700,000 knee replacements each year [1].400,000 ACL Repairs [2]. A total of 2.5 million knee sports injuries each year [3]. So many surgeries and so many active lives turned upside down, at least for a little while. So how do these knee patients get back to living a normal life?

Having worked with hundreds of knee patients as a Patient Recovery Coach at Halley Orthopedics/X10Therapy, I have identified a few key strategies to returning to health and athletics after knee surgery:

  1. Bend that knee
  2. Regain your strength
  3. Lose the fat
  4. Be mindful of (but not obsessed with) your knees

Bend that knee

Mend the bend. You want zero knee extension and maximum knee flexion (bending backwards) or a total range of motion (ROM) in your knee of about 130º. That means some work after surgery. Bending and straightening your knee is made all the more difficult if you didn’t have good ROM before your surgery, as that is predictive of your post-surgery results. Your quadriceps could also be tight, and the swelling might get the best of you and create scar tissue if you don’t get your ROM back relatively soon after surgery.

Your physical therapist will try to help you bend, but 7 percent of total knee replacement patients end up in trouble and face a secondary procedure called a Manipulation Under Anesthesia. Furthermore, again for knee replacement patients, the average bending at six weeks is only 83º. At six months, ROM lingers below 110º [4]. To ensure that you get back to your life as quickly and safely as possible, you may choose new technology like The X10 Knee Recovery System™ for your recovery. This technology out of Michigan has been around for six years and is now covered by BCBS of Michigan for pre-hab range of motion and strength work and post-surgery rehab. Now available in 19 states, the future of knee surgery rehabilitation may lie in this pain-free, high-tech, cloud-connected in-home tool. It is certainly worth exploring if you find yourself facing a knee surgery recovery.

Regain your strength

As much as you will hear all about “the bend,” it may be that regaining pre-knee surgery strength will determine your satisfaction with knee recovery more than anything else. Your quadricep muscles do a lot of the heavy lifting whether during a high intensity sporting activity or simply getting off the couch. Unfortunately, you can lose nearly 2 percent of your strength with each day of inactivity. [5] This can turn into a huge obstacle to overcome once you are bending and moving that knee again. Strength training after surgery is a must and should be undertaken as soon as you are cleared for it by your surgeon and physical therapist.

A good set of easy strength exercise can be found here: Strength Training After Knee Surgery. If you have tried yoga in the past and want to work your way back, here is a terrific yoga session to consider trying: Lauren Bringle Yoga for Post Knee Surgery.

Lose the fat

Young or old, ACL or partial knee replacement, excess weight puts undue stress on your knee joints, and your overall body weight ends up pressuring your knee joints. Each extra pound exacerbates any misalignment or weakness. Why not give yourself a break? Drop those 30 pounds with a healthy diet. Eat the right foods to help you avoid inflammation. Putting your mind to a weight loss program after knee surgery can feel good both physically and mentally.

Be mindful

If you are young and healthy and found yourself sidelined by a knee surgery, change your game or be more strategic in how you apply your athletic skills. Protect yourself on the basketball court or soccer pitch. Play your game but try to put yourself less in harm’s way.

If you elected to have a knee replacement due to bone-on-bone knee pain, then realize the simple fact that you cannot do some of the things that you did before without compromising the new artificial joint’s long-term use. If you return to running, the plastic meniscus will wear out faster. If you play aggressive basketball, the wear on the joint will be greater due to the impact of the jumping inherent in the game. If you get back to tennis, look to doubles as opposed to singles. Yes, you can return to skiing, but look for the green dots and not the double black diamonds.

Being mindful and smart does not mean missing out on the things you love. It just means looking out for yourself and your long-term knee health.

Back to Full Strength/Back to Your Life

I know from vast experience with my patients that you can return to full mobility after knee surgery. The experience of pain/injury, surgery, and extended rehab can have a profound impact on a person. To get back to your game, you need to make the most of the curve ball that knee surgery and recovery has thrown at you.

Can you do it? Of course you can!


[1] https://www.uptodate.com/contents/total-knee-replacement-arthroplasty-beyond-the-basics

[2] https://www.uofmhealth.org/conditions-treatments/cmc/knee/acl

[3] https://www.braceunder.com/blog/2017/7/20/blog-15-basic-knee-injury-statistics-by-chris-schattinger-ms-cscs-cissn

[4] http://www.cochrane.org/CD004260/MUSKEL_continuous-passive-motion-after-knee-replacement-surgery

[5] http://www.drmirkin.com/fitness/muscle-loss-from-inactivity-34-percent-in-just-two-weeks.html

PJ Ewing is a Patient Recovery Coach for X10 Therapy. He joined the company in 2012 and has helped more than 350 knee patients recover from knee surgery to date. PJ is an active blogger on knee surgery and recovery, and is the chief editor of The X10 Meta-Blog. PJ is a graduate of The University of Michigan (BA) and Notre Dame University (MBA).

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