Doctor palpates the knee of a patient

Over the years, there have been improvements in surgical approaches, equipment, endoprosthesis design, and the materials from which they are built. There is evidence of the usefulness of physical activity after surgery, but little is known about the impact of sports activities, such as running after knee replacement, and the load it brings to the artificial joint.

Continuation of sports activities depends on preoperative sports activities, the patient’s age and the existence of other diseases. It also depends on the patient’s expectations, previous experience and most importantly motivation.

Also read: How to overcome running fatigue

Do partial knee replacements work?

Partial knee endoprosthesis (unicomplementary) is used in cases when only one part of the knee is damaged, most often the inner and less often the outer part of the knee or the patellofemoral globe. The term “uni” (unicomplementary) means that only part of the damaged knee joint is replaced.

A partial knee endoprosthesis is implanted through an even smaller incision than a total one, while the implantation procedure is less invasive. Therefore, recovery is faster, hospital stay is even shorter and return to normal activities is faster than with a total endoprosthesis.

However, with partial knee replacement, there is a certain risk of “durability” of the prosthesis. Namely, world statistics indicate that the lifespan of implants is about 10 years, while the lifespan of a total knee prosthesis in 80% of cases is longer than 25 years.

If you are a runner you should check with your doctor to find the best partial artificial knee replacement for athletes.

Can you run after a partial or total knee replacement surgery?

Running after knee replacement

Running has long been considered one of the exercises to avoid after partial or total knee replacement. In the old days, patients were told to go home and rest their knee after artificial joint replacement. They could walk, play golf, and possibly play some doubles tennis, but running was on the list of what not to do after knee replacement. Precautions after knee replacement were very pronounced.

The fear was that the implants would either wear out or break down the cement that was fixing them to the bone. Unfortunately, this advice both depressed runners and led to a higher rate of bone osteoporosis and muscle weakening.

Joint loosening and failure may have been increased by this conservative advice. By advising patients to return gradually to running, we build bone density and muscle strength, thereby decreasing the risk of joint loosening. The plastic inserts now used are so durable that there is a very low likelihood of them wearing out.

However, most people, by the time they have succumbed to a joint replacement, have already lost their normal gait patterns, and are weaks. It takes months of intense fitness training, preferably under the guidance of skilled trainers and physical therapists, to restore optimal body mechanics. While the bone healing into the undersurface of the implants is mostly complete after six weeks, the rest of the body usually requires four to six months of training before running after knee replacement is safe.

When can you run after knee replacement?

Limitations after partial or total knee replacement are different from person to person. Especially when talking about exercise limitations after knee replacement. Most patients require an assistive device (walker, crutch, or cane) approximately 3 weeks after knee replacement surgery, although this varies significantly from patient to patient.

After 6-8 weeks, you will be able to do low-impact exercises, such as cycling on a stationary track, walking and swimming. Your physical therapist may advise you to introduce new activities during this time. Running, jumping, and other high-impact activities should be avoided.

High-impact activities are not recommended to do after knee replacement. However, if you have been running before knee replacement and you know how to do it properly, after rehabilitation and months or a year of therapy, you may start running again slowly.

The key is not to rush the process and ensure you go back when you are ready. Remember that too much exercise after knee replacement isn’t recommended. You will get different opinions about when you should return to running. It does depend on the knee operation but we always consider rehabilitation milestones rather than time frames. It’s only when you meet the milestones that can you return to running/sport. This will ensure an optimal and safe return and avoid disappointment from returning too early.

More importantly, we must consider the long-term health of your knee. Your knee has to survive for many years after an operation and incomplete or rushed rehabilitation is only to the long-term detriment of your knee health.

How long it takes to return to running is also dependent on how strong the knee is before the operation. Talk to your orthopedic surgeon about any questions regarding your activities to learn more about setting realistic expectations after surgery.

How do I start running after knee surgery?

There are few studies on the impact of high-stress sports on artificial knees. And many of those studies no longer apply due to advances in materials and surgical techniques. This, unfortunately, means that there are also few studies on exercise after knee replacement. Most of the available advice comes from runners who underwent the procedure themselves.

People after knee replacement must consider this lack of evidence when deciding whether or not to run. The suggestions outlined below may help reduce the risk of injury. But running knee surgery (knee makoplasty, chondroplasty, meniscal repair, arthroscopic knee surgery, knee cartilage surgery, medial compartment knee replacement), will always carry risk. Only the athlete can decide if the benefits are more important.

Follow this return to running program after knee surgery:

Start slowly

Recovery from knee replacement surgery takes time. It may be months before a patient is ready to walk. Once they can walk without pain, athletes can slowly move toward running. This may mean jogging a few steps one day a week. Or it could mean power walking until they reach a steady jog. Whichever route they take, the key is to start slowly. This will let the joint adjust to its new stress load. It will also help the surrounding muscles grow stronger which will protect the joint.

