Which Activities Should I Avoid After Total Knee Replacement?
The most commonly recommended activities to avoid after total knee replacement surgery include high impact sports, work activities that involve repetitive jumping and landing, and activities that require prolonged crawling and kneeling.[1]
In the following article I will discuss these activities and how you may still do them safely without risking damage or injury to the knee replacement implant.
What are the two types of implant fixation?
The two main implant types are cemented fixation and cementless fixation. Depending on the kind of implant you received your post surgical restrictions may be different. [2]
More active individuals with healthy bone growth may receive a cementless fixation implant which requires the bone to grow into and attach the implant.
Cementless implants may be better for individuals who plan to return to a more active job or participate in recreational sports. In the following interview, Dr. James D Abbott, MD discusses both implant fixation types and some of the pros and cons of each.
Can you damage a total knee replacement?
While your knee replacement is made out of strong components and in most cases you will be standing and walking the same day of surgery, YES, it is always possible to damage the implant.
One study reported mechanical loosening (16%), and implant failure (10%). [3]
Can I jog and play sports after a total knee replacement surgery?
Cementless fixation implants seem to be more appropriate for patients who are interested in jogging or returning to sports that require running.
As patients receiving total knee replacements are getting younger, their desire to return to sports and other active lifestyle activities is growing. [4]
A question like this must take into account the individual’s personal situation and characteristics.
Considerations to include before jogging:
Patient body type – larger bodies produce greater impact forces and may be more harmful to implants.
Training history – A person with a long history of training is likely to have better technique and possibly reduced impact forces due to better technique.
Age – as much as I hate to admit it, statistically speaking, a younger person may have an easier time returning to impact activities after a total knee replacement. But remember, there is always an exception to this rule!
Running surface – running on softer more compliant surfaces may reduce peak impact force and prolong the life of an implant. Running on turf, grass, a treadmill are more compliant surfaces than running on asphalt and cement.
Running type – midfoot and forefoot runners may have a lower peak impact than heel strike runners based on some of the clinical research. This may reduce peak loads on the implant and prolong the life of the implant.
Finally, it is important to consider the total risk of all cause mortality and morbidity. If jobbing is your passion and an important component of personal life satisfaction the risk of running may NOT outweigh its benefits.
Stress reduction, improved cardiovascular health, and other factors are just a couple benefits and should not be forgotten.
Is CrossFit dangerous after a knee replacement?
No sport or exercise is inherently dangerous. What is great about CrossFit, Yoga, Pilates, and most any exercise routine is that it can be highly customizable.
In my CrossFit class I have had several members who had knee replacements 6 months, 12 months, and longer ago. These members were able to modify jumping jacks with toe taps, replacing jogging with rowing, and basically swap any part of the programmed exercise for something comparable.
I would strongly encourage any of you to consider returning to your preferred fitness routine with the help of a licensed physical therapist or personal trainer who understands your limitations and can modify the programming to ensure you progress safely.
Am I allowed to kneel after a total knee replacement?
Unless your surgeon specifically stated that you are not allowed to kneel due to your implant type, wound healing complications, or bone weakness then in most cases you are allowed to return to kneeling and kneeling activities.
In my clinic I typically introduce kneeling once the surgical incision is completely healed with no sign of drainage.
We usually begin kneeling and applying pressure to the knee on a deep 8-inch cushion. This would be comparable to a couch cushion.
We then progress to kneeling on a bed, then pillow, then carpeted floor.
As a physical therapist my main goal in helping patients learn how to kneel safely is in preparing them to learn how to transition from the floor to standing.
It is reasonable to assume that a small percentage of patients will fall at some point during the first 3 to 12 months after knee replacement surgery. In this case, it is important that the patient be able to return to standing if they have fallen in an unsafe environment like a street or on a subway.
Is it safe to get on the ground after a total knee replacement?
Getting on the ground after a total knee replacement is an important part of the recovery process.
Not only because you may want to get down on the ground to play with small children and pets, or clean under the couch, but also because there is a chance that you may fall and would need to get up from the ground.
Yes, it is safe to get on the ground, but this should always be performed first under the supervision and direction of your physical therapist.
In the following video series I am sharing several suggestions for getting down on the ground and getting back up.
References Cited:
[2] https://orthoinfo.aaos.org/en/treatment/knee-replacement-implants/
About the Author -
Anthony Maritato, PT has been a licensed physical therapist since 2006. He specializes in post surgical care and rehabilitation of total knee replacement and rotator cuff repair surgery.
Mr. Maritato is also nationally recognized as a therapist educator teaching courses related to Medicare reimbursement, contracting, and documentation.
Total Therapy Solutions LLC is Tony's primary practice which he owns with his wife Kathy who is also a licensed physical therapist.
