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For those of us who had or are scheduling total knee replacement, a big question we all have is whether we can go back to the activities and exercises we once enjoyed.
However, are there exercises to avoid after knee replacement surgery?
We each should consider things like our age, strength, fitness level and our doctor’s advice. High impact activities and especially high impact sports may be possible but not advisable.
Some activities will put pressure on your knee. In addition, activities like soccer and basketball also increase the risk of other players running in to you and causing damage to your surgically repaired knee.
Use good judgment in the gym as well. You should be more concerned with building up the strength in the muscles around your knee using less weight and increasing repetitions. Trying to max out with heavy weights and setting personal bests may be putting too much stress on the knee and supporting structures.
Get advice from your doctor and from your physical therapist before you decide what activities and exercise are best for you. You may be able to jog, play basketball and other high impact sports but is it a wise decision in the long-term health of your new knee?
There are a few studies that have been done on post TKR activity but the jury is still out for the most part. At my age I have made the old decision:
It is better to be safe than sorry.
16 Exercises To Avoid After Knee Replacement Surgery – What Not To Do
1. Running and Marathons
I’ve read about people who ran marathons after TKR. They may be younger than me (I’m 68) or they may have a passion to run marathons despite the possible long-term effects.
I’ve tried jogging on grass and on the sand at the beach for a distance of 100 yards. I can jog without pain or limping but for me it is not something I want to do on a regular basis.
I prefer to ride a bicycle, stationary bike, or to walk and hike. For those of you who have run all of your life and want to run again it may be the reason you had TKR.
My doctor advised me that even though I would be able to jog, he would not recommend it (me walking two weeks after knee replacement).
One of the benefits from TKR for me was increased range of motion. Surprisingly, one of the exercises my physical therapist had me do were squats using a large exercise ball on my back against a wall.
She advised me that deep knee bends and squats (with or without added weight) were not something she would recommend. By using the ball and the wall, I could work on my joint’s range of motion while putting less stress on my knee.
I continue to do those same squats today 3 times a week.
Playing basketball post TKR is possible. I have a friend who has had both knees replaced and he plays full court basketball twice a week.
He has always had a passion for basketball and one of his main reasons for having TKR was to get back on the basketball court. I’ve watched him play and at age 64 he is able to play, but not at a high level.
He knows the risks of playing but basketball is something he lives for. For me, I am content to shoot baskets with my grandkids and play an occasional game of half court 3 on 3 where I concentrate on passing and shooting from the outside.
Fakes and drives to the basket are no longer part of my game. My defense is minimal. I do everything I can to avoid contact with others.
I have never heard or read about anyone returning to football post TKR. Flag football and touch football are certainly an option.
Like basketball, you run the risk of putting yourself in harms way colliding in to other players. I prefer to play catch, throw grandkids passes and occasionally assume the roll of “all-time passer” in a game of 3 on 3.
When I was a young athlete, running stairs was a part of my training for several sports. Usually they were concrete steps or metal bleachers (both high impact with little give).
Today I am happy that I can walk up and down stairs without pain. I even opt to take the stairs versus the elevator when I have a choice.
Before TKR I would opt for the elevator. Walking up and down stairs is good exercise post TKR (my best tips to avoid knee replacement surgery).
“Stair Step” machines are a good alternative. You have a never-ending staircase and you never have to turn around and walk down the stairs.
The machine is easy on your joints and combines a great cardio workout as well. You can adjust the speed of the machine to go as fast as you like.
You should consult your doctor or physical therapist before attempting high impact stair stepping or stair running.
Jumping after TKR sounds like something that you should avoid. My jumping at age 68 is at best 2 to 3 inches off the ground.
Playing basketball and rebounding are out of the question for me but I find myself doing limited, in-control, conscious jumping when I play pickle-ball or when jumping off medium rocks when hiking.
Before TKR I made a conscious effort to always take off and land on my good knee. Now my TKR knee is strong and stable enough to be able to take off and land on both knees. (Small, controlled heights).
Skydiving is out of the question for me because of the landing.
Anytime that you add weight to your exercise program, whether in the weight room or on the hiking trail, you increase the stress on your knees.
If you plan to backpack it is important that you build up the strength in your surgical knee before planning a trip. Consider your age, your own weight and fitness level before planning a multiple day trip.
Consult your doctor or physical therapist to get their opinion. You may have to limit the amount of weight you carry and you may not be able to keep up with the pace of younger hikers.
You may have to stay on maintained trails and opt not to hike cross-country routes. Remember that when you are in the backcountry it may be difficult for you to be helped or rescued if you have problems with your knee.
Like me, you may decide to take day hikes with a small pack and increase the length of your hikes. I haven’t ruled out backpacking completely but if I did it again I would be careful to avoid remote areas, choose good hiking partners, look for easy to moderate hiking trails, and limit my first trips to just a few days.
Start with day hikes and see how they go before making the decision to backpack.
8. Heavy Weight Training
My doctors and physical therapist both advised me to avoid heavy weight training and lifting. It seems like common sense and now that I have aged I am more concerned with increasing repetitions in the gym and building strength.
I do the same for other parts of my body as well, not just my knee. There are so many low impact options in a gym or fitness center (read about my workout routine after knee replacement).
It seems foolish to pile on the weight and strive for personal bests.
Many of us love to dance and if we choose our dancing wisely we should be able to return to the dance floor. Dances that require sudden stopping, twisting and turning, or lifting a partner might not be advisable.
One of my friends line dances and says she is still not able to line dance pain-free 6 months after TKR.
My neighbor has had both knees replaced and she teaches Zumba 2 days a week.
