So you had your knee replaced, and you’ve been discharged from physical therapy; what’s next?
If you’re like most people, you’ve gotten most of the flexibility back in your knee, but it still doesn’t feel trustworthy.
You can move it around, but you don’t have the strength you need to feel confident, and there might even be some lingering pain.
For better or worse, the physical therapy clinic sent you on your way and assured you it would feel better if you just gave it some time.
Well, you've given it some time, and you’re not back to 90%, let alone 100%.
Where do you start?
First things first, if you want to get back to the things you love, you need to the things you love you need to address the pain.
If you don’t have any pain, you can skip this part.
Before we get into this, we need to define pain.
Pain ISN’T damage. That’s the big thing you need to understand. If something hurts, it doesn’t mean something is breaking.
It means you need to pay attention.
Pain is an alarm bell that tells you something might not be right, and you should look into it.
So, if you had a knee replacement within the last 6 months and you’re still in pain, it’s unlikely something is “broken.”
What’s more likely is that your body isn’t used to its new normal, and so it’s sending you pain signals to be cautious and look into it.
How do you fix it?
Gradual desensitization.
That might sound overwhelming, but it’s dead simple; here’s how you do it.
Figure out how much activity you can handle pain-free; for this example, we’ll use walking.
Let’s say you can walk 0.5 miles before it gets uncomfortable, and you can do that 5 times per week.
That’s your baseline.
To progress, add about 10% more walking one day per week, which would look something like this.
Week 1 | Week 2 | Week 3 | Week 4 | Week 5 | Week 6 | |
Day 1 | 0.5 miles | 0.55 miles | 0.55 miles | 0.55 miles | 0.55 miles | 0.55 miles |
Day 2 | 0.5 miles | 0.5 miles | 0.55 miles | 0.55 miles | 0.55 miles | 0.55 miles |
Day 3 | 0.5 miles | 0.5 miles | 0.5 miles | 0.55 miles | 0.55 miles | 0.55 miles |
Day 4 | 0.5 miles | 0.5 miles | 0.5 miles | 0.5 miles | 0.55 miles | 0.55 miles |
Day 5 | 0.5 miles | 0.5 miles | 0.5 miles | 0.5 miles | 0.5 miles | 0.55 miles |
*Week 1 is your baseline.
When you gradually progress in a controlled manner like this, your body has time to adapt and build confidence.
Since everything is already healed, it’s through building confidence and allowing your body to adapt to more and more stress that you turn off the pain alarm bells.
Now that we’ve taken care of the pain, we must discuss strength and control.
One of the most common complaints of knee replacement patients is that they feel unstable or poorly balanced.
This happens because when you get a knee replacement, many nerve connections get cut, so the connection between your knee and your brain isn’t as strong as it used to be.
If you want to get that back, you can’t wait for it.
If you do, it’s likely that you’ll never get anywhere near your previous abilities.
To regain your strength and control, you have to get out and USE your new knee.
Focus on building strength through your full range of motion, which means don’t AVOID doing hard things with your knee.
If you want to hike challenging trails, do it.
If you want to lift weights, do it.
If you want to ride your bike long distances, do it.
The thing you need to pay attention to is HOW MUCH you do at a time.
It’s helpful to use the same progression outlined in the table above to ensure you don’t do too much too quickly.
You can use it for any activity, not just for walking.
Beyond that, you need to pay attention to your symptom levels.
If you find you get pain or swelling with specific activities, you need to listen to your body.
Here’s a simple rule of thumb.
Keep symptoms below 5/10 in terms of intensity.
If the discomfort goes away immediately after stopping, you’re not pushing too hard; it’s okay to keep going.
If the discomfort lingers more than 24 hours, you need to dial it back next time because you DID push too hard.
In summary
If you’re not back to 100% after being discharged from physical therapy, you need to focus on 2 things.
Getting out of pain and building the strength/control necessary to get your life back. Using the strategies we’ve outlined above will help you do that.
If you want more in-depth help from one of our RxProfessionals, book a call below.
