Alenna Stirpe

Alenna has graduated from the University of Toronto with a degree in Kinesiology. She is excited to be sharing her knowledge in the fields of rehabilitation and healthcare with the Curovate community.

3 posts

Can I kneel after knee replacement?

Yes! After your operated knee has healed and after 8-12 months of rehabilitation, you should be able to kneel.

Here are three common reasons why a person may not or feel like they may not, be able to kneel.

  1. Range of motion (ROM):
    ROM is a measure of how much you are able to bend or extend a joint. The ROM of your knee before surgery is one of the biggest contributing factors to the ROM of your knee after surgery.1 Generally, you need a ROM of at least 90 degrees in your knee to sit comfortably in a chair. According to a study looking at 100 replaced knees, 64 patients were able to kneel with little to no discomfort if they were able to bend their knee more than 90 degrees.2

  2. Pain:
    Even a year after knee replacement it is normal to experience pain or discomfort in your knee, especially when moving it beyond a comfortable range. This is one of biggest factors preventing people from kneeling after they have had knee replacement surgery.3

  3. Fear:
    It has been shown that people who have had a knee replacement often do not think they can kneel when they actually can. In a study involving 122 patients, only 36% said they could kneel while 63% of the patients said they could not kneel. When the actual kneeling ability of the patients was measured, 74% of them were able to kneel on the ground without any negative effects. The reasons for the difference in what patients thought they could do and what they actually could do was mostly based on the fear that kneeling would be painful or harmful.4

If you are experiencing discomfort or are worried about the effects of kneeling, please speak to your healthcare provider about your situation.

By completing your rehabilitation exercises every day you will be increasing the ROM of your knee and reducing your likelihood of experiencing pain while keeping yourself on track to being able to kneel again!

What kind of exercises and sports can I do after a knee replacement?

If you have had or are going to have a knee replacement, then you have probably wondered about what kind of exercises and sports you will be able to do when you have recovered.

It is important to begin a knee replacement rehabilitation program as soon as possible after surgery. The faster your operated leg regains its strength and flexibility, the more likely you will be to see improvements in your independence and with activities of daily life.1

At 13 to 16 weeks after knee replacement surgery, it would be a good time to begin some endurance activities but there are some requirements before you start:

  1. You must have minimal to no pain in your knee.
  2. You must have minimal to no swelling in your knee.
  3. You must be able to bend and straighten your leg almost as well as your non-operated leg.
  4. You must be able to walk fast without walking aids (walker or cane) or limping.
  5. You must be able to walk for 20 minutes without experiencing pain or swelling.

Speak to your healthcare provider before beginning any new exercises, especially if you are not sure if you meet the five requirements listed above.

The charts below provides recommendations for patients following knee replacement 13-16 weeks AFTER surgery. These charts have been adapted from a clinical commentary released by the Journal of Orthopaedic and Sports Physical Therapy in 2008. A clinical commentary is written by a group of clinical experts when there is no definitive answer provided by research. This means that there isn't a study that says "golf is safe after 16 weeks." So a group of experts decided this based on what they know and the research that is available.

Our physical therapist, Nirtal Shah, states: "Some of these activities may be possible before 13 weeks such as stationary biking, others around 13 weeks such as swimming and some may take 8-12 months such as golf, skiing and doubles tennis. This is a guideline and should be used with the guidance of a healthcare provider."

Recommended Activities
Swimming Golf
Biking (stationary) Walking
Dancing (ballroom, jazz, square) Horseback riding
Bowling Croquet
Horseshoes Aerobic (low impact)
Shooting Shuffleboard


Activities Recommended with Previous Experience
Biking (road) Canoeing
Hiking Speed walking
Skiing (stationary, cross country) Rowing
Tennis (doubles) Weight machines


Activities Not Recommended
Racquetball Squash
Rock climbing Soccer
Singles tennis Volleyball
Handball Football
Gymnastics Lacrosse
Hockey Basketball
Jogging


No Conclusion
Fencing Rollerblading/inline skating
Downhill skiing Weightlifting



It is important to remember that your recovery from surgery should be a slow and steady process. Doing your rehabilitation exercises everyday will allow you to be more mobile as you recover and get you back to doing the activities you love!

References

6 Things You Need to Know After Knee Replacement

1. Pain management:

There will be pain in your knee and leg after having a total knee replacement. It is very important to begin your rehabilitation as soon as possible after surgery but pain can make moving your leg almost impossible! That is why taking the proper dosages of your pain medication is necessary for your comfort and recovery.1

2. Avoid infection:

Undergoing any kind of surgery has a risk of infection. Out of 6489 patients with total knee replacements, 116 of them experienced infection. That means only 1.7% of these patients developed an infection.2 Making sure your wound is kept clean and dry and that your medication dose after surgery includes antibiotics can help you avoid infection.3

3. Avoid blood clots:

In a study of 517 patients with total knee replacements, only 14% of the 468 patients taking preventative medication experienced blood clots. Although, in the 49 patients who did not take this medication, 84% of them experienced blood clots.4 Therefore, it is very important that you are taking the appropriate medications to lower your risk of getting a blood clot.

4. Swelling management:

After knee replacement, it is important to use the PRICE method3 to reduce swelling in your operated leg and aid in reducing your chances of experiencing a blood clot. The PRICE method includes:

I. Protection - After surgery, you will be given a "weight bearing restriction." This means how much weight you are allowed to put on your leg after surgery. Reduce the risk of further injury by putting only the amount of weight on your leg as you have been instructed. You will also be given some form of assistive device (like a walker or a cane) early on to help unload the surgical leg.5

II. Resting - Allowing for your operated leg to heal by avoiding stressful activity but still doing required exercises.

III. Icing - Use of cold treatments to reduce pain and swelling. First, protect your skin from direct contact with the ice and make sure the wound stays dry. This can be done by placing a plastic bag over the scar before you ice your knee. Then cycle the cold treatment, 20 minutes on followed by 40 minutes off.

IV. Compression - Use of an elastic bandage to minimize swelling and provide some support. For further information and instruction on how to wrap an elastic bandage check out our previous blog here.

V. Elevation - Decrease swelling and pain in your knee by positioning your operated leg above the level of your heart. Putting a thick cushion or pillows under your leg while laying down is a good way to do this. However, make sure when you are elevating your knee to keep it straight and not bent.

5. Get moving:

As soon as you are able to, start moving the toes of your operated leg. Continuously moving your toes and ankles for 2 minutes, 3 times an hour is a great start! It is important to start your rehabilitation program in order to limit stiffness.2,6

6. Rest:

Although it is important to move your operated leg, it is also important that your body rests. Giving your body time to rest and recover at a comfortable pace while doing required rehabilitation after surgery is one of the best things you can do!

Total knee replacement surgery is...

A surgery that replaces up to three parts of the knee joint with implants. These implants are made of metals and hard plastics. This kind of surgery is usually done to help with pain and mobility issues due to osteoarthritis in the knee.7

Just like we have an app for ACL rehabilitation, Curovate is in the process of developing an app for patients after a total knee replacement surgery! If you have any questions, suggestions or wish to be one of the first people to test our app please email us at meetcura@gmail.com

References