13 Tips To Avoid Or Delay TKR Surgery: Total Knee Replacement Alternatives

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I tried to avoid knee replacement for many years. In this article, I share my personal research along with the advice I received from doctors and knee suffering friends.

If something wouldn’t have a negative effect on my overall health, I was willing to try new ideas for relieving pain and avoiding knee replacement. I hope some of these ideas might help others that are seeking pain relief and alternatives to knee replacement.

My Experience Living on a Bad Knee

When I hurt my knee 40 years ago, I never expected to experience the day-to-day discomfort that I do now. Future implications for my knee weren’t shared with me before they operated and removed my cartilage.

This was a few years before arthroscopic knee surgery.

In the mid 70’s the surgeon cut open your knee with two incisions. One incision was about six inches long and another a bit smaller.

After the surgery, I was put in a half cast for six weeks during which time I never bent my knee. Now years removed, knee surgeries like mine have the patient up and moving the knee on day one.

For the past four decades I’ve lived with a bad knee, however, it hasn’t kept me from doing many of the things I love to do. Over the years I have had to adjust some of my activities to reduce inflammation and discomfort.

After each surgery, I had 6 weeks of physical therapy.

For several years I was able to run a mile 3 times a week and play basketball twice a week. I played softball year around and I backpacked the Sierras in the summer several times for a week logging ten miles a day.

At age 50 I had to stop running, playing softball and playing basketball. During Christmas, I would often gain ten pounds and I could feel the pain increase in my knee.

The less weight I carried the better the knee felt.

I tried to avoid high impact exercise and began to swim and ride my bike more. I rode my bicycle to work as often as the weather permitted and I tried to swim daily.

I also had heard from friends that doctors were injecting hyaluronon (rooster comb) into knees with cartilage damage. I heard stories of cartilage regrowth and pain elimination.

I scheduled an appointment with an orthopedic surgeon and he scheduled my first MRI. After my first visit, he told me I was a candidate for knee replacement and that when the pain became too much that I should return for a knee replacement.

In the meantime, he suggested that I try the series of six hyaluronon injections in my knee. At that time, he advised me that the shots helped 60 percent of the patients.

Today when you receive these shots the doctor uses ultrasound to guide the needle.

When I had them done, the doctor guessed at the best place to inject the medicine. I was very optimistic and after the first injection, I thought I felt an improvement.

As time went by and I received all six shots I became convinced that I was one of the 40 percent of the patients that did not respond favorably to the injections. I decided to live with the pain and return when the pain in my knee became unbearable.

Related: Best Ways To Prepare for Knee Replacement Surgery

Avoiding TKN Surgery: 13 Total Knee Replacement Alternatives

Tip #1 Keep the Weight Off

Almost everything I read as well as the advice from my doctor emphasized the importance of being physically fit and not being overweight. The less weight you carry the less stress on your knee.

The most telling example for me was that I usually gained 10 to 12 pounds during the Christmas season.

The pain in my knee increased and it was harder to move when I was engaged in an activity. It was too hard to give up the seasonal treats so I lived with the pain and limited mobility until I shed the extra weight sometime in February or March.

Keep the weight off.

Tip #2 Avoid High Impact Exercises

High impact exercise usually means that both feet are leaving the ground at the same time. Examples are running, jumping jacks, rebounding in basketball and many others.

During high impact exercise, the body absorbs the impact and the knees and back can definitely be affected.

Any exercise that involves running, jumping twisting and turning puts stress on the knee.

After my two knee surgeries to remove the cartilage in the 1970’s I continued to engage in high impact exercise. Thirty years later at the age of fifty, it was necessary to make the change to low impact exercise.

The pain was too much and my knees no longer responded to the pounding, twisting and turning. I was unable to compete at a competitive level.

Biking, hiking, swimming and golfing took over for running, basketball and softball.

Related: Best Shoes for After Knee Replacement (Cushion)

Tip #3 Adopt Low Impact Exercises

There are many options available for those of us that want to avoid the high impact exercises. When I made the switch, I found that most low impact exercises did not involve competitive activities that I once thrived on.

Walking, swimming, biking, hiking, and elliptical machines are some of the most obvious.

You can find competitive activities like pickle-ball, table tennis, bocce ball, horseshoes, and shuffleboard to name a few.

Most of the activities I mentioned to not involve much cardio workout. You may have to go to the gym to use machines that are low impact and get your heart beating.

Tip #4 Keep Moving on Your Knee

This may sound counterintuitive but moving is important for the joint, even if you’re in pain. A sedentary lifestyle will only add to your discomfort and more than likely you’ll gain weight if you aren’t moving.

When I spent my time running, playing basketball and softball I found that my range of motion in my knee decreased.

I would occasionally get on a bicycle and find that it was painful to do a full rotation with the pedal using my right knee.

The more I rode the bike, the range of motion increased and the pain decreased. It is important to exercise a bad knee but includes stretching activities and other activities that challenge your range of motion.

