Front Porch: No replacement for exercises after knee surgery

As I mentioned several weeks ago, I’ve been at home recovering from total knee replacement surgery. It’s not fun. Nor was it when I had my other knee done last year.

What I’ve learned, more so than with many other surgeries, is how important the weeks (especially the first six) post-op are. It’s not just fix the knee, heal a bit and off you go.

In those early weeks, if you don’t work hard to get full extension of your leg and significant flexion of your knee, it may be hard to ever gain good range of motion, those things that allow you to kneel, climb stairs comfortably and go from sitting to standing, get in and out of a car easily, among many of the things we take for granted that our knees help do for us.

I bring this up because I know so many people who have had knee surgery of some sort or are contemplating it. Some don’t pay close attention to their post-op care and have problems, and others aren’t aware that surgery is just the beginning. Plus, I’ve heard stories of failures in post-operative care that are pretty disconcerting.

I have a high school friend who is a noted rosarian in her state and spends hours of time on her knees in her rose beds. When she needed knee replacement, she had to put in extra time afterward to be able kneel without pain and for long periods of time again. She prepared for it … and did it.

My surgeon told me of cases where the patient didn’t do the work afterward, and they had to operate again to break up the adhesions and do whatever it is they had to do so that proper knee function could be achieved. I’m told also that the physical therapy that occurs afterward in those cases is … well, less pleasant than if a second surgery didn’t have to take place.

I have another friend who kind of blew off the flexion exercises and came close to needing surgical intervention. Happily, her come-to-Jesus talk with her doctor put her on the right PT path, and, as a new believer, she put in the work just in time so she avoided that.

Understand, post-op PT isn’t like agonizing boot camp for the knees (well, mostly it isn’t), but it needs to happen – even the uncomfortable parts – for the surgery to be a true success. There’s a lot of swelling at first, which impedes bending, which is why ice is your friend. Borrow or purchase a polar ice machine, which will make the icing easier and more productive.

The other thing I’ve come to learn is that it really does take a year for total recovery. Not that you’re debilitated for that time, but that progress is ongoing.

Because I hate opioids (for the initial pain), I work hard to get off them fast. I was totally done by two weeks, using Tylenol instead (not as effective, but still useful). I was driving before week three (because I was off drugs and could bend my knee sufficiently to get it into the car). Holding on to the grocery cart in the store enabled me to make short grocery runs (I’m still not ready to face Costco), and I’ve gone out to lunch with a few friends already.

Mostly, I’m at home working on myself and spending time in my recliner with my friendly polar ice machine – and healing. Oh, and working on our income taxes for 2023. Blech. And I go out for PT twice a week. Younger folk are probably dancing by they’ve reached the same point in their recovery.

I understand that not everyone has insurance and that formal PT may not work out for everyone, but there are exercises you can do at home that can ensure a good outcome.

I just want to alert my peers (it is us older folks who are having these surgeries, for the most part) that it’s a two-phase endeavor. Do not under any circumstances forget the aftercare.

Voices correspondent Stefanie Pettit can be reached by email at upwindsailor@comcast.net.