Latest / The Total Knee Success Podcast: Your Essential Resource for Navigating Total Knee Replacement / Episode 123: Fear of Movement After Knee Replacement (Can Rehabilitation Help You Move With More Confidence?)

Transcript

Episode 123: Fear of Movement After Knee Replacement (Can Rehabilitation Help You Move With More Confidence?) · The Total Knee Success Podcast: Your Essential Resource for Navigating Total Knee Replacement

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  In three studies, people who reported avoiding
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  movement also reported more difficulty with everyday
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  tasks a year after surgery. Those findings tell
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  us what tended to happen together, which came
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  first, the fear or difficulty moving. Are you
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  ready to get back to what you love after knee
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  replacement? The Total Knee Success podcast is
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  your trusted guide with practical tips, evidence
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  -based strategies, and no fluff. It's not personal
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  medical advice, just solid education to help
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  you manage pain, regain mobility, and get back
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  to living the life you love. Let's dive in. Welcome
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  back to the Total Knee Success podcast. I'm Michelle.
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  You walk out to the car, open the passenger door,
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  and pause. You can get to the car just fine.
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  It's the turn to sit down and the moment you
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  have to bring your leg inside that make you hesitate.
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  Before surgery, you probably did all that while
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  carrying on a conversation. Now you're standing
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  there trying to decide how much your knee will
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  bend and what it'll feel like when it does. This
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  is the second episode in our series on new knee
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  replacement research. Last time we talked about
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  preparing your muscles before surgery. Today
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  we're looking at what happens when you're hesitant
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  to move after surgery, even during something
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  as familiar as getting into a car. By the end
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  of this episode, you'll know what researchers
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  have found about fear of movement and what it
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  can look like to build confidence with a movement
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  you've been hesitant to try. We'll come back
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  to that passenger seat and talk about how you
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  could work on it in physical therapy. Think about
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  the movement before you sit down. Your knee may
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  feel stiff when you bend it, or you may remember
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  a sharp pain the last time you got into the car.
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  Even before you turn, you're already expecting
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  that it might hurt again. If you're worried a
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  movement will hurt or injure your knee, you might
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  start avoiding it. Researchers call that fear
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  of movement or kinesiophobia. To measure that
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  fear, researchers used a questionnaire called
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  the Tampa Scale of Kinesiophobia. It asked people
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  how much they agreed with statements about movement
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  and injury. The higher the questionnaire score,
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  the more worried the person was about moving.
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  In 2020, a team led by Oliver Brown reviewed
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  13 papers on fear of movement after total knee
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  replacement. In some of those studies, researchers
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  compared people's fear scores and how far they
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  could bend or straighten their knee on their
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  own. At two weeks, four weeks, and six weeks
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  after surgery, people with higher fear scores
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  tended to have less knee motion. In three studies,
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  people who reported avoiding movement also reported
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  more difficulty with everyday tasks a year after
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  surgery. Those findings tell us what tended to
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  happen together, which came first, the fear or
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  difficulty moving. The studies leave that question
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  open. Three studies in that review tested ways
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  to help after surgery. One used a home program
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  that included practicing everyday movements.
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  Another used cognitive behavioral therapy, a
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  type of counseling that helps people work through
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  how their expectations affect what they do. A
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  third used a video -based psychological program.
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  In each study, the people who received that extra
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  help reported less fear than those in the comparison
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  group. That gave researchers a reason to keep
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  looking at what would help. In October 2026,
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  Wen and colleagues reviewed 11 trials with just
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  under 1 ,100 people who'd had a knee replacement.
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  In each trial, people were assigned by chance
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  to different treatment groups. One group received
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  the usual rehab for that study. In some trials,
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  that meant a home program where participants
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  worked on bending and straightening their knee,
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  strengthening their leg. In others, it meant
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  regular physical therapy in a hospital setting.
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  The reviewers wanted to see how people did with
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  a different or added program compared with that
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  usual care. Here's what that looked like in two
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  of the trials. In one, both groups had the standard
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  home program. One group also practiced movements
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  against the pull of an elastic band. In another
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  trial, both groups had their regular physical
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  therapy in the hospital. One group also learned
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  a relaxation technique that involved tightening
