Latest / The Total Knee Success Podcast: Your Essential Resource for Navigating Total Knee Replacement / Episode 108: Carrying After Knee Replacement (Five Questions to Ask)

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Episode 108: Carrying After Knee Replacement (Five Questions to Ask) · The Total Knee Success Podcast: Your Essential Resource for Navigating Total Knee Replacement

• 0:00
  Tripping and falling a week before her daughter's
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  shower was not something she wanted to happen.
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  In fact, falling was not on her list at any time,
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  ever. It's not personal medical advice, just
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  solid education to help you manage pain, regain
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  mobility, and get back to living the life you
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  love. Let's dive in. Welcome back to the Total
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  Knee Success podcast. I'm Michelle. Carmen was
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  about six months past her knee replacement and
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  was coming home after a weekend away. She parked
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  in the driveway beside the door and saw a large
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  delivery box sitting on the landing outside.
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  Excellent, she thought, her daughter's shower
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  gifts had arrived. But how was she going to get
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  everything inside by herself? Her overnight bag,
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  purse, water bottle, and jacket were still in
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  the car. She put her purse over her shoulder,
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  picked up the overnight bag, and grabbed the
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  water bottle and jacket with the other hand.
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  Then she tried to step around the box and reach
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  for the door. The overnight bag pulled her to
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  one side. The loose purse over her shoulder kept
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  slipping, and she had no hand free for the railing
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  or the doorknob. When she felt herself wobble,
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  she put everything down and started over. She
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  wasn't going to risk falling. Carmen's not a
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  real person. Her story reflects situations people
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  often run into after knee replacement. This is
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  the final episode in our Falls, Balanced, and
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  Everyday Independence series. Episode 105 covered
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  what to do after a fall. Episode 106 explained
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  why balance may still need more attention even
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  as your operated leg gets stronger. Episode 107
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  used the CDC's steady framework to help you look
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  at fall risk and safety around your home. Today,
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  we're looking at what changes when you carry
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  a box, a bag, laundry basket, or something else
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  around your home. By the end of this episode,
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  you'll have five questions you can ask before
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  you pick something up. Those questions can help
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  you decide whether to carry it as is, divide
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  it into smaller amounts, use a cart, or ask someone
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  for help. These five questions also apply if
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  you're at work or doing a project outdoors or
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  during an outing. Your surgeon may give you a
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  temporary lifting restriction stated as a specific
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  number of pounds or kilograms, and you should
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  follow it. That number cannot describe the shape
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  of the item, how well you can grip it, whether
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  it blocks your view, or where you have to carry
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  it. The five questions will fill in those parts.
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  The first question is what are you carrying?
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  Start with the item itself. How heavy is it?
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  Can you get a comfortable grip? Is it wide enough
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  to obstruct your view? If it's a box, will anything
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  inside shift while you walk? A compact bag that
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  stays close to your side may be easier to carry
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  than a lighter box that's wide and hard to hold.
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  Studies of healthy adults have found that carrying
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  something in front of your body can change walking
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  speed, step length, and posture. Carrying something
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  on one side can also change the way a person
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  leans and how evenly they step. Those studies
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  help explain why carrying can change the way
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  you walk. They do not tell us exactly how much
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  someone should carry after knee replacement.
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  Carmen already knew how the overnight bag felt
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  because she packed it and carried it all weekend.
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  The delivery box was the unknown. It was wide,
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  there was no comfortable place to grip it, and
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  she didn't know whether the contents would slide
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  when she lifted it. Two items can weigh the same
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  thing and feel completely different in your hands.
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  Shape, grip, size, and movement inside the container
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  can make one much easier to control than the
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  other. The second question is, what will your
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  hands need to do? Before you pick something up,
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  think about what you'll need to touch along the
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  way. Will you need a railing, your cane, or a
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  walker, a door knob, or your keys? Will the item
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  require both hands? Reaching the door with both
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  hands full leaves you trying to balance the item
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  while you open it. Carmen put on her jacket,
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  slid the water bottle into the side pocket of
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  the overnight bag, and took her person keys inside
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  first. When she came back for the overnight bag,
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  she carried it in one hand and kept the other
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  hand free for the railing and the door. Two bags
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  with similar weight may feel balanced, but they
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  still occupy both hands. One bag may be the better
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  choice when you need your other hand for support.
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  If you use a walker, both hands need to stay
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  on the handles. I've seen people place a heavy
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  shopping bag on one side of the walker, hooking
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  it on the handle. Then the walker pulls toward
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  that side, doesn't move as well, and it can actually
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  tip your walker. A walker bag, basket, or the
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  storage area built into the walker is usually
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  a better place for a few light items. A small
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  stable bag may also sit on the seat of a four
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  -wheeled walker if it stays securely in place
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  and doesn't slide off near your feet. Check the
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  instructions for your walker and ask your physical
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  or occupational therapist to help you test the
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  setup if you're unsure. The third question is,
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  can you see where you're going? You need to see
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  the floor, the next step, and anything you may
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  need to walk around. When a box or basket obstructs
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  your view, you may miss a threshold, the edge
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  of a step, a cord, or something left on the floor.