Soccer like many activities is played on grass which impact wise is preferable to concrete.
There is a good deal of starting and stopping in soccer. There is also the need to kick the ball which puts more stress on your knee. I avoid playing organized soccer.
I will kick the ball with grandkids mostly using my non-surgical knee. My right knee was replaced (I am right footed), personally I would never kick a soccer ball hard or punt or placekick a football anymore.
Several of my friends play tennis after TKR. Some have had one knee replaced a few have had both knees replaced.
They are all my age or older (68) and they all play only doubles now. They seem to all agree that singles requires too much running, quickness and sudden stops.
Many TKR people in my community have given up tennis for pickle-ball. Pickle-ball is played on a smaller court and you can also play doubles.
Doubles pickle-ball does not require as much moving but still requires good reflexes and you can work up a sweat. Table tennis is similar to pickle-ball and requires even less movement.
If you have been a long time tennis player, doubles tennis, pickle-ball and table tennis may be good options for you post TKR.
12. Baseball or Softball
If you want to return to playing competitive softball or baseball you might think twice. Playing in open leagues with younger players who are gung ho could be a mistake.
The risk of injury is far too high. You need to be realistic (read my article about essential medication after knee replacement).
There are many Softball and Baseball Leagues for seniors that adjust their rules to modify running the bases, sliding, making diving stops and catches that might not be realistic for us post TKR.
I have an acquaintance that returned to Senior Softball after knee replacement and he plays roughly 100 games a year. He spent a good year working religiously at the fitness center after his physical therapy before going back out on the softball field.
Remember that Senior Softball, especially in the 60’s and 70’s age group is nothing like 20 and 30 year olds playing softball. Defense is a lacking and players are not making the highlight reels.
Running the bases is more like jogging or fast walking for many. You may be limited to certain positions like catcher, pitcher, or first base.
There still is a risk of collision and injury but most people in Senior Softball are careful and are acutely aware of the risk of injury. You don’t have to worry about sliding and guys trying to break up the double play.
13. Rollerblading and Skating
Think twice before you strap on a pair of roller skates, rollerblades or ice skates. You really need to have strong support around your knees before skating.
Roller-skating may cause less stress on your knee but ice-skating on a slick surface using a blade versus 4 wheels could be dangerous for someone with a knee replacement. You also run the risk of collisions from inexperienced skaters.
Rollerblades have a single line of rollers and they are not as stable as roller skates. You might opt to watch your grandchildren skate while you stand on the sidelines.
Aerobics can put a lot of strain on your knees with short, impactful exercise. This includes jumping, twisting, and lunging into various positions.
There are many levels of aerobics and you may be able to design and modify a program that works for you. Consult your doctor or physical therapist to see if they have a suggested workout for you.
Water aerobics may be the perfect replacement for regular aerobics. I believe that water activities, because of their low-impact nature, can work great for recovery, strength, and cardiovascular health!
If you enjoy aerobics, consider making the transition to the pool. Most community pools and clubs offer water aerobics.
I was looking forward to doing yoga post TKR to help with stretching and range of motion.
I was not able to do some of the poses such as the child’s pose and the cow or cat pose due to pressure on my knee.
The cow and cat pose seem easy right? I was not and am still not comfortable putting equal weight on my knees when I am on all fours.
Like aerobics, you can modify yoga to meet your needs but don’t sign up for long-term yoga classes until you have tried a few home-based exercises to see what your new knee is comfortable with.
16. Skateboarding, Paddle Boarding and Surfing
It might be a good idea to sell your surfboard and skateboard after knee replacement surgery. Both activities put a lot of stress on the knee.
Surfing, like paddle boarding requires that you move quickly from a prone position to a standing position. I have a neighbor who surfed for many years.
He still likes to go surfing with his son and grandson put he is content to ride the wave prone on his surfboard or use a bogey board. I have bogey-boarded post TKR and have had no problems.
A Few Alternative Exercises I Prefer
I have been very active all of life and I continue to be active after knee replacement. I have been able to continue with some of my old activities but I have also found new activities that I can enjoy.
Until I was 55, I played softball and basketball on a regular basis. I still play catch now and then, shoot a few baskets, and make a trip to the batting cages but I no longer engage in competitive play.
Pickle-ball has taken the place of softball and basketball. I play doubles and the reflex reactions and cardio workout keep me fit and sharp.
I can choose to play recreationally or I can opt for more competitive games. Pickle-ball was a great way to meet new friends when I moved to a new area.
Occasional games of golf and ping-pong also help to fill the gap left by basketball and softball. Before knee replacement I walked, hiked, swam and cycled.
All four are enjoyable ways to get outside and build up the muscles in my legs and get some cardio benefit as well.
Swimming as become one of my favorite exercises because I am able to get a full body workout. Continue to work out 3 to 4 times in the gym (read about my knee replacement swim routine).
Have your physical therapist develop a workout program for you once you complete formal physical therapy.
Rushing in to activities too soon after TKR is not a good idea. Be diligent while rehabbing with your physical therapist and then continue with a regular fitness routine after your physical therapy is over.
Design a program that includes workouts at the gym and some activities that you enjoy participating in. Basketball, football and other high impact sports may have caused old injuries that may have led to your TKR.
Eliminate those risky activities and sports and be content to sit on the sidelines and watch younger players compete.
After my TKR I was excited to be able to move and do activities without pain, but I was initially concerned and nervous about damaging my new knee by engaging in some of my old activities.
After hard work with my physical therapist and continued work on my own I was able resume all of my activities by month 4. Staying active will help strengthen your knee and make it more likely to last for many years.
Be sure to consult your doctor and physical therapist before starting any activity or sport post TKR.