Tip #5 Use Anti-Inflammatory Over-the-Counter Medication

I used over the counter anti-inflammatory medicines when I was running, playing basketball and softball. These usually consisted of ibuprofen pills and creams.

I normally took a pill before playing and another after the competition. I tried to be cautious and not take anti-inflammatory pills on a regular basis.

However, I had teammates who as they said “ate’” as many as 4 pills every couple of hours especially when playing weekend softball tournaments that included 5 to 6 games.

I always thought that was not healthy because there are too many negative side effects. Anti-inflammatory pills and creams were helpful for me but I never abused them.

I seldom took them when I was not engaged in activity. Check out my article on Aspirin and the best medicine after knee replacement.

Some doctors also recommend anti-inflammatory diets. For me, lots of fruits and vegetables became a daily part of my diet.

Tip #6 Ice Regularly

You often see athletes icing their knee even when they aren’t injured.

As an athlete, I remember learning the old acronym “RICE” which stands for rest, ice, compression and elevation. When using ice the goal is to reduce inflammation.

Ice can reduce pain and swelling if used immediately after activity.

Especially after playing basketball or after a 10-mile hike, I would apply ice to my knee as soon as I returned home. I usually sat in my recliner with my knee elevated and applied ice for no more than 15- to 20 minutes.

I always used ice wrapped in a towel so that the ice did not directly touch and burn my skin. I am convinced that in my case it reduced the swelling and eased the pain.

If I failed to ice my knee after the above-mentioned activities I saw increased swelling and the fluid on the knee caused me pain the next morning.

These days I use the Cryo Cuff device because I can use one load of ice all day.

Tip #7 Build Strength

Muscles around the knee, especially the quadriceps muscle, play a significant role in the stability of your knee joint.   Muscles will also take the pressure off the joint by absorbing impact when walking and running.

There are many exercises you can do for your quadriceps muscle. Here are a few:

• Bicycle riding
• Stationary Bicycle riding
• Leg Lifts
• Elliptical machines
• Swimming
• Walking stairs
• Calf Raises
• Step-ups
• Prone Straight leg raises

Bicycle riding, hiking and swimming were my choices. Many of the gym workouts were boring for me and I enjoy being out in nature as I get my exercise.

Some exercises will actually cause your knee pain. We want to avoid those exercises that apply weight to our knee when we bend it.

Instead, try keeping your leg straight and locked and do leg raises that work the top of the thigh (quad).

In the quad (upper thigh area) there are multiple muscles so be sure to work all of them.  Check out my other article on the best knee replacement exercises.

Tip#8 Consider Taking Supplements For Joint Health

Many of my fellow athletes and friends swear by Glucosamine Sulfate Supplements. It is a widely used supplement that may ease pain in people with knee pain.

It can also be found in skin creams used to treat arthritis.  Glucosamine Sulfate is a natural sugar found in and around the fluids and tissues that cushion your knee.

When I first tried using the supplement, it was in the early stages of its popularity and people were raving about the success they had using it.

Related: Best Supplements and Vitamins for Knee Replacement

Unlike ibuprofen that acts relatively quickly, glucosamine supplements take anywhere from 4 to 8 weeks to be effective. I am sorry to say that after several bottles of pills I was unable to notice any significant difference.

They didn’t work for me but they may work for you.

If you are taking medicine make sure you consult your doctor before taking any supplements.

Tip #9 Join a Swim Club or Find a Place With A Community Pool

As I have mentioned before swimming is a great low impact activity for the knee as well as your entire body. However, not everyone has easy access to a swimming pool.

You can join a health club that has a pool or use a community or YMCA pool. Most charge a fee so you will be spending some money unless you have a backyard pool.

I was fortunate to have a backyard pool for years. The backyard pool was great for range of motion exercise and water walking.

Fortunately, I was able to use a pool at my former place of work – at no cost!  The place I swam had lap lanes and had available equipment like kickboards and pull buoys.

Of note: I was unable to use fins comfortably as they put added stress on my knee.

Many of my friends run/jog in the water and do water-aerobics. This might be something you could try.

Swimming involves time and can be quite boring. It does give you plenty of exercise and time to think.

Tip #10 Use a Brace

There are many kinds of knee braces on the market. Early on I purchased and wore neoprene compression braces when I was playing basketball and softball.

The compression brace kept my knee warm and added support for my knee. I always rotated two braces as they get sweaty and can smell pretty bad after continued use.

When I was forty, the doctor prescribed a custom knee brace for me. I was fitted and told that it was the same brace worn by the San Francisco 49er quarterback at the time.

The cost at that time was enormous $1,100.00.

Thankfully my insurance company paid the bill. Unfortunately, I found the brace to be cumbersome to use.

It took a long time to put on and I had to constantly adjust it with a small tool.

