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one month after Knee Replacement….what next??

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March 18, 2020 at 3:19 pm #39677

Chet
Participant

Well, exactly one month ago total right knee replacement went well without complications (I’m 65 y/o), no infection etc….experienced PT here in Denver says I’m doing better than average especially swelling….me says a little sore and stiff but off narcotics, ditched crutches and cane and back at work not quite full time….PT says still big deal is stretch and range of motion (today 125 degrees flex but that is painful, full extension with effort)…just starting gentle strength excercises….I’m sure I’m WAY deconditioned…PT says I can start walking 20 minutes and stationary bike 20+ (more for range of motion)…anyway my longer term concern is how to start Z1 aerobic…PT here says don’t worry re that for three more months….I hate to run, passion is hike and ski mountaineering/touring….I’ve briefly chatted with Scott about this in past years but now is real post op did it and starting to recover….my hope is back to ski mountaineering and touring by a year from now…..any advice re rollerskis or stuff other than just hiking to start back on the endurance component of training?? Advice that my current PT may not be as tuned into??Thanks!!!! Chet
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Posted In: Injury & Rehab

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Anonymous on March 19, 2020 at 1:08 pm #39690

How active is your PT? If (s)he is also an athlete or works with many, then I would follow the recommendations. If not, then get a sport-experienced second opinion.

As far as roller skiing goes, it’s a great tool for ski-specific training. BUT. They take a lot of getting used to. And they have no brakes…

The first season I had some, I was nervous enough that I barely used them. The second season was much better and they were a great addition to my program. I would use a vehicle and several bikes to do uphill laps. Lock bikes at the top, drive down, ski up, bike down, repeat. (“Real” roller skis would just turnaround and go down, but wiping out on pavement sucks.)

Participant

Pete Dickinson MS,PT on March 20, 2020 at 6:39 pm #39712

I can echo Scott’s experience with the roller skis. In dealing with a back injury I would shuttle a car up a long hill, ride the bike down, pick up my roller ski gear and ski back up to the car. It works and minimizes some of the downsides with fall risk. Bit of a time suck to do all that however.
As far as you recovery goes…Bike is your friend at this stage, you can get more activity in, without flaring up your knee by other impact activities (walking). The name of the game right now is to regain full extension. If you try and load it too much with the exercises you are accustomed to (lots of walk/hike/heavy exercise), the knee will tighten up. Now is the time to make a run at your range of motion. Restrictions in motion tend to ‘cement’ in if you get too far down the road.
One option is to walk/bike at Z1. Do 10min walk/10min bike….repeat x3 to start. Gradually increase time based on your knee response. Work your extension ROM prior, and after.
Cheers,
Pete

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