Your knee is vital to your mobility allowing you to move your leg forward, backward, and side to side. But when it is damaged or diseased, it can cause immense pain and make it difficult to get around.
Knee replacement surgery is a standard and successful procedure to relieve pain and restore function in people with severe knee problems. So, recovery and rehabilitation after surgery are essential to help people return to independence and daily activities.
But how much walking after knee replacement is too much, and when can you expect to return to your usual routine?
Knee Replacement Surgeries and Rehabilitation:
There are different types of knee replacement surgeries. The most common is total knee replacement (TKR) and partial knee replacement (PKR).
Total Knee Replacement:
In total knee replacement surgery (TKR), the surgeon removes the damaged surface of the bones that form the knee joint and replaces it with an artificial implant. The artificial joint is usually made of metal and plastic. Some of the latest implants are made of ceramic.
When the surgery is complete, the incisions are closed with stitches or staples. A drainage tube may be inserted to remove any excess fluid from the knee. You will then be taken to a recovery room, where you will be monitored for complications.
Partial Knee Replacement:
In a partial knee replacement (PKR), the orthopedic surgeon only replaces the damaged portion of the knee. This is usually done when only one section of the knee, such as the inner compartment, is affected by arthritis.
The incisions for a PKR are usually smaller than for a TKR. The surgery is done with either a general anesthetic or a regional anesthetic, which numbs the area around your knee and thigh muscle. You can go home the same day or the day after surgery.
Recovery and Physical Therapy:
After either type of knee replacement surgery, you will need to participate in a rehabilitation program. The goals of physical therapy sessions are to regain your range of motion, build up your strength, and help you walk without pain.
Most knee replacement patients stay in the hospital room or rehab facility for three to five days after TKR major surgery. For PKR surgery, you may go home the day of surgery or the day after.
You will start physical therapy the day after your knee surgery. A physical therapist will teach you exercises in bed and how to use any assistive device, such as a continuous passive motion machine or stationary bike, used during your recovery process.
The therapist will also help you get out of bed, stand, and walk with the help of a walker or cane. You will likely need to use a walker or cane for four to six weeks for significant improvements. You may also need a knee brace or ankle pumps for protection while your joint heals.
Most people can return to their normal activities within three to six months. However, it may take up to a year to recover fully.
How Much Walking After Knee Replacement
Walking is an essential part of your rehabilitation after knee replacement surgery. It helps restore range of motion and build strength in the calf muscles around your new joint. But it’s important not to overdo it. Too much walking can put too much stress on your new joint and delay your recovery.
Your physical therapist will help you gradually increase your walking distance as you get stronger. They will also guide you on when to rest and how to ice your knee to help reduce swelling and knee pain. Generally, surgeons and therapists say that patients should avoid walking more than two miles a day during the first few months after surgery.
Within a few weeks, you should be able to walk for at least 20 minutes at a time. Sometimes, people can return to walking long distances and even running soon after surgery. However, this is usually not recommended as it can put too much stress on the new joint.
It may take up to three months before you can walk long distances without pain. It is essential to listen to your body and take breaks when you need to.
Guidelines for Recovery After Knee Replacement Surgery:
Here are a few guidelines to help you walk safely after knee replacement surgery:
If you have a TKR, start by walking short distances with the help of a cane. Gradually increase your walking distance as you get stronger. Aim to walk for at least 20 minutes a day. You can break this up into shorter walks throughout the day. Coming home from the hospital, most people can walk around their house and outside for short periods.
If you have a PKR, you may be able to start walking without a walker or cane soon after surgery. But be sure to ask your physical therapist before you start walking on your own. Once you start walking, gradually increase your distance as you get stronger.
The pattern you use to walk is also important. When you walk, keep your heel slides down first, then roll through your foot to push off with your toes. This pattern takes stress off your knee joint.
Walking up and down stairs:
After knee replacement surgery, going up and down stairs may be difficult at first. Here are some tips to help make it easier:
When going upstairs, lead with your straight leg raises and use the handrail. Step up with your operated leg, keeping your knee straight. Then bring your other foot up to meet it.
When going downstairs, lead with your operated leg and use the handrail. Step down carefully, keeping your knee straight. Bring your other foot down to meet it. As you get stronger and more confident, you may be able to walk up and down stairs without using the handrail.
After knee replacement surgery, you will need to exercise to regain muscle strength and motion in your knee. It is essential to follow their instructions and do the exercises as often as they recommend.
Most people feel pain when they first start doing exercises after surgery. But this is normal and will get better with time. If the pain does not go away or gets worse, tell your doctor or physical therapist.
As you get stronger, you may be able to do more challenging exercises, such as riding a bike or swimming. But be sure to check with your doctor or physical therapist before you start any new exercise.
Range of Motion:
It is important to regain a normal range of motion in your knee joint after surgery. This will help you feel more comfortable and make it easier to do your everyday activities.
Your physical therapist will show you how to move your knee through its full range of motion. They may also use a machine called a continuous passive motion (CPM) machine to help stretch your knee.
You may need to do range-of-motion exercises several times daily, especially in the first week or two after surgery. As you get stronger, you will be able to do these exercises less often.
Pain and Swelling:
It is normal to feel some pain and swelling after surgery. Your doctor or physical therapist will give you medicine to help with the pain. They may also recommend using rest, an ice pack, compression stockings, and elevation (RICE) to help reduce the swelling due to blood clots.
The strong pain medications you take right after surgery can make you feel sleepy. So, it’s essential to get plenty of rest. But it is also important to get up and move around as soon as your doctor or physical therapist says it’s okay. Walking is a great way to reduce pain and swelling.
You may have some drainage from your incisions (surgical cuts). To help prevent infection, it is essential to keep the area clean and dry.
Eating a healthy diet is an integral part of recovering from surgery. It can help you heal and get stronger.
Your doctor or physical therapist may recommend that you take a daily multivitamin. They may also recommend that you eat foods rich in protein, such as lean meat, fish, and tofu. Protein can help your body heal and repair scar tissue.
It’s also important to stay hydrated by drinking plenty of fluids. This will help your body heal and reduce pain and swelling.
What Not to Do After Knee Replacement Surgery:
After knee replacement surgery, there are some things you should avoid doing, initially. These include:
Bending your knee more than 90 degrees:
Bending your knee more than 90 degrees can put too much pressure on your new joint and may cause it to become dislodged. This is especially important in the early stages after your surgery when your joint is healing. So, for the first few weeks, avoid high-impact activities that require deep knee bends.
Crossing your legs:
Crossing your legs at the knee can also cause pain and swelling after surgery. This is because it puts extra pressure on your new joint. To avoid this, keep your legs uncrossed as much as possible.
Sitting in low chairs or on low sofas:
Avoid sitting in low chairs or on low sofas. This can put your new joint in an awkward position and cause less pain. If you need to sit in a low chair, put a pillow on it first to raise your leg.
Wearing high heels:
Wearing high heels can increase the risk of developing new knee osteoarthritis and exacerbate pain in those who already have the condition. Heels change how we walk, putting more pressure on the knees with each step. So, ditching the stilettos and opting for flats or low-heeled shoes is a good idea if you want to protect your knees.
Sleeping on your stomach:
Sleeping on your stomach can be uncomfortable and pressure on your new joint. If you find it difficult to sleep on your back, try sleeping on your side with a pillow between your legs.
It is best to wait until your incisions have healed and you have some range of motion before starting a walking program. Walking is an excellent exercise for people with knee replacements, but it is essential to start slowly and increase your distance and intensity gradually. Be sure to talk to your doctor or physical therapist about an appropriate walking plan.