New Knee---What Now?

[MartyD]

It's been 2 weeks since I got a new knee, a total replacement. I'm supposed to start physical therapy this week. I'm not really looking forward to this because of PT's myopic viewpoint on how to rehab. I had a PT come to the house to basically make sure I could walk around the house without falling down. It was not a good first impression. I've been doing SS for about 8-9 years now. Between that and reading about PT's shortcomings on this website I'm looking for a rehab program that is more productive. I have weights, power rack, shoes, belt and a rowing machine. That last 3 days I've been rowing 2x for about 10 minutes each time on a very low resistance setting. More to just get moving again and mental health. I know a lot of it is just listening to how your body reacts but it would be really nice to have a template to start from. I'm really motivated because I have already got my ski pass for the upcoming winter. I even have my skis in a corner of the living room for a constant reminder and motivator. Any and all suggestions are greatly appreciated. SS has been a fountain of youth for this 66 years young geezer.

[Dave Klopp]

Work on getting full range of motion before doing any squats with a loaded bar. Once the ROM has been established go through LP being conservative with weight increases. Of course, focus on good form.

[I_iz_a_fatass]

I have no advice but a question for other people replying: Do you think it'd help to lay out with the PT what your goals are before they start dispensing the usual stupid, e.g. "I want ot get full range of motion as fast as possible so I can get back to weight training"?

[bbuszard]

I don't have any advice, but I will be watching the replies closely. I've had my right knee scoped twice and expect that something similar will eventually be facing me in the future. Best wishes for a swift and successful rehab.

[Cheesepuff]

I'm 62. I was referred for knee replacement, a couple times... I declined. So my specifics will be different. But the principles are the same. Figure out what your range of motion is. Work the range you have without pain. Load progressively, just like the program, but you may need to be creative. Be patient, but stubborn. Consider the techniques in Sully's book, they are better than what I did, and no doubt would have worked much better.

I spoke with many people who had the surgery, some to considerable depth. One had a PT that gave them a machine that flexed their knee for considerable duration for the days she had it. However, in this case, she thought had it too short a time. Obviously, with your background / muscle mass you will respond different / better. If what they have you do works, then figure out a way to do it with progressive loading, long after their programmed allotment. Be gentle with yourself.

Do everything walking related with as good a form as you can. Use canes, trekking poles or walkers, whatever achieves the best form / least pain.

Only lift with neprene knee sleeves and sweat pants. (Sully told me this) Warm knees are happy knees. In retrospect, I should have walked with knee sleeves too.

SQUATS
Ask your doctor about any range of motion issue, and of course when you're free to "normal activity".
Maintain some caution even then... they tend to "turn you loose" without fully rehabbing you.
The goal is to get back to being able to doing pain free squats.
Box squats are a good option, unloaded at first. (progressive height adjustment with plates or something) (see Barbell Prescription)
I've also done some squat motions with my hands on the racked bar (normal bar because I'm de-weighting myself like a pullup)
Get yourself a very light bar (aka broomstick), a 5' 1" doll rod weighs about 2#. you can put some small plates on it. Up to your next lightest bar. I also have a 22# bar. Which pisses me off because I have a Rogue Chan bar and a Rogue B&R bar (aka expensive bars). Micro load. (8x half pound plates are handy)

Error towards avoiding setbacks.

DEADLIFTS
Deads may be easier, and therefore more weight sooner. It is important to keep this lift reliable for the growth factors / recovery etc.

ARMS
Benches and presses should progress faster than squats.

Page 96 to 102 of the Barbell Prescription has a section called "Modifying the Squat to Your Circumstances". I wish this was around when I couldn't squat air. I used a trap bar, now I'd do box squats.

SCAN THE FORUM LIKE ITS YOUR JOB
"Knee replacement rehab"
http://startingstrength.com/resource...p/t-65091.html
http://startingstrength.com/resource...p/t-71527.html

Good luck.

[Kent Berry]

....I had a PT come to the house to basically make sure I could walk around the house without falling down. It was not a good first impression....

Agreed 100%. I only did the home PT sessions post op. The lady tested me to see how long I could balance on one leg and a bunch of other Tai Chi type crap. I had the distinct impression that she was just trying to fill up her billable time. I got my ROM up to 120 degrees during the home sessions and gave them the heave-ho. I didn't do any out-patient rehab. There really wasn't much they could do for me.

I'll just repeat the post I made here. Just get your ROM up and start slowly. No worries.

[MartyD]

Now I know why PT'S have a dismal rep. I got my range of motion up to 120 degrees. I had tears in my eyes when I did my first set of squats. I knew I was no longer "broken". I've done 5 workouts so far. It feels so good!

[SteveL]

Now I know why PT'S have a dismal rep. I got my range of motion up to 120 degrees. I had tears in my eyes when I did my first set of squats. I knew I was no longer "broken". I've done 5 workouts so far. It feels so good!

Awesome!

[Cheesepuff]

Now I know why PT'S have a dismal rep. I got my range of motion up to 120 degrees. I had tears in my eyes when I did my first set of squats. I knew I was no longer "broken". I've done 5 workouts so far. It feels so good!

Great news. Well done.

[Argosy]

Had a full replacement apr '16. Most important part of PT was getting the knee to bend to the max the prosthetic allows. Mine bends to 125 deg. Lots of work and painful. As an aside if you're taking any opiate for pain immediately begin weaning yourself off them and go to a topical nsaid.
30 days after surgery I started sqts again. Body wt, 2 wks later up to the bar then slowly added weight. At around 160 began feeling a little pain by 200 had to quit, this was oct of 16. Began again a few months later but went to 1X20 up to 125 and this is where I've stayed. Sometimes I'll do 25 or 30 but any additional wt seems to cause pain.
At about 240# dd lft my knee again begins aching so I cut back the wt and add reps.
Strangely enough my knee doesn't bother me doing upper body work��.
With your experience you shouldn't have any problems. The only surprise I had was the amount of pain.
I also walk the golf course a couple times a week and ride a bicycle. I'm 73.
Also my physical terrorist was bound and determined to get me to 125 deg and the hell with my tears of pain.