Focus on full-body strength

How to Perform Farmers Walk with Dumbbells

Strong muscles protect the joints that they surround. This is why trainers always urge runners to hit the weight room. And it is even more important for runners who have had joint replacement surgery. Weight lifting also does more than strengthen muscles. It can help runners keep their body weight at an ideal level. This, in turn, reduces stress on the joints of the lower body.

Add in resistance training

The old advice states that high-impact sports may cause knee replacement implants to come loose. Some doctors are now challenging that idea. They think that implants come loose as the bone around it becomes weaker. But there is a solution! Resistance training helps to increase bone density. And the best part is that athletes can start even before they’re ready to run. Athletes can focus on their arms, core, or uninjured leg using machines. It’s a good idea to stick a trainer at first, especially during recovery. They can help athletes avoid injury

Focus on form

Bad form can injure even the healthiest of runners. But when the runner has an artificial knee, bad form can ground them for good. Runners with artificial knees should have a trainer critique their form. Physical therapists can also do this if they work in sports medicine. It is important to note that this goes for power waking as well as running. Walking a mile and running a mile puts the same amount of stress on a joint. While walking is slower, the athlete ends up taking more steps. This means that form is important no matter what speed the athlete is moving.

Check your equipment

Runners with artificial knees may find that old running equipment is no longer comfortable after the knee replacement. This is more likely if the runner preferred toe shoes, minimalist shoes, or barefoot running. Runners can blame their increased discomfort on the lack of shock absorption. Whether the runner’s shoes are worn out or never had much padding to start with is irrelevant. The less shock a shoe absorbs, the more stress goes into the joint. This, in turn, will put more wear and tear on the joint. It can also increase damage to the surrounding tissue or bone. Over time, this damage can permanently take a runner off their feet. Once the athlete is ready to run again, they should make sure they’re doing it with supportive shoes and appropriate knee braces.

Choose the softer side

There’s more than one way to reduce stress on a joint. Supportive shoes are only the first step. The second step is avoiding super hard surfaces such as asphalt or concrete. Runners should opt for padded tracks or dirt trails instead. These options are much softer which means the ground will absorb stress with each foot-fall. And, as with supportive shoes, this will lead to less strain on the runner’s knees.

Does running lead to knee replacement?

Is running bad for the knees and does it cause knee replacements? This belief is incorrect.

This is a long-standing misconception probably because injuries to the knees, shins and joints are quite common in runners. The theory says that running wears out the knees, erodes the protective cartilage in the kneecap and thus reduces the knee’s ability to cushion the blows and ultimately leads to arthritis.

However, the truth is that long-term running is probably good for your knees. Consider, for example, a Stanford University study. Scientists were interested in whether or not regular running on long distances causes more frequent occurrence of osteoarthritis in the knees. Over a period of 20 years, two groups of older runners (between 50 and 72 years) were compared with a control group of non-runners of similar age. At the end of a 20-year study period, the researchers concluded that arthritis did not occur more frequently in runners than in non-runners. On the contrary, degenerative changes occurred faster in the knees of non-runners compared to the knees of runners.

Another study by Austrian scientists involved scanning the knees of a small group of dedicated marathoners in 1997 and then again in 2007. The result of the research is almost the same: the condition of the knees of no runner has deteriorated over the ten years that have elapsed between the two tests. In other words, running seems to have protected the runner’s knees from damage.

Evidence shows that the best indicator of later knee problems is the earlier injury they suffered, as well as that people with healthy knees will not be harmed by running, they are even likely to protect them. Even people with poor running knees are unlikely to make their condition worse, they could improve it.

Therapy for knee replacement

Rehabilitation after endoprosthesis is of special importance. A person undergoing surgery requires a specially developed exercise program. At the same time, the patient will have to leave many sports, due to the need to reduce the load on the knee.

For the next few years after surgery, the patient must be under the supervision of a physician.

There is an opinion that after the replacement of the endoprosthesis the patient should save and protect the knee. This means that running after knee replacement was prohibited. However, this claim is only partially true.

The need for a frugal way of working, for the first time after surgery, certainly exists, but the first exercise can begin on the second day. Furthermore, the load in the implementation of the training will gradually increase. Consider what exercise therapy during rehabilitation will help in the rapid recovery of a damaged knee after an injury or surgery.

The rehabilitation period can be divided into three main phases:

Postoperative period

Consider gymnastic exercises that are recommended to be performed in the postoperative period. Such exercises prevent thrombosis, muscle atrophy and support the functioning of the musculoskeletal system.

