Running After Knee Replacement Surgery
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Since undergoing knee surgery in 2017, a lot of you have reached out with questions about your personal knee issues. Many of your questions are specifically related to running after knee replacement, partial or full.
To be super clear, my knee surgery was involved, but we ended up not doing a replacement.
I never want to leave people hanging though when there are questions, so I sought input from a physical therapist who was able to provide some valuable medically-based information, as well as a friend who went through the experience of a knee replacement and came out the other side running.
So can you run after having a partial or full knee replacement? We’ll get to that and more. Let’s jump in!
What is a Knee Replacement?
Before we go any further, it’s important to understand at least at a basic level what a knee replacement is and what it entails.
Knee replacement, also known as knee arthroplasty, according to Johns Hopkins is a procedure where the knee joint is resurfaced. The common cause or need for an artificial joint replacement is some type of arthritis.
Surgeons use metal and plastic parts to replace the damaged joint surfaces and even the kneecap. The surgery should relieve the knee pain an individual is experiencing from arthritis, disability, or injury.
There are both partial and full knee replacements.
Partial knee replacements only has the damaged areas of your knee replaced. This allows you to keep more of your natural bone, tissue, and ligaments. Many individuals are candidates for this surgical option because only a specific part of their knee joint is damaged.
Total replacements involve a longer surgery and involves replacing most if not all the surfaces of the joint. Whether someone needs a total knee arthroplasty or not depends on their knee(s) and what they hope their future looks like in regards to activity level, pain reduction, etc.
Can You Run After Knee Replacement?
Yes. But also, there’s a lot of nuance to that.
The reality is it really all depends, which is probably a frustrating answer. But again, everyone and every situation and every knee is different.
Beyond the many reasons a person may need a knee replacement, other factors play into whether a person can return to their active lifestyle, including running, post-surgery. It’s also important to note that whether you want to return to running or other high-impact sports like skiing, basketball, or tennis, to name a few, the information here can be helpful.
“How active and strong you were prior to surgery, as well as after surgery, may dictate your ability to return to runner,” said Sarah Zimmer, PT, DPT and owner of Boulder Sports Physiotherapy.
“However, most new research studies, especially with the newer technologies of joint implants are showing that a return to running after surgery is absolutely possible.”
Yay! That’s great news.
Knee Replacement and Running Info
I had this discussion with my orthopedic surgeon when trying to figure out the root of my knee pain in 2017. A partial replacement was the first recommended option because it would alleviate the intense pain and allow me to run again.
That being said here are the often quoted potential downsides:
- Knee replacements only last around 15 years
- The pounding of running can definitely decrease that lifespan
- A partial knee replacement that needs to then be replaced is very likely moving towards a total knee replacement
On the FLIP SIDE this is why you go to a sports medicine Dr. They can tell you about the advancements and tell you that running with it is possible, if you follow some of the basic GOOD RULES of running that I’m constantly shouting about around here:
My take is if you freaking LOVE to run as much as I do, then find a way to do it safely and pain free if it’s possible. Listen to your body, be smart and enjoy whatever movement it agrees to give.
Runners With Knee Replacments
To back that up with some real life examples, Sarah shared a study from UTMB Ultra Racing that surveyed participants with hip and knee replacements. It found all of the knee replacement individuals who had responded to the study had finished the race.
And one of my favorites.
Dick Beardsley, who in his 60’s with two total knee replacements was still running 50 miles per week!
Now, I’d like to point out he was an elite athlete who built up the muscle, the stamina and the drive. But he also didn’t go to a standard physician telling him to now just take it easy.
Richard might be an extreme example compared to what most of you are looking to do. But more proof that there are runners with knee replacements out there doing the things that you want to keep doing.
Which leads us to some really important things to consider on the how and why they keep going!
How to Return to Running After Knee Replacement
We’ve already done all the caveats that this is going to vary based on your situation, but you know that. So let’s look at what things have helped others to be most successful.
#1 Intense Focus on PreHab
As with many surgeries, orthopedic or not, a person’s physical health plays a role in how quickly they recover and return to pre-surgery activities, particularly high-impact activities. With joint replacement surgery, this can definitely play a crucial role.
Sarah recommends, if you don’t already, incorporating core and lower body strength training consistently every single wee at least 2-3 months prior to surgery. This not only forms a routine and helps you learn proper form, but also prepares you for the demands of the rehab protocol in conjunction with your daily life.
- 30 Day Core – this is a starter 10 min a day program that is going to help hit all the areas if you are newer
- Intermediate Strength – if you have time for some weights at home, I love combining this and the core program
- Remember you may need to limit range of motion if it creates pain. Go to PT BEFORE surgery to get moves if needed, it’s worth it. Absolutely sped up my return after my own knee surgery.
#2 100% Committment to Rehab
Amanda’s Note: couldn’t agree more! I did 90 minutes a day to get back my strength and come back a better runner. The PT said it was absolutely why I came back faster than many…that and I did a LOT of PT before ever having surgery.
- KT Taping was fantastic for helping to reduce swelling
- Ankle pumps and elevating the leg help with swelling as well
- Don’t rush the PT, but stick with it everyday. Do everything they ask.
- Listen to your PT and don’t try to progress too fast, you’ll set yourself back.
So points three and four can conflict. 🙂
Do what they give you in the office. Do the exact homework they give you….but don’t try to add more and more.
I would also really recommend that you try to find a sports focused physical therapist. What you do in those early weeks of recovery plays a massive role. A standard PT has a goal of getting you mobility to walk, but that’s not our goal.
Our goal is for you to run!!!
A great friend of mine who had massive ACL and knee surgery in both knees at different times due to skiing accidents, found a marked difference in the recovery of each leg based on that initial PT.
