walk normal again”.
So, you need a recovery routine that helps you do this.
Generally, the two things that stop people from walking normally after a total knee surgery is pain and stiffness (and also, not having a good understanding of what to expect).
A routine that addresses decreasing your pain and stiffness is what you need to work into daily life. And, it’s a lot simpler than you may think.
Pick 3-4 specific times of the day to do it and get it done. Keep doing this routine until you don’t have to do it anymore (that is until the pain and stiffness is gone – it could be 2 months or longer. How long have you had the routine of brushing your teeth?)
Most pain and stiffness people have right after surgery has to do with inflammation and swelling. So, if your routine emphasizes keeping the inflammation and swelling down, you’re going to get rid of a lot of pain. So pain will be less of a factor to walking normal.
Inactivity also plays a big role in the area of stiffness and swelling. This is because moving your muscles actually helps to decrease swelling. And the effect that movement has on “stiffness” should be pretty obvious.
So your daily recovery routine should include elevation above the heart level (as much as possible) and “movement”. The movement we’re talking about is simply “bending and straightening” the knee and doing your ankle pumps.
But What If I’m Still Stiff A Year After Surgery?
Some people still have problems with ROM and stiffness long after they’ve had surgery. This stiffness may be due to scar tissue build up or simply tight muscles. Have a physical therapist evaluate your restriction and get you on a program.
If it’s scar tissue you may need a more specialized treatment.
However, if you’re still dealing with tight and stiff muscles, then getting on a daily routine that targets the specific muscles that are restricting normal motion is needed.
If you’ve been hampered for a while after your surgery, then it’s probably not just your knee that is stiff. Over time, your stiff knee will affect your hip and your ankle. So having a physical therapist develop a range of motion routine for your hip and ankle will also help your stiff knee.
In either case, whether your knee replacement is within 6 mos or has been over a year, a regular daily routine needs to be adopted to “get back to normal”.
For most people, a routine that manages any swelling or inflammation, and works at stretching tight muscles and soft tissue is the best approach to get normal motion back in a stiff knee.