In the first few days after surgery, the following set of exercises is prescribed:

  • The patient moves his toes, squeezes and releases his feet. The number of repetitions in the initial phase is 12-15. In the following days, under the supervision of a physician, the load will gradually increase.
  • Then you need to raise your toes towards you, avoiding pain during exercise. Number of repetitions from 4 to 5 times.
  • The patient performs actions that encourage flexion and extension of the legs in the knee area, repeating 3-4 times.
  • The final phase of rehabilitation becomes tension and relaxation of the gluteal muscles. Performing 4-5 repetitions in the postoperative period will be quite sufficient.

The application of these manipulations is considered effective in the early stages of rehabilitation. Initially, you need to develop your leg in a lying position, after which you can move to a sitting position.

Early phase

Unlike postoperative, the early rehabilitation period is carried out at home. It is not uncommon for a patient, once in a familiar setting, to ignore medical prescriptions and stop working to restore knee joint function.

At this stage you can develop the knee in three places: sit, lie down, stand.

Gymnastic exercises in a sitting position:

  • Sick toes produce flexible and extending movements. Number of repetitions of 10 times.
  • Furthermore, it is necessary to rotate each foot, first along and then counterclockwise.
  • The patient raises the leg without bending it at the knee joint (at a 45-degree angle). The action is performed 10 times in one move.
  • Then you have to perform a series of swinging limbs in the air. The exercise when performing knee exercises takes a few seconds.

Lying gymnastics:

  • The patient lies on his stomach, bending his knees. It takes 7 repetitions to achieve the desired effect.
  • Settling on his back, the patient, who is in rehabilitation, performs a barbell with support on his shoulder blades and a healthy leg. The number of accesses is 5-10 times.

Standing gymnastics:

  • Rolling from foot to foot.
  • Walking up the stairs
  • The patient rests on a chair, bending the leg at the knee joint, first forward, then backward.

The exercises are performed until the patient feels pain in the affected limb.

At this point, the person should already be moving with a cane or other support device.

Remote phase

This period of rehabilitation is necessary for the patient to be able to return to his normal life. Recovery at this stage and the rehabilitation period after knee joint replacement takes about 12 months. In addition, every six months, the patient undergoes a complete examination with mandatory scheduling of an MRI scan for the patient’s knee.

The remote stage implies an increase in the load on the controlled joint. The patient can go to the gym and workout with a moderate load.

The most preferred types of physical activity for the development of prosthetic complete articulation are swimming, rowing, walking, cycling. To achieve the desired result, you can do yoga or go to a sanatorium for a while for complete rehabilitation.

Competitive sports such as running, wrestling, boxing and weightlifting after knee replacement are still prohibited for the patient. At this stage, experts also recommend giving up bad habits, not smoking or drinking alcohol. In addition, it is undesirable to eat foods that are rich in calories.

You can find a multitude of videos for knee joint rehabilitation on the internet, where a whole series of consecutive actions are clearly and correctly displayed.

Knee replacement rehab timeline

This question is often asked by visitors to specialized forums dedicated to endoprosthesis replacement issues. Progress is purely individual, a full return to normal activities is possible within 3-6 months after the procedure, during which you will renew your life, learn the most ordinary things.

The difficulty of the recovery process is that people with arthritis live with debilitating pain for years. During this time they develop desirable positions for sitting, standing, moving, becoming inactive and some muscle atrophy. Those same habits, called abnormal neuralgia, don’t go anywhere even after you wake up in the postoperative ward. The process of removing them is complicated, thorny; it is advisable to go under the supervision of a rehabilitation doctor.

In degenerative joint diseases, patients are entitled to disability benefits. For its registration, it is necessary to collect the necessary research results, confirming the inability to move independently.

Rehabilitation after an endoprosthesis can also be a reason to gain a similar status if, as a result of surgery, you are unable to do your usual job. Such social assistance is provided within 12 months.

Can you damage a knee replacement with running?

After the implantation of a knee endoprosthesis, patients should be encouraged to remain physically active, but with certain restrictions and guidelines.

Increased bone strength improves the fixation of the endoprosthesis to the bone and reduces the frequency of its loosening. To properly assess which physical activities patients may and may not do after knee implantation, each patient should be individually assessed and the following factors considered: prosthesis wear, joint load, prosthesis type, patient age, other diseases, preoperative activity level.

Wear of the endoprosthesis is inevitable and depends on the level of activity and the load that the patient imposes on his body weight and type of activity. However, with new materials for a prosthetic knee replacement the level of wearing is minimum so running isn’t something what not to do after knee replacement surgery.

Youtube knee replacement exercises

Post-operative exercises weeks 1-2 for total knee replacement

Post-operative exercises weeks 2-4 for total knee replacement

Post-operative exercises weeks 4-6 for total knee replacement

Also read: What is functional movement training?


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