#3 Plan Ahead for the Weeks and Months of Recovery
Prepare for that post-surgery time by obtaining any equipment you may need like a can, walker, or ice machine, removing any fall hazards in the home, and even finding a local rec center with a pool where you can eventually do aqua jogging.
Following a rehab plan post-surgery is a non-negotiable, especially if you hope to return to running or other activities.
“This surgery is unique in that you are literally gaining a brand new body part that the rest of your body has never met nor worked with before,” said Sarah.
“Working closely with a PT or other rehab professional allows you to strengthen the knee joint, relearn how to do functional movements with the rest of the body (i.e. walking, squatting, stairs, jogging, etc.) and lower your risk of injury or the need for another surgery in the future.”
And knowing that you can hit the pool for swimming or pool running or perhaps jump on the bike in a few months will absolutely motivate you and help you make progress towards your goal of running again.
#4 Focus on Your Diet
This may sound funny, but Robin’s PT asked her to cut back on the calories she normally ate, as she was used to burning 2000-3000 a day ultra running. And while recovery 100% is not a time for dieting, you may need to make some adjustments away from what you’re used to.
I think most of us understand how important a healthy diet is to support our running, but it’s almost more important during recovery. This might be when we’re most prone to pity parties filled with whip cream toppings, but that’s not going to solve this issue.
Checkout other tips for anti-inflammatory eating!
And remember that you absolutely still need to stay on top of hydration and might need to cut back some on salt if having issues with water retention an swelling.
#5 Sleep Then Activity
The other basics were obviously sleep. It’s when our body repairs itself.
Focus on 8-10 hours per night, yes you may sleep MORE right now because the body is actually working pretty hard.
I freaking love sleep for runners and swear runners don’t get enough anyways. But in addition to that I think the recovery period is when we have to find other ways to keep busy. For me that meant reading tons of books, doing the PT, finding things to keep my mind occupied and create different habits.
During the time that I was running, I kept finding ways to be active. It wasn’t the same as running, but you HAVE to keep moving for your mental health and to be strong when you want to try running again.
- Lifting upper body
- Small baby steps in walking to eventually a jog
- Swimming
- Stretching
- Biking
#6 Mental Training
Possibly the worst part of injury is the mental side of things. I mean we’re tough as runners, so handling the pain seems like just a small piece of the enchilada. Here’s my steps for mentally and emotionally recovering.
In talking to Robin about her recovery, she said there obviously good days and bad, especially when you have to let go of a specific race goal that you’ve put so much time in to. But a few things that did help:
- Meditation
- Journaling
- Mantras
- Focusing as noted above on what you can do
- Getting movement in other ways
- Having some other hobbies, cooking, knitting, whatever
- STILL getting outside
The last one was HUGE for me personally. I’d sit at the trail head with a book while David went to mountain bike. It could make me sad, but it was way better than being stuck at home inside.
#7 Jogging After Knee Replacement
All right, so the months have passed, you have done the physical therapy and have been cross training to build stamina…it’s time to test it out.
I am HUGE fan of getting runners to first just make sure they are walking 3 miles pain free and at a good clip before ever thinking about running.
Once that is a yes, then put ego out the door and it’s time to look at the Couch to 5K program.
Personally, I didn’t even start there. I started even lower. I worked from a 25 minute mile walking to a 15 minute mile and then I allowed myself to run for 30 seconds. It felt weird and crazy, but not painful. So a few days later I allowed myself 1 minute of walking.
AND THAT is the process. You let your pain be your guide, but that plan will keep you from overdoing it.
Because you will want to.
Preparing for Surgery
As with any surgery, it’s important that you know what questions to ask to ensure you have found a good fit for your situation and your goal after surgery.
Sarah recommends asking some of the following questions to your orthopedic surgeon and other care team members:
- Ask specific questions about the surgery and what happens. Patients should be aware of the exact process.
- Ask about the surgeon’s post-surgical protocol. This will outline what they think is best for hospital stay, starting rehab, length of rehab, and more.
- Ask about their thoughts on returning to running. The surgeon should be honest with you but also support you in every way possible based on your goals.
- Are there any negative effects or reasons not to have the surgery? What are your risks?
- Ask your PT if the rehab sessions are with a PT/PTA or a tech. You want to make sure you are working with someone skilled, especially as you get strong enough to do more high level exercises and return to running rehab. You may want to ask if they are familiar with return to running protocols.
Why Wouldn’t You Want to Run After a Knee Replacement?
The reality is returning to an active lifestyle after knee replacement surgery is important, but with some caveats.
“It’s important to understand that the process to return to running is long and should not be rushed,” said Sarah. “An individual should prioritize strength training and gait/running retraining so they return with good mechanics and reduced risk of injury.”
Individuals with other issues such as rheumatoid arthritis, lupus or other chronic neurological disease may also want to be cautious.
Among her recommendations is that they have many conversations with their doctor and physical therapist about what is safest for them and what will ensure a good quality of life while also allowing them to have an active lifestyle.
Running After Knee Replacement Story
When this article was originally published, I had the story of Robin. A ultrarunner in 2017 who had a full knee replacement and was in the process of working her self back to running.
She shared some insights about the recovery being painful and feeling really slow. Which I think are important to understand and help you set some expectations.
While my knee surgery involved aligning my knee cap and lots of clean up, I was able to start moving without crutches in a few days. That’s unlikely after knee replacement.
She also talked about doing ALL THE strength work and eating really well and her driving desire to get back out there. But life changes and she eventually decided that she simply wanted to spend time biking instead which felt better for her and lessened the chance of her other knee needing surgery soon.
So we took out her story to ensure she didn’t keep getting emails about what it was like to keep running on TKR.
Best of luck to you in your journey, I hope this helped to give you some guidance or hope or just information along the way!
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