Richard Haynes, Owner of Total Joint Fitness: Keys to Successfully Recovering from Total Knee Replacement Surgery

Richard Haynes: When I go into their homes, I see them right after they leave the hospital. When they come home, sometimes they’re taken back by the amount of pain they experience. I’ll get a lot of times where they’ll say, “Well, Richard, my knee didn’t hurt this bad when I was in the hospital.” Of course, they were medicated properly in the hospital. They were getting IV medications and a stronger medication.

When they get home, they’re usually given an oral type of medication that’s not quite as strong. I find a lot of patients aren’t compliant with taking the medication as needed. One of the problems they have, when they get home, is not being compliant with pain medications because they’re afraid of getting addicted or they knew somebody that knew somebody that got addicted to it. A lot of them tend to try to get off that pain medication quickly. Then they end up suffering a lot of chronic pain and making the rehabilitation and their nights, by the way, a lot harder than it should be.

Another problem I see with a lot of patients –and no matter how many times you talk to them, you know patients hear this information, but it seems to go in one ear and out the other, and they don’t realize it until they experience it themselves– is that the patient does not become patient enough, if that makes any sense. A lot of times, the patient will realize or hear stories about how a knee replacement went with somebody down the street, or they get a misconception about another knee surgery from some information that may not be quite right.

What they’re expecting is a linear type of healing process taking place with a knee replacement, and that is not quite it. In other words, they think each day from the day they leave the hospital until they get home, every day’s going to be a better day. There’s a lot of ups and downs in those first two to four weeks after total knee replacement surgery where you’re going to have some highs, and you’re going to have some lows.

Those are just two of the biggest problems I see right away which are noncompliance with medication, and we’re not pushing medication, believe me. We’re not pushing pain pills because a lot of people have an adverse effect to that, but they’ve got to be comfortable. A lot of them don’t realize just how invasive some of this surgery was, even though going back to your earlier comments, the technology has improved, especially with robotic surgery and this minimally invasive surgery. Still, their body has been invaded with a foreign object. They need to take the pain medication as prescribed and make their days a little more comfortable, and then sit back and be patient.

We’ve read it and seen it many times, in this microwave society, we want instant results, and that’s not the way it’s going to work with a knee replacement. They need to be patient and let their body do its job.

Phil Faris: You described the first two to four weeks as having a lot of ups and downs. How long does the process normally take before someone is fully recovered with a total knee replacement?

Richard Haynes: If you talk to your doctor or orthopedic surgeon about it, and they may have sped up the time frame a little bit due to the newer technology, but they’re going to tell you it’s going to take eight months to a year for total healing of a knee replacement. That doesn’t mean you won’t be driving, golfing, gardening, doing whatever you like to do. When patients come home from surgery, I let them know to usually give it six weeks from the day that the knife hits your knee, or that surgeon goes in and does that surgery before you start stabilizing.

In other words, every day begins to be about the same. You don’t have these highs and lows, or one day the knee is giving you trouble, and the next day it’s not. It could be five to six weeks and, again, it’s always patient-driven. Everybody reacts differently to this, but six weeks, I have found over my years of working with patients in the home, is a fantastic time for that knee to begin to level out, and each one of your days is now consistent. By then, you’re off the pain medication, as well, unless you need it to help sleep at night. Other than that, you’re generally off pain meds by then.

Phil Faris: Once you’ve gotten through the pain part, what’s the next step that a patient must go through in the rehab?

Richard Haynes: The big part of having a knee replacement is getting the flexion, or the bending of the knee, and the extension or the straightening of it. That’s really what your rehab is all about, in the beginning, the bending and straightening of the leg itself. Your strength levels come back quickly. A lot of people today are even given exercises now to do before surgery to prep their leg for the rehabilitation because muscle has memory and, once it understands those exercises, it comes back quicker.

As far as getting the pain under control, the big process as far as rehabilitation will be, bending the knee, getting that knee to bend properly and to straighten properly; we call that flexion and extension in physical therapy. Those are the two big aspects of knee replacement rehab that you really must focus on. We, as therapists, or you’ll see some personal trainers, as well, down the road focus on that, as well, and maintaining the swelling, keeping that swelling at bay because the swelling will dictate how much bend you get in that knee.

Phil Faris

Phil Faris is a Best-Selling Author, business consultant, radio host for Never Too Late for Fitness Radio, and contributing writer for Business Innovators Magazine covering Influencers, Innovators, and Trendsetters in Business, Health, Fitness, and Leadership.