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  and then letting go of different muscle groups.
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  The people who learned that technique reported
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  less fear when they left the hospital. Those
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  are two different ways the researchers changed
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  what people received. Across the 11 trials, the
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  review looked for a pattern in how people rated
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  their fear. Overall, the people in the groups
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  with the added or different programs reported
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  less fear of movement. The difference between
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  groups looked larger in studies that measured
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  fear within the first four weeks after surgery.
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  In studies that measured it at 12 weeks, the
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  difference was smaller. The early results varied
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  quite a bit across studies, so there's more uncertainty
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  about how much of a difference a particular program
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  might make. If you've been holding back from
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  a movement you'd like to get back to, there's
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  a reason to be encouraged. Some people in these
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  studies felt less worried about moving within
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  the first few weeks. Four of the trials also
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  looked at how well people were using their knee
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  at 12 weeks. The groups with the added programs
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  had better scores on measures of knee function,
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  which included things like getting around and
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  using stairs. Think about what goes into walking
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  up a step. You need enough bend to get your foot
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  onto it and enough strength to bring yourself
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  up. You also need to feel ready to put your weight
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  on that leg. Those are things a physical therapist
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  can work on with you and the place to start depends
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  on which part you're having trouble with. So
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  let's get back to the passenger seat. If you're
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  comfortable standing at the open car door and
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  the hesitation starts when you bring your leg
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  inside, that's a specific part of the movement
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  you can work on. Physical therapy can be a good
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  place to feel safe trying a movement you've been
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  hesitant to do on your own. You and your therapist
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  can start with a part of it that feels doable
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  and build from there. Your therapist might have
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  you sit on a firm chair in the clinic and practice
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  lifting your foot a little, the way you would
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  bring it in through the car door. If it's the
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  bend you're worried about, you could start by
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  seeing how far you can bend your knee comfortably
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  while you're seated, with plenty of room for
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  your foot. And I'm giving you a general example.
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  Your therapist can help you choose what to practice
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  based on how your knee is doing and the instructions
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  you received after surgery. That practice can
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  carry over the next time you get into the car.
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  If bending your knee feels easier, you may find
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  you have more room to bring your foot through
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  the door. Or you may find that the way you practice
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  lifting your foot in the clinic works better
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  in the car too. You might still hesitate for
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  a second and then find the movement goes more
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  easily than you expected. If there's a movement
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  you've been putting off, consider bringing that
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  one task to your next physical therapy visit.
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  It can be as simple as, I'm okay once I'm sitting
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  on the edge of the seat. It's getting my leg
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  inside that I'm worried about. Can we practice
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  that? You can start while you're still unsure.
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  That's part of what the practice is for. Feeling
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  a little more comfortable with one part of getting
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  into the car can give you a place to start the
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  next time you open the door. This type of process
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  can work for all different movements. Getting
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  in and out of the car is just one example. What
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  about stairs? Sitting in a low chair? Maneuvering
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  in the bathroom? All of those things can be things
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  that you can work on in physical therapy. If
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  walking is one of the things you're struggling
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  with, my book Walking Like Yourself Again After
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  New Replacement explains why walking can feel
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  stiff or uneven and how strength, motion, balance,
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  and habits affect the way you walk. You can find
• 7:59
  information about it in the show notes and at
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  TotalKneeSuccess .com. For free general information,
• 8:06
  you can also sign up for the Total Knee Success
• 8:08
  Insider Newsletter. The link is in the show notes.
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  Next time, we'll look at a relaxation technique
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  that involves the tightening and releasing of
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  different muscles, similar to what we described
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  earlier. Can it help with sleep and pain after
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  knee replacement? We'll look at what the researchers
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  found. If you're finding this podcast helpful,
• 8:28
  please subscribe and leave a review. I'd really
• 8:30
  appreciate it. Your review helps the podcast
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  reach more people who would like this information
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  too. Thanks for joining me. I'm Michelle, and
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  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 TotalMeSuccess .com and be sure
• 8:51
  to subscribe and share because every step forward
• 8:54
  takes you closer to living the life you love.