Latest / The Total Knee Success Podcast: Your Essential Resource for Navigating Total Knee Replacement / Episode 113: Walking With a Walker After Knee Replacement (How to Use Support Without Losing Your Walking Pattern)

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Episode 113: Walking With a Walker After Knee Replacement (How to Use Support Without Losing Your Walking Pattern) · The Total Knee Success Podcast: Your Essential Resource for Navigating Total Knee Replacement

• 0:00
  So even reputable patient instructions don't
• 0:02
  agree on one specific length of time for using
• 0:05
  a walker after knee replacement. Someone you
• 0:08
  know may have stopped using a walker at 10 days,
• 0:11
  while your healthcare team may recommend that
• 0:13
  you use yours longer. Walker use varies from
• 0:17
  person to person. Are you ready to get back to
• 0:21
  what you love after knee replacement? The Total
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  Knee Success podcast is your trusted guide with
• 0:26
  practical tips, evidence -based strategies, and
• 0:29
  no fluff. It's not personal medical advice, just
• 0:33
  solid education to help you manage pain, regain
• 0:35
  mobility, and get back to living the life you
• 0:38
  love. Let's dive in. Welcome back to the Total
• 0:43
  Knee Success podcast. I'm Michelle. This is the
• 0:47
  first episode in a new four -part series about
• 0:50
  walking after knee replacement. We're starting
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  with the walker. In the next episode, we'll talk
• 0:55
  about the cane, then stairs and curbs, and we'll
• 0:58
  finish with hills, grass, gravel, and other uneven
• 1:01
  ground. If you've recently had a knee replacement,
• 1:05
  there's a pretty good chance you're using a walker
• 1:07
  in these early days after surgery. And that can
• 1:10
  make something as ordinary as walking across
• 1:12
  your kitchen suddenly feel surprisingly complicated.
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  How far should the walker go in front of you?
• 1:18
  Which leg moves first? Should you be putting
• 1:21
  weight through your hands? Is a walker with four
• 1:23
  wheels okay? What happens when you get to the
• 1:26
  curb outside your house? And perhaps the question
• 1:29
  I hear most often, How long am I supposed to
• 1:32
  use this thing? Those are good questions because
• 1:35
  a walker is not just a piece of equipment. How
• 1:38
  you use it affects how you move. By the end of
• 1:40
  this episode, you'll have a better idea of how
• 1:42
  to set up and use your walker, what to pay attention
• 1:45
  to while you're walking, and what to consider
• 1:48
  as you work toward needing less support. One
• 1:52
  quick reminder before we get into this. This
• 1:54
  episode is for education. Your surgeon and physical
• 1:57
  therapist may give you specific instructions
• 1:59
  about weight -bearing. the type of walker you
• 2:02
  should use, how long you should use it, and how
• 2:05
  you should handle stairs or other obstacles.
• 2:07
  Those individual instructions come first. Let's
• 2:10
  start with something that causes a lot of unnecessary
• 2:14
  worry. There is no single walker timeline that
• 2:17
  applies to everybody after knee replacement.
• 2:20
  You may hear someone say, my surgeon told me
• 2:22
  two weeks. Someone else may use a walker longer.
• 2:26
  A particular surgical program may have a standard
• 2:28
  guideline. while another surgeon or therapist
• 2:31
  may base the transition more on how each person
• 2:34
  is walking. For example, Mayo Clinic's current
• 2:37
  total knee replacement guide tells patients to
• 2:40
  use a walker for the first one to two weeks and
• 2:43
  to change to a cane when the healthcare team
• 2:45
  says it's safe. MedlinePlus gives broader guidance
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  and tells patients to use the walker or crutches
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  until the surgeon or physical therapist says
• 2:55
  it's okay to stop. So even reputable patient
• 2:58
  instructions don't agree on one specific length
• 3:01
  of time for using a walker after knee replacement.