It was necessary for me to arrive early for games to start the process, no more showing up at game time. The benefit I gained from wearing the brace was minimal so I never used it more than ten times.

Related: Best Compression Sleeves to Reduce Inflammation and Swelling

I was also worried that the brace was supporting my knee and that the muscles around my knee were not getting the work they needed and that they might become even weaker.

I am not sure if that was true but I felt like I was relying on the brace instead of the muscles in my knee. I still have the brace twenty years later but it sits in the closet.

Tip #11 Use Hiking Sticks

In my mid-twenties after two knee surgeries, I was introduced to backpacking. I would go on weeklong backpacking trips with friends hiking 6 to 10 miles a day with 40-pound backpacks.

I did pretty well but I could feel pain in my knee if I did a lot of steep downhill hiking during the day.   In my mid-fifties I began hiking twice a week with an organized hiking group.

The hikes ranged from 6 to 12 miles. Quite a few of the hikers were my age or older.

Many of the veteran hikers used Hiking sticks. I thought it was sort of wimpy and showy.

Now, I realize that good equipment (sometimes expensive) can make many activities less painful and more enjoyable. A few of my fellow hikers noticed my slight limp and advised me to use hiking sticks.

Finally, a friend lent me one of his on an especially steep hike.

I noticed right away that it took some weight off of my knee. I went home, searched for the best hiking poles for bad knees, and bought my own.

From then on I began using at least one hiking stick for my right knee. On steep hikes, I usually use both sticks.

There are many types of hiking sticks made from ultra-light materials. Most of the sticks break down and make travel with hiking sticks easy.

Tip #12 Avoid Walking Down (Stairs, Hills) Opt For Any Surface Besides Concrete

We are encouraged to walk stairs and not use elevators for health reasons. That sounds like good practice for someone with healthy knees.

In my case, I enjoyed the exercise I got from walking up stairs with very little if any pain.

Walking down the stairs was another story. The constant catching of the muscles around the knee and the impact on my knee as I hit each step was painful.

I found myself always trying to land on my left foot because the left knee was healthy and absorbed the impact just fine. I also began to use the rail more and more like a hiking stick to lessen the impact on my knee.

It was the same for me while hiking. Uphill was fine but when you go up you usually have to go down and downhill was always the most painful part of any hike.

As a youngster I spent a lot of time playing in the street and on concrete courts and playgrounds. Playing sports on hard surfaces began to cause swelling and pain in my knee.

Walks with the family on sidewalks around the neighborhood became painful as well. I began to look for more comfortable surfaces to walk, run and play on.

Wooden courts were much easier on my knee that concrete playgrounds. All weather tracks with some bounce and give were now my choice for running.

For walks and hiking, I looked for dirt trails instead of sidewalks. Softball was okay because I played on dirt and grass.

Even now when I have the choice I veer off the sidewalk and walk on grass when I have the choice.

Tip #13 Carefully Choose Shoes and/or add Soft Inserts

Just like walking on hard surfaces, walking in some shoes caused me a great deal of pain. Dress shoes with leather soles were by far the most painful.

I began to look for shoes with thick soles. At that time Rockport shoes were very popular. I tried them for a while with some success.

The most comfortable shoes I owned at the time seemed to always be my sport shoes. In the old days we called them tennis shoes or sneakers.

Today multiple shoe companies use the latest technologies to make shoes for specific activity. I prefer those that have gel or an air chamber to cushion the knee when the foot impacts any surface.

I highlighted my experience with the best shoes after knee replacement

I wear my sports shoes almost everywhere now and I do not mind paying the extra expense for well-made shoes. For hiking, I also pay a bit extra and try to find a comfortable shoe that is flexible and has some cushion on the sole.

There are many shoe inserts that my fellow hikers use. I have tried a few that are helpful but I am convinced that choosing the right shoe for the activity is the most important thing you can do.

Conclusion

As you age you realize that that you need to be flexible and adapt as your body is changing. Contrary to a popular myth, you can teach an old guy new tricks.

A few of my favorites from the list are:

• Swimming as an exercise option
• Hiking poles
• Choosing the right shoes
• Ice regularly

Although you may not notice a difference right away the benefits will add up over time.  Especially something like icing which reduces inflammation.

Icing regularly for a long period of time will reduce wear and tear on your knee and possibly add a few years to your knee (whether in good or bad shape).

If you can adopt a few of these tips the effects add up.  You know the saying  “the sum is greater than the parts”.

I believe that taking care of your knee and considering all the things you can do to minimize inflammation and wear-and-tear can pay off with a few extra years!

There are many items on the market that promise to ease knee pain. You don’t always have to spend money to enhance your quality of living.

I hope that I have shared some alternatives for exercise and lifestyle that can make living with a bad knee easier.

If you are willing to invest in the health of your knee there are many products out there that are useful too. Not everything I tried worked for me.

Do your own research, talk to your doctor, try some of my suggestions and find out what works for you.