By: Dr. Arnan Sisson, PT

Date: 4/6/2022

We see hundreds of people each year calling up the clinic complaining of these stubborn knees that will ache with walking, climbing over stairs, and even waking them up all night long.

More often than not, we can do some soft tissue treatments and tailored exercise to free them up to where the problem goes away within 8 weeks or so.

This even applies to most folks that come in with MRI findings of arthritis within the knee joint. This is actually a really common finding with anyone over the age of 30, and it’s usually not the main culprit behind the pain.

But there are some select folks that have such severe wear and tear on the knee to where a knee replacement is a good fit for them.

I’m in no way though a huge fan of surgery for aches/pains. In many cases its not necessary or out right dangerous (ex, back fusions can actually increase pain in many cases afterwards).

But when it comes to the situations where a knee replacement is warranted, the outcomes are actually pretty good. Their does appear to be some great research out there on outcomes of knee and hip replacements. Their miles ahead of surgeries for the back, neck, foot, and hand.

At the moment of this write up I have around 7-8 patients that are being rehabbed after a knee replacement.

While the surgery for these clients went pretty well, it’s important to rehab the knee correctly before and after the actual procedure. This is mainly due to the fact that the knee muscles have a tendency to “lock up” after the procedure.

This is to be avoided at all costs, if you invest the time to avoid this you can enjoy a pain free & mobile knee many years after the surgery. But if the time isn’t put in then you can oftentimes deal with pain or stiffness that gets in the way of an active life with family and friends.

So, with all that said, I’m going to give out two of my top tips for anyone planning out a knee replacement to SIGNFINCANTLY increase their odds of a great outcome after.

The first strategy involves constant icing. Before you go in for your knee replacement you want to do everything in your power to keep the pain levels low. If your knee is angry and inflamed right up to the procedure, you’ll have much higher pain levels for weeks after the surgery. This could affect rehab and long term outcomes.

When you ice, make sure to apply it for 15-20 minutes so the cold effect can get to the deep structures of the knee. This would be done every few hours.

Icing is also important after your surgery. There is going to be a lot of swelling and deep muscle bruising from the tourniquet used on the thigh with the surgery. Placing ice on these tissues right away will reduce your swelling, pain, and improve your range of motion much faster.

The second secrete is to improve the strength of the quadricep muscle as much as possible.

This is the muscle towards the front of your knee that goes up to the upper thigh. This is primarily involved with supporting the knee in a standing position. And if the strength of this muscle is at a higher level prior to surgery you’ll be able to get off the walker sooner and even have less pain.

The best way to work this muscle out at home would be to find your lowest chair, place your hands out in front of you, and do as many sit to stands as possible. This is done 2-3 times a week.

If this movement agitates the knee too much, then you can just raise the height of your chair and hold some weight in your hands and make the range of motion shorter.

So feel free to try both these tips out if your prepping for a knee replacement, but most importantly speak with a trusted knee specialist about conservative treatment first before the surgery route.

If you do this then the best case scenario is that you avoid a painful surgery, and the worst case scenario is that you’ve “prehabed” the knee before surgery. With either situation you can work your way towards an active pain free life!

P.S. If you’re thinking about a knee replacement and would like to plan out what the best “pre or post-hab” plan would look like for your case then feel free to give us a ring at (804) 493-3256 to set up at free 20 minute phone consultation with Dr. Sisson.

During the call we can discuss the best 3-4 strategies we can use to reduce your pain before/after surgery and get the best outcome long term.