Exercise! - Pre-knee replacement exercise

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12-28-2008, 10:16 PM
I am going to have to have my knee replaced at some time in the next few months. I am in pain almost all of the time. I should get it done right away, but I really want to lose some weight. I have lost 25 pounds so far (bringing me down to 275.) I have a recumbent bike, but it seems to bother my knee, which is bone-on-bone.

I have heard that what I should be working on right now is "upper body strength." Does anyone have any suggestions of what I can do to at least build myself up a little bit and be a little stronger before the surgery??

12-28-2008, 10:20 PM
Meg had knee replacements this year. Search out her posts. She did very well and recuperated very nicely too.

12-29-2008, 06:21 AM
Hi Beth! :wave:

Like Susan said, I had both my knees replaced in August and am very happy with the results. :) Both were bone-on-bone and one was bowed about an inch and a half due to severe arthritis. Now I'm completely pain-free when I walk and the only thing that bothers me a bit is walking down the stairs, but that gets better every day. :carrot:

You're very smart to be focusing on exercise now to get ready for the surgery because the better the shape you are going into the surgery, the easier the recovery will be for you. Even with both knees replaced, I was able to stand unassisted and play air hockey for 15 minutes a few days after surgery and never used a walker once I got home (I didn't need it in the hospital either, but they yelled at me if I didn't use it :lol:). I only needed a cane for the stairs for a few days. Everyone was pretty dazzled by my progress, so I felt like exercise really paid off.

My doctor and I had a goal of me being in the best possible shape going into surgery, so I did about 90 minutes of exercise every day in the months before leading up to the surgery date, divided between strengthening and cardio. I belong to a gym, so all the equipment I needed was there.

Cardio was important for calorie burning, but also helps with building a strong oxygen delivery system, which is important for healing. For cardio, I generally did about 30 minutes of high intensity intervals on an elliptical, which was the least painful for my knees, and about 30 minutes of recumbent bike. I found that moving the seat back on the recumbent bike helped my knees when they were painful.

I did both upper and lower body strengthening. My doctor encouraged me to focus on building up the muscles that surround the knee to create a kind of internal knee brace for post-surgery. Because one leg was weaker than the other, I did as many exercises one-legged as possible so not to let the stronger leg dominate. I did one-legged leg press, squats, leg extensions, and leg curls. I also did traditional squats, lunges and hack squats to the extent of my comfortable range of motion. My goal was to have Quads of Steel! :lol:

Upper body strength is also very important and your goal should be to be able to lift your body weight just with your arms. Sit in an chair with arms and pretend that you're in a wheel chair -- you want to be able to lift your butt completely off the chair by pushing up with your arms. You'll need this upper body strength to get in and out of a wheelchair in the hospital, get out of bed, use a toilet with grab bars, etc. You'll be surprised at how much you need to haul yourself around with your arms at first! Even now, I still need to be able to lift my body weight with my arms to get out of a bathtub or get off the floor because I can't kneel.

I did all the traditional upper body workouts, focusing on the main muscle groups of chest, back, shoulders, biceps, and triceps. Pullups and pushups were great because they're compound exercises that work a lot of muscles at the same time. Building up your bi's and tri's with arm exercises like curls and dips will help with pushing yourself out of a wheelchair. Ab and lower back work will help you strengthen your core and give you a strong foundation for learning to walk all over again.

You're also right that losing some additional weight will help with recovery. Since every extra pound that we carry puts four pounds of stress on our knees, you'll be thanking yourself post-surgery for every pound that you get rid of ahead of time. Even at a normal weight, it was challenging to go up and down stairs at first, so I can't imagine how tough it would have been with extra weight. And extra weight will wear out your new knees much faster, so the lower your weight is, the longer your new knees will last. That's important to me because I'm relatively young (54) for knee replacements (thank you decades of obesity :rolleyes:) and I'm not anxious to re-do the surgery any sooner than necessary.

Best of luck to you, Beth, and let me know if I can help in any way. :hug:

12-31-2008, 12:25 AM
Hi Meg
I'm still freaking out about the knee replacement. My weight is going to make things tough, and I need to get into a daily routine of exercising. I have started some things but I need a plan to go by or I falter. The recumbent bike ended up hurting my knee bad. I may have done too much, but ever since I increased my time on the bike, I've been miserable. I can't move the seat back any more than it is, because I have short legs and then can't reach the pedals. But it's not so close that when I pedal my knees are in my face.
Tell me about the one leg extension, leg curls. At my weight, any kind of squat is out of the question. I haven't been able to squat at all for probably 35 years.
I have started pushing myself up off the chair using just my arms. I don't have a good chair to do it in, but my office chair seems to work ok.
I've got a lot of work to do, and I'm kind of floundering right now. Thanks for responding......

12-31-2008, 04:14 PM
Beth, I have a book suggestion for you that I think would be extremely helpful: Total Knee Replacement and Rehabilitation: The Knee Owner's Manual (http://www.amazon.com/Total-Knee-Replacement-Rehabilitation-Owners/dp/0897934393/ref=pd_bbs_sr_1?ie=UTF8&s=books&qid=1230754035&sr=8-1) It has a lot of information about pre-surgery exercises and preparation, as well as what to expect post-surgery. Check it out -- I thought it was really worthwhile. :)

The leg extensions and leg curls that I do use gym machines, which I used both at my regular gym and at physical therapy. Do you have access to gym equipment or do you work out at home?

Have you tried other forms of cardio than the bike? I found the elliptical to be the least painful of all cardio, though I didn't try swimming and that's completely non-impact. Walking and running are out of the question because of the impact, of course, but maybe there's another form of cardio you could do that isn't so painful?

Thinking of you, Beth! :hug: