Regaining Mobility Safely, Slowly, Securely
At first
Most people experience reduction in joint pain and improvement in their quality of life following joint replacement surgery. While joint replacement surgery may allow you to resume many daily activities, don’t push your implant to do more than you could before your problem developed.
Give yourself at least six weeks following surgery to heal and recover from muscle stiffness, swelling and other discomfort. Some people continue to experience discomfort for 6-12 weeks following their joint replacement.
During visits to the physical therapist’s office, your therapist may use heat, ice or electrical stimulation to reduce any remaining swelling or pain. You should continue to use your walker or crutches as instructed.
Your physical therapist may use hands-on stretches for improving range of motion. Strength exercises address key muscle groups, including the buttock, hip, thigh and calf muscles. You can work on endurance through stationary biking, lap swimming and using an upper body ergometer (upper cycle). Physical therapists sometimes treat their patients in a pool. Exercising in a swimming pool puts less stress on your joints and the buoyancy lets you move and exercise easier.
When you are safe putting full weight through the leg, several types of balance exercises can help you further stabilize and control the hip or knee. Finally, you will work with a group of exercises to simulate day-to-day activities, such as going up and down steps, squatting, rising up on your toes, bending down and walking on uneven terrain. You may be given specific exercises to simulate your particular work or hobby demands.
By six weeks, you may be able to return to many normal activities such as driving, bicycling and golf. When you see your surgeon for follow-up two to six weeks after surgery, he or she can advise you on both short and long-term goals.
As a rule, all joint replacement recipients should heed the following limitations during the first weeks after surgery:
- Expect to use a cane or walker for several weeks
- No kneeling, bending or jumping for the first month
- Don’t drive until ok with your doctor (usually 4-6 weeks)
- No alcohol with pain medication
- Don’t smoke – it slows healing
- You may hear some clicking in your knee as it heals; it’s normal
- Avoid sexual activity until after six-week check-up
- Continue wearing elastic stockings until your return appointment
In general, physical activities should:
- Not cause pain, either during activity or later
- Not jar the joint, such as when running or jumping
- Not place the joint in extreme ranges of motion
- Be pleasurable
Additional tips for living with your new joint:
- Ask for help – while your goal is to eventually do things for yourself, don’t take unnecessary risks by trying to do too much too soon.
- Recuperation takes approximately 6-12 weeks – you may feel weak during this time. Use ice for swelling and discomfort. Ice your knee for 15-20 minutes after each exercise period to reduce pain.
- Keep your appointments with your doctor – it’s important to monitor healing and function on a regular basis. You may need to check in with your doctor two to three times during the first two years, and at intervals of two to three years thereafter. During those visits, your surgeon will take X-rays and monitor wear.
- Under optimal conditions, your artificial joint may last for many active years. You should always consult your orthopaedic surgeon if you begin to have pain in your artificial joint or if you suspect something is not working correctly.
- Watch for infection – your new joint is a foreign substance to your body. Germs from other infections can move to your new joint and cause infection. Call your family doctor immediately if you have any signs of infection, e.g., skin infection, urinary tract infection, abscessed teeth, etc. Early treatment is crucial.
- Alert your dentist or family physician – tell them about your joint replacement before any dental work or procedure, such as a cardiac catheter, bladder exam, or surgery. You may always need to take antibiotics first to prevent infection.
- Your new joint may set off metal detectors in airports and other secured buildings. Your doctor can give you an identification card to carry in your wallet.
Long Term
Most patients have less pain and better mobility after joint replacement surgery. Your physical therapist will work with you to help keep your new joint healthy for as long as possible. This may mean adjusting your activity choices to avoid putting too much strain on your joint. You may need to consider alternate work activities to avoid the heavy demands of lifting, crawling and climbing.
More extreme sports that require running, jumping, quick stopping or starting and cutting are discouraged. More low impact exercises such as cycling, swimming, golfing, bowling and level walking are ideal.