• 3:05
  Someone you know may have stopped using a walker
• 3:07
  at 10 days, while your healthcare team may recommend
• 3:10
  that you use yours longer. Walker use varies
• 3:13
  from person to person, so follow the timeline
• 3:16
  and guidance your surgeon and physical therapist
• 3:18
  have given you. Those instructions may be based
• 3:21
  on time, how you're walking, or a combination
• 3:24
  of the two. Early after knee replacement, the
• 3:27
  muscles around the knee, especially the quadriceps,
• 3:30
  may not be activating or controlling your leg
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  as well as they usually do. Pain, swelling, and
• 3:35
  the effects of surgery can all contribute to
• 3:38
  that. A walker gives you additional support while
• 3:41
  that control improves. Now let's talk about what
• 3:44
  kind of walker you actually have, because all
• 3:47
  walkers are not the same. A standard walker has
• 3:50
  four legs and is lifted forward. A two -wheeled
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  or front -wheeled walker rolls forward on its
• 3:56
  front wheels. A four -wheeled walker, or sometimes
• 4:00
  called a rollator, moves more freely and usually
• 4:03
  has hand breaks. One device is not automatically
• 4:07
  right for every person. They behave differently
• 4:09
  and some knee replacement programs specifically
• 4:12
  tell their patients which walker to use. Mayo
• 4:15
  Clinic's current patient guide specifies a two
• 4:18
  -wheeled walker and says not to use a four -wheeled
• 4:21
  walker during that early period. So if you already
• 4:24
  own a Rolator because you used it before surgery,
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  don't automatically assume that it's the device
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  your surgical team wants you using immediately
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  afterward. Ask. The same applies if your friend
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  offers you a walker from their garage. Make sure
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  it's the type recommended for you, that it's
• 4:42
  in good condition, and that it's adjusted for
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  you. Now let's fix it. When you stand with the
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  walker, you should be able to stay reasonably
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  upright instead of folding yourself over the
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  handles. A common starting point is to stand
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  upright with your arms relaxed and have the hand
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  grips around the level of the crease of your
• 5:01
  wrist. When you hold the grips, your elbows should
• 5:04
  have a slight bend. And this is a starting guideline.
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  Your physical therapist may adjust it based on
• 5:09
  your height, posture, arm length, balance, and
• 5:13
  how you actually move with the device. And then
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  there's another problem I see all the time. The
• 5:18
  walker itself may be the right height, but the
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  person pushes it halfway across the room and
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  then tries to catch up with it. Keep yourself
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  within the walker's base of support and just
• 5:29
  behind it. You want the walker close enough that
• 5:32
  you can remain upright and control your steps
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  rather than reaching forward for it. You also
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  don't want to walk too far forward to the front
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  bars of the walker because you might then lose
• 5:43
  your balance backward. So get some instruction
• 5:46
  if you're having some questions with that. Now
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  we get to the actual walking pattern. If you
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  have a standard walker, you generally place the
• 5:53
  walker a short distance ahead and make sure all
• 5:56
  four legs are firmly on the floor before you
• 5:59
  step. If you have a front -wheeled walker, you
• 6:02
  roll it forward a short distance. Early on, many
• 6:06
  people are taught a pattern where the walker
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  moves first, then the operated leg advances,
• 6:10
  and then the other leg follows. That lets the
• 6:14
  walker and your arms provide support as your
• 6:17
  operated leg accepts weight. How much weight
• 6:20
  you're allowed to put through that leg is individual
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  to your medical instruction. Many people, after
• 6:27
  an uncomplicated primary knee replacement, are
• 6:30
  allowed to bear weight as tolerated. But a revision
• 6:33
  surgery, fracture, complication, or another procedure
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  can change the instructions. So follow the weight
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  -bearing status your own surgical team has given
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  you. At first, that sequence may feel very deliberate,
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  moving the walker, the operated leg, and then
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  the non -operated leg. As you gain control, your
• 6:53
  steps can become smoother and more continuous.
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  And this is where I want to make sure you're
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  paying attention to something besides distance.
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  How are you walking? Are you taking one tiny
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  step with the operated leg and then rushing the
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  other leg up to it or just past it? Are you barely
• 7:09
  putting weight on your operated side even though
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  you've been told that you may? Are you keeping
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  the operated leg rigid while you swing the whole
• 7:17
  leg around? Are you leaning heavily on both arms?