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  You might also have a concern if you have a small
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  pet, a dog, or a cat that might be underfoot.
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  Carmen could not see the edge of the landing
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  or the threshold while holding the delivery box
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  in front of her. She left to where it was, opened
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  the door first, and then decided whether to move
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  the whole box or open it outside. A laundry basket
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  can obstruct your view of the first stair. A
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  grocery bag can swing into your leg. A tall stack
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  of towels can block your view of the floor. The
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  item may feel light and still make walking harder
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  because you cannot see where your feet are going.
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  The fourth question is, where are you taking
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  it? A short walk across a level room is very
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  different from carrying the same item through
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  a narrow doorway, around a tight turn, across
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  a wet walkway, or up a flight of stairs. Think
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  about the whole distance before you lift it.
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  Look at the surface, the turns, any steps or
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  thresholds, and where you can set the item down
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  safely when you arrive. One study measured knee
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  loading while healthy adults walked and climbed
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  stairs carrying about 30 pounds. The added weight
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  increased a measure of demand on the inside of
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  the knee, and climbing stairs created more demand
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  than level walking. The study did not include
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  people with knee replacements, and 30 pounds
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  is not a suggested test weight. The useful point
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  is that stairs can make the same amount of weight
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  much more demanding. Carmen's overnight bag only
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  had to travel from the car to the table inside
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  the door. She could see the walkway, keep one
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  hand free, and place the bag on the table without
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  bending to the floor. The delivery box had to
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  come off the landing, cross the threshold, and
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  fit through the doorway. She handled the box
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  separately. A cart can be a useful tool. It can
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  reduce how much you carry in your hands on a
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  level surface. But you still may need to turn
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  it, move it across the threshold, and you do
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  need to stop where you want it. And remember,
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  a household cart is made to move items. It's
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  really not designed to support your body weight
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  like a walker. The fifth question is, does carrying
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  it change the way you walk? Once you start walking,
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  pay attention to what happens. Do you lean to
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  one side? Do your steps become quick or choppy?
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  Does the item bump your leg? Do you rush because
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  your grip is slipping? Can you stop and turn
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  without the item pulling you off balance? Keeping
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  an item close to your body usually gives you
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  a little more control, provided you can still
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  see where you're going. A wider box or a box
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  held away from your body is harder to control.
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  Then handles that dig into your fingers or a
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  smooth basket that starts to slide out of your
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  grip can also change the way you walk. When you
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  begin carrying things again and want to get stronger
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  or more agile, start with something you can hold
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  comfortably for a short distance on a level surface.
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  Add one challenge at a time. You might carry
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  it a little farther, go through a doorway, or
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  add a small amount of weight. That makes it easier
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  to notice which part changes your walking. And
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  remember to follow any lifting restrictions from
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  your surgeon. This episode provides general education,
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  and your physical or occupational therapist can
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  help you work through a specific task that's
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  difficult at home. Stop and change the plan if
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  carrying causes increasing pain, a new limp,
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  repeated buckling, or swelling that continues
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  to build. A fall with an injury or a sudden inability
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  to bear weight needs prompt medical attention.
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  Carmen's second attempt looked very different
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  from her first. Her purse and keys were already
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  inside. She had carried the overnight bag by
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  itself with one hand free. Then she opened the
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  delivery box on the landing and carried the gifts
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  inside in smaller groups. She never had to lift
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  the wide box through the doorway. She just pulled
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  it in with one hand once it was empty. She still
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  brought everything inside. It took a few extra
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  minutes and she stayed steady while she did it.
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  Tripping and falling a week before her daughter's
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  shower was not something she wanted to happen.
• 9:37
  In fact, falling was not on her list at any time,
• 9:40
  ever. Before you carry something, ask yourself
• 9:44
  five questions. What am I carrying? What will
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  my hands need to do? Can I see where I'm going?
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  Where am I taking it? And does it change the
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  way I walk? Sometimes one trip is fine, other
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  times two smaller trips. A different container,
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  a cart on a level surface, or another person
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  carrying the awkward part makes more sense. The
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  goal is to get the item where it needs to go
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  without losing your balance along the way. If
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  carrying changes the way you walk, my book Walking
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  Like Yourself Again After Knee Replacement can
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  help you understand what you're noticing and
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  work toward a more natural walking pattern. You
• 10:20
  can also join the free Total Knee Success Insider
• 10:23
  Newsletter for new episodes, articles, and knee
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  replacement education. Both links are in the
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  episode description and at TotalKneeSuccess .com.
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  In episode 109, we'll talk about the top five
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  products you don't need after knee replacement.
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  We'll look at items that are often promoted as
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  essential, and when something's simpler, something
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  you already own or no product at all, may work
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  just as well. Thanks for joining me. I'm Michelle
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  and this has been the Total Knee Success podcast.
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  This podcast is for educational purposes only.
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  Discover more at TotalKneeSuccess .com and be
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  sure to subscribe and share because every step
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  forward takes you closer to living the life you
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  love.