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  Are you staring at your feet the entire time?
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  Those patterns may be understandable early on.
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  Pain, swelling, quadriceps weakness, balance
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  changes and simply being cautious can all affect
• 7:33
  the way you walk. But generally the goal is not
• 7:36
  to practice an awkward pattern thousands of times
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  without noticing it. That produces some bad habits.
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  The walker gives you support while you rebuild
• 7:46
  a more efficient walking pattern. As your operated
• 7:50
  leg accepts more weight within your restrictions,
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  your quadriceps help control your knee and your
• 7:56
  legs move through more easily to the next step.
• 8:00
  You don't have to turn every trip to the bathroom
• 8:02
  into a gait lab, but you do want to notice whether
• 8:05
  the walker is helping you move with better control.
• 8:07
  and a more natural walking pattern. That awareness
• 8:11
  can help when you're figuring out with guidance
• 8:13
  from your surgeon or PT when it's safe to move
• 8:16
  from a walker to a cane. Distance is only part
• 8:20
  of the picture. A shorter walk with better control
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  may be more useful than going farther while repeatedly
• 8:25
  practicing a poor pattern. If you're trying to
• 8:28
  get your walking looking and feeling more like
• 8:30
  yourself again, it's easy to get the free download
• 8:34
  the top 10 walking tips after knee replacement.
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  I'll put a link in the show notes for you if
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  you'd like to check it out. Also, pay attention
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  to the basics with the walker, like how you turn
• 8:44
  and how you back up in line with your chair to
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  sit down. Those moments can make a big difference
• 8:50
  in feeling steady. When you turn with your walker,
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  use smaller steps. Avoid planting the foot of
• 8:57
  your operated leg and twisting your body over
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  it. If you need to back up to a chair, keep the
• 9:02
  walker with you as you take some small steps
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  backward. Back up until you can feel the chair
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  or you see the chair and know it's there behind
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  your legs. Then use the armrests or the edge
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  of the chair to reach back and help lower yourself.
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  A walker is not a fixed grab bar and can tip
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  if you pull on it while you're sitting down.
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  The same principle applies when you stand. I'm
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  sure your therapist has instructed you on getting
• 9:29
  yourself positioned, pushing from the chair or
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  armrests, and then establishing your balance
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  and then taking hold of the walker. As your walking
• 9:38
  improves, the way you use the walker may change
• 9:40
  too. Early on, you may need more support from
• 9:43
  your arms and your steps may be slower, smaller,
• 9:46
  and more deliberate. As your operated leg gets
• 9:49
  better at accepting your weight and your quads
• 9:52
  get stronger and give you more control, you may
• 9:55
  notice that you're not leaning on your hands
• 9:57
  as much. Your steps may start to become more
• 9:59
  even and moving the walker forward may begin
• 10:02
  to feel less like a separate step in the process
• 10:05
  of walking. That progression doesn't have to
• 10:08
  happen on a particular day. Pay attention to
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  what your walking looks and feels like. Are you
• 10:13
  standing more upright? Are you taking more even
• 10:16
  steps? Are you putting weight through your operated
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  leg as instructed? And are you relying less on
• 10:21
  your arms while still feeling pretty steady?
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  The goal isn't to rush yourself away from the
• 10:28
  walker. It's to let your walker provide the amount
• 10:30
  of support you need while you work toward a smoother,
• 10:33
  more natural walking pattern. For some people
• 10:36
  that eventually means moving to a cane or walking
• 10:39
  without an assistive device. For others, continued
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  walker use may remain the safest and most appropriate
• 10:45
  choice. As you start using a walker for more
• 10:49
  than short walks around the house, everyday situations
• 10:52
  bring a few other challenges. Outside the house
• 10:54
  you may face a threshold, curbs, stairs, grass,
• 10:58
  or another uneven surface. What you need will
• 11:01
  depend on the walker you're using, the environment,
• 11:03
  and your own strength and balance. And we're
• 11:06
  going to talk specifically about stairs and curbs
• 11:08
  in episode 115, so I'm not going to get ahead
• 11:11
  of myself here. Carrying things is another issue
• 11:14
  because both hands need to be available for the
• 11:16
  walker. A walker bag, basket, or tray or another
• 11:20
  setup can help with small items. So you've gotten
• 11:23
  better at walking with a walker. You feel like
• 11:26
  it's easy. So when are you ready to stop using
• 11:29
  it? Readiness is more than a date on the calendar.
• 11:33
  If your surgeon has said, use the walker for
• 11:35
  two weeks, follow that instruction and ask what
• 11:39
  they want you to do at the end of those two weeks.
• 11:41
  If your therapist is progressing you based on
• 11:43
  function, ask what they're looking for. The decision
• 11:47
  may include your balance, your ability to accept
• 11:49
  weight on your operated leg, your quadriceps
• 11:52
  control, how heavily you're relying on your arms,
• 11:55
  whether you're limping, and what happens to your
• 11:58
  walking pattern when the walker is taken away.
• 12:00
  If you walk well with the walker and then immediately
• 12:03
  develop a pronounced limp without it, getting
• 12:06
  rid of the walker has not necessarily improved
• 12:09
  your walking. Tossing out the device is not the
• 12:13
  finish line. The larger goal is to walk safely
• 12:16
  and progressively return toward a more natural,
• 12:19
  efficient, and symmetrical pattern. Walking is
• 12:22
  not simply a question of whether you can get
• 12:24
  from one side of the room to the other, although
• 12:25
  that is definitely important. The pieces of the
• 12:29
  walking pattern generally need to come back together.
• 12:33
  Your physical therapist can watch those pieces
• 12:35
  in real time and help determine whether the walker
• 12:38
  is still helping, whether you're ready for less
• 12:40
  support, or whether something else needs more
• 12:42
  attention first. And there are times when a change
• 12:45
  in walking deserves medical attention rather
• 12:48
  than another gait tip. Contact your healthcare
• 12:51
  team if walking suddenly becomes more difficult.
• 12:53
  You develop new or rapidly increasing pain or
• 12:56
  swelling. Your operated knee begins giving way
• 12:59
  unexpectedly if you have a fall or if you have
• 13:02
  another new symptom that concerns you. Seek urgent
• 13:05
  or emergency care for symptoms such as chest
• 13:07
  pain, shortness of breath, or other symptoms
• 13:10
  your health care team has told you require immediate
• 13:13
  evaluation. For many people after knee replacement,
• 13:17
  a walker provides short -term support while walking
• 13:20
  improves. Other people may need or choose to
• 13:23
  use a walker longer term. The important point
• 13:26
  is that you are using the level of support that's
• 13:29
  right for you. So here's what I would love for
• 13:32
  you to take from this episode. Use the walker
• 13:34
  your healthcare team recommends, make sure it
• 13:37
  fits, and follow your weight -bearing instructions.
• 13:39
  Let it give you the support you need while you
• 13:42
  work toward a smoother, more symmetrical walking
• 13:44
  pattern. Before you stop using it, make sure
• 13:47
  you're ready for less support. And that brings
• 13:50
  us directly to the next episode. In episode 114,
• 13:54
  we're talking about walking with a cane after
• 13:56
  knee replacement. Which hand should hold it?
• 13:59
  When do you move the cane? How do you know if
• 14:01
  you're ready for one? And what if you look fine
• 14:04
  with a cane, but start limping as soon as you
• 14:07
  put it down? If you'd like more knee replacement
• 14:10
  education and new episodes as they come out,
• 14:13
  join the free Totally Success insider newsletter.
• 14:16
  You'll find a link in the show notes. Thanks
• 14:18
  for joining me. I'm Michelle and this has been
• 14:20
  the Total Knee Success podcast. This podcast
• 14:27
  is for educational purposes only. Discover more
• 14:30
  at TotalKneeSuccess .com and be sure to subscribe
• 14:34
  and share because every step forward takes you
• 14:37
  closer to